Montana is slated to become the 29th state to pass Medicaid expansion after a
critical vote in the Montana House Thursday, in which a half-dozen poison pill amendments from tea party Republican Rep. Art Wittich were beaten back.
After Wittich's committee hearing—dominated by "witnesses" from the Kochs' Americans for Prosperity, a "do not pass recommendation" from the committee, and a complicated rules battle—moderate Republicans and Democrats prevailed and got the bill to the floor. It passed on its second reading, after all amendments but one were rejected, in a 54-46 vote. Thirteen Republicans joined Democrats to pass the bill, which has already been approved by the Senate. Final action by the Senate, which will have to reconsider the bill because it has been amended, is expected Saturday.
There are elements of the bill that could be problematic when the state takes it to the Obama administration to get a necessary waiver to use the expansion funds:
Like the governor's proposal, [Republican Sen. Ed Buttrey] Buttrey's bill would accept federal funds under the Affordable Care Act and extend benefits to non-disabled adults without children. […] But unlike the Democratic proposal, it would require recipients to pay premiums and participate in "workforce development" programs aimed at moving people off of Medicaid and into jobs that pay enough to qualify for federal subsidies to buy private coverage on HealthCare.gov. […]
[Not] all Montana Democrats are entirely comfortable with the only Medicaid expansion bill left before them, written as it is by a Republican.
"There are lots of things in the bill that, quite frankly, I struggled to accept," said House Minority Leader Chuck Hunter. "But I think [it's] in the spirit of having something that works for both sides of the aisle to accept."
For the 70,000 low-income, uninsured Montanans in the Medicaid gap—a huge number considering the state only has a little over a million people—it's at the very least hope that the are on the path to coverage. But it also means the Kochs don't have a hold on Montana Republicans, and that's also pretty huge.
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