Posted: Apr 3, 2013 9:01 AM by Marnee Banks - MTN News
Updated: Apr 3, 2013 12:22 PM
HELENA - A bill that expands Medicaid to 70,000 more low income Montanans has passed a critical vote in the Senate.
The entire Democratic caucus, and five members of the Republican party, voted in favor of Senate Bill 395 by a tally of 26-24.
The bill expands Medicaid so a family of four making $32,000 a year would qualify for government run health insurance. Right now, that cap sits at $8,000.
Senator Dave Wanzenried (D-Missoula) is sponsoring the bill at the request of the Montana Hospital Association.
"Unlike what you have been lead to believe a lot of those people that would qualify [for Medicaid], they are working," Wanzenried testified on the Senate floor. "They are certainly not standing outside the back door here with their hand out saying I want a hand out."
Wanzenried says his bill also reforms Medicaid making it more cost effective for doctors to serve Medicaid patients.
However, the senators who spoke in opposition to the bill say the reforms aren't significant enough to combat the cost of implementing expansion.
According to the bill's fiscal note, the cost to the state of Montana will be $44 million over the next four years.
Senator Fred Thomas (R-Stevensville) says his concern is that the federal government picks up 90% of the tab, leaving the state with the rest.
"And we think the federal government is only going to require us to match 10%?" Thomas asked. "It's foolish to believe the federal government, who is broke, that you can count on them to keep us at 10%."
For some lawmakers this issue isn't black and white, or even just a "yes" or "no" vote. There are really three sides to this issue of Medicaid expansion.
First, Democrats who believe more low income Montanans need to have access to health care.
Second, a majority of Republicans who believe the Medicaid system is broken and adding more people to the program is destined to be a disaster.
And finally, a handful of Republicans who stand in the middle wanting a compromise.
Senator Ed Buttrey (R-Great Falls) says he voted for the expansion bill because he wanted to keep at least one bill alive which could expand Medicaid and dramatically reform the system.
"We have to have a solution. We don't want to come out of this session with no solution as to what we do for medical coverage moving forward," Buttrey explained. "I don't support the full expansion of Medicaid. But there are a limited number of bills now that have titles that will support reforming Medicaid and implementing a new Montana made solution."
Before the Senate began debating the bill, Republican leadership urged their caucus to stick together and vote no on Medicaid expansion. However, it was evident not everyone in their caucus was on board.
Senator Jason Priest (R-Red Lodge) asked the members of the Republican caucus who were planning on voting for SB 395 to raise their hands.
"Are we able to stay together?" Priest asked his caucus.
Seven lawmakers raised their hands. But a few hours later only five voted for the bill.
Some of those Republicans point out that Priest runs a dark money group called the Montana Growth Network (MGN). MGN has been sending out negative Medicaid mailers targeting the districts of these lawmakers.
Senator Jim Peterson (R-Buffalo) says the vote on SB 395 was about gathering votes so MGN and other dark money groups can target their districts with dirty postcards next election cycle.
"I am going to vote for the bill even though I know the dark money repercussions are coming," Peterson said on the Senate floor.
The rift in the Republican Party has impacted the debate on several key bills this session: education funding, campaign finance reform and now Medicaid expansion.
The Republicans who call themselves "Reagan Republicans" say they have been intimidated to not buck the party on the issue of Medicaid.
Senator Llew Jones (R-Conrad) voted for the bill saying his constituents were asking him why he hadn't been involved in bringing Medicaid expansion up for a vote earlier.
"You know why I wasn't engaged in this issue? I could say it wasn't my area of expertise, but the real reason was intimidation," Jones said on the Senate floor.
However, leadership doesn't see it that way.
"The threat of somebody, your opponent in a primary or your opponent across the aisle running an ad, in my opinion, is a big so what," Priest said rebutting claims the comments were targeted at MGN. "If you believe in what you are doing come to the Senate floor and take the vote and own your choices."
But for the five Republicans who boldly pushed a green light, they believe there is still hope to get what they want, and that's a compromise somewhere between Democrats and where their own party stands.
Senate Bill 395 must pass one more vote in the Senate before heading to the House where all lawmakers agree it faces a major uphill battle.