BUTTE, Mont. (AP) — For all the uncertainty over the fate of a health care overhaul in Washington, tens of thousands of Montana’s working poor are already in a double quandary: Even if Congress leaves Medicaid expansion mostly intact, the future of the state’s program remains uncertain.
Gov. Steve Bullock, who counts Medicaid expansion as a key achievement in his first term, has less than two years to justify its continuation. The program is scheduled to end in 2019 if state lawmakers decline to renew it during the legislative session that starts in January of that year.
Among the 31 states with expanded Medicaid, Montana’s program is unique. As part of a grand bargain to placate moderate Republicans in the conservative-leaning state, Bullock and his fellow Democrats agreed to charge most enrollees premiums and co-pays, establish a jobs program intended to help able-bodied Medicaid recipients find good-paying work, and seek reauthorization.
While Montana Democrats tout their state’s plummeting number of medically uninsured — from 20 percent of the population in 2013 to 7 percent last year — the number of Medicaid enrollees has far exceeded expectations, and some worry the program cannot be sustained.
Since it took effect in January of last year, nearly 80,000 of Montana’s 1 million residents have enrolled. The state had projected only 33,000 by this time.
A U.S. Senate bill to replace the Obama administration’s health care law would phase out, over several years, the federal money given to states to expand Medicaid. That might not be soon enough for conservative Montana lawmakers who are eager to revisit the expansion program when the session reconvenes in 2019.
“So, is this thing really working?” said state Sen. Bob Keenan, a Republican from the western Montana town of Bigfork. “I’m from the state of Missouri at this point in time — show me.”
Keenan and other critics are skeptical the state is doing enough to get people into jobs — and off Medicaid — in…