Poisoning Medicaid: Will Winning Mean Losing for the Poorest in Montana?
by William Skink
Economic pressure will keep widening the cracks and unraveling the strings of the safety net. The latest housing report shows prices climbing across nearly all housing sectors. In those lower brackets that’s really going to hurt. Why? Medicaid expansion.
What is being celebrated as a bipartisan bill making its way to the Governor’s desk could be a poison pill. When asked, Pogie had this reply:
While Democrats would certainly prefer the more sensible bill they promoted before Art Wittich killed it, SB 405 is better than nothing. The Montana Budget & Policy Center explains it better than I could:
Even with our concerns about the additional hurdles SB 405 places on low-income families, we will support this legislation and we hope policymakers will seriously consider this compromise. We’ve been saying it for over a year now – 70,000 can’t wait. We cannot ask our fellow Montanans to continue to wait for health care. This is too important. –
See more at: http://www.montanabudget.org/the-montana-help-act-a-new-pathway-to-insure-70000-montanans/#sthash.DJgwkVnZ.dpuf
We can agree on that last sentiment, the catchy slogan 70,000 can’t wait, because it’s true. Viscerally so.
But is this bill really better than doing nothing? Conner, at Flathead Memo, disagrees:
The unanimous Democratic support for the blast is proof that Gov. Bullock and the Democratic Party have embraced the perverse axiom that the needs of the few outweigh the needs of the many. In this case, the few are the up to 70,000 Montanans who might be helped by SB-405, and the many are the 165,600 poorer people already on Medicaid and CHIP whose incomes will be reduced two percent by SB-405.
That’s right. The people most down and out will have their piggy banks robbed to help people who are not as poor. It’s an economically regressive policy that’s the inverse of everything Democrats say they stand for. But the poorest of the poor are the least likely to vote, so picking their pockets won’t result in payback at the polls.
Is this true? I haven’t read the specific language of this bill, but the link Pogie provides goes into a little more detail:
However, as part of any compromise, there are concerns regarding provisions of this bill. The HELP Act will charge new enrollees a premium for access to health care coverage. While the premiums will be limited to 2% of enrollees’ modified adjusted gross income, this could be a real stretch for Montana’s low-income families. Additionally, the bill requires new enrollees to pay co-pays for certain services (up to another 3% of their modified adjusted gross income). This cost sharing can add up to 5% of their modified adjusted gross income – that is the maximum allowed under federal law. The good news is that co-pays will not be applied to preventative health care, health screenings, immunizations, or generic pharmaceuticals for chronic medical conditions.
Another concern is the penalties for failure to pay premiums. For Montanans who are below 100% of the poverty line ($11,770 for an individual or $20,090 for a family of three), there is no disenrollment for nonpayment, however the unpaid premiums become a collectable debt by the state. For Montanans who are above 100% of the poverty line, failure to pay within 90 days of notice will result in disenrollment. They can be reenrolled upon payment.
The Governor has yet to overtly signal if he’ll sign this “compromise”. If it gets that far, I hope he vetoes it.