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Committee advances reauthorization of Montana’s HELP Medicaid expansion after hours of testimony
Summary
The Senate Public Health Committee heard hours of testimony in favor of House Bill 245, the HELP Act reauthorization, with healthcare providers, tribal leaders, businesses and people with lived experience urging continuation. The committee advanced the bill in executive action by a 6–5 roll-call vote.
Representative Ed Buttrey told the Senate Public Health Committee that House Bill 245 would continue Montana’s Medicaid expansion program, known as the Health and Economic Partnership (HELP) Act, and preserve its workforce-development provisions.
The hearing drew broad support from hospitals, tribal health leaders, medical professionals, business groups and Montanans who said the program improved access to care, reduced uncompensated care for providers, and helped people get healthy and into work. Speakers included rural hospital leaders, tribal clinic CEOs, primary-care and behavioral-health providers, and individuals who credited the expansion with helping them obtain treatment and employment.
Buttrey described program outcomes from the past decade and emphasized the HELP Act’s built-in checks in state law. “This is a program that we designed over 10 years ago,” he said, noting the statute (cited in committee as MCA 53-6-1313) specifies what would happen if federal funding changed. He said the bill removes a separate statutory sunset because funding is already subject to legislative appropriation every session.
Medical witnesses stressed the program’s clinical benefits. Dr. Nicole Clark, a neurologist, described a patient who was able to finish school and obtain stable employment after receiving care under expansion. Joanna Wales, a public-health dentist, told the committee she saw monthly extractions fall from 75 to 35 a month after expansion and said the change reduced emergency dental visits.
Tribal leaders and tribal facility executives said Medicaid expansion has supported tribal health infrastructure and workforce growth. Joel Rosette, CEO of Rockaway Health Center, said Medicaid expansion helped his federally recognized tribal clinic add services, hire staff and develop apprenticeship pathways.
Fiscal questions were raised. The committee’s Medicaid financial manager, Jean Hermanson, said the governor’s budget includes a Medicaid expansion caseload request and that total funds are projected at about $1,000,000,000 per year with roughly 90% federal funding; the remaining state share is covered by a mix of general fund and dedicated fees and hospital assessments. Representative Buttrey provided a more detailed breakdown during closing, saying the annual funding picture would include roughly $900 million federal dollars plus state general fund and other dedicated sources.
After hours of testimony the committee moved to executive action. Senator Ricky moved the motion to advance HB 245; a roll-call vote followed. The committee vote was 6 yes, 5 no; recorded yea votes included Senators Kirk Carpenter, Yakovich (by proxy), Windiboy (by proxy), McGilvray, Newman and Smith; recorded nays included Senators Ricky, Glim, Fuller, Emmerich and Chair Lenz. The committee reported HB 245 out of Senate Public Health by that 6–5 margin.
Supporters urged passage to secure coverage for roughly 80,000 Montanans covered under expansion and to continue workforce and behavioral-health gains tied to the program. Opponents did not appear in the room during the hearing; committee discussion focused on fiscal mechanics and federal funding risk.
