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Senate rejects sponsor’s Medicaid‑expansion revision and indefinitely postpones alternate plan
Summary
Senate Bill 199, which would have revised Montana’s Medicaid expansion to include new community‑engagement requirements tied to federal waivers, failed a do‑pass recommendation and was later indefinitely postponed on the Senate floor. Supporters said the bill offered stability amid federal uncertainty; opponents said it risked ending expansion.
Senate Bill 199, a proposal to revise the state's Medicaid expansion to incorporate productivity/community engagement requirements contingent on federal waivers, failed to advance and was subsequently indefinitely postponed by the Senate.
Sponsor Senator Trevis described SB 199 as a moderate reauthorization patterned on earlier legislation and tied to federal waivers. "S B 1 99 is largely H B 6 58 from 02/2019," Trevis said on the floor, and explained the bill would reauthorize expansion if waivers allowing productivity requirements are approved by the federal government. He cited fiscal‑note assumptions and said the bill contains a contingent termination clause if waivers are not approved, giving the Legislature time to act.
The sponsor and supporters argued the bill would provide stability amid federal uncertainty and avoid an abrupt program shutdown that could prompt a costly special session. Trevis noted the November 2024 Medicaid expansion dashboard figure of 76,188 adults enrolled and warned that a rapid budget gap could affect thousands if the program ended abruptly.
Opponents said the statute changes would place expansion at risk by conditioning eligibility on waivers and by amending existing law instead of relying on the department's waiver authority. Senator Ellis said, "I believe that Senate Bill 1 99 is written so that in a backhanded way, it puts Montana's Medicaid expansion program at risk of ending." Other senators raised technical concerns outlined in the fiscal note and questioned administrative capacity to verify new requirements.
The committee motion recommending SB 199 do pass failed on a 23–27 vote. Later on the floor, a motion to indefinitely postpone the bill passed 28–22; the Senate announced that SB 199 has been indefinitely postponed.
Sponsor Trevis and supporters said the bill aimed to preserve access while making the program more accountable if waivers were granted; opponents urged a no vote, warning of coverage losses and implementation challenges. With the indefinite postponement, SB 199 will not proceed this session unless reconsidered.
