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House committee hears testimony on HB185 to extend continuous Medicaid coverage for children under 6
Summary
Representatives and dozens of health, tribal and provider witnesses testified in favor of House Bill 185, which would direct the state to apply for a Medicaid/CHIP waiver to provide continuous eligibility for young children (sponsor said an amendment would narrow a five‑year approach to three years); the committee requested a fiscal note and amendment before acting.
Representative Staffman introduced House Bill 185 to the House Human Services Committee, asking the Department of Public Health and Human Services to apply for a Medicaid/CHIP waiver allowing multi‑year continuous eligibility for children from birth until their sixth birthday. Staffman said the bill aims to reduce administrative churn that causes eligible children to lose coverage and cited national momentum: "Since then, there are now 9 states that have actually sought and received waivers," he said, and added the committee would soon see an amendment changing the proposal from five years to three years.
Multiple proponents — tribal leaders, pediatric providers, mental‑health advocates and statewide medical organizations — testified in support. Lance Forster (Montana American Indian Caucus) submitted a letter urging a "do pass" and tribal consultation; Patrick Yawake (representing the Blackfeet and Chippewa Cree tribes) emphasized that American Indian families off reservation rely on Medicaid/CHIP where Indian Health Service is not available. Lauren Wilson, advocacy chair of the Montana chapter of the American Academy of Pediatrics and a practicing pediatrician, told the committee: "Under unwinding, 36,000 Montana kids lost coverage," and said gaps in coverage can prevent children from obtaining preventive care or medicines they need.
Providers and advocacy groups described clinical and logistical harms from churn: Amy Anders of Shodair Children’s Hospital recounted a case in which a child admitted for suicidal behavior lacked active Healthy Montana Kids coverage when the family could not be located, delaying coverage confirmation; Jean Branscum (Montana Medical Association) and other organizations argued the policy would reduce administrative red tape for families and the agency.
Research and out‑of‑state experience were presented to the committee. Elizabeth Burak (Georgetown University Center for Children and Families) summarized longitudinal studies associating childhood Medicaid coverage with longer‑term improvements in education and earnings and highlighted Montana’s outsized declines in child enrollment since the federal unwinding. Stephanie Jaram (Oregon Health Authority) described Oregon’s section 1115 demonstration waiver that implemented continuous eligibility and explained that CMS requires demonstration projects to meet budget neutrality.
Informational witnesses from DPHHS (Mary Lemieux and Chappelle Smith) identified themselves to answer federal authority and program questions. Committee members asked technical questions about enrollment timelines (testimony noted some enrollment processing can take 45 days to four months), whether newborns can effectively be enrolled at or soon after birth (panelists said many newborns are enrolled with coverage that can be backdated), and how the waiver demonstrates budget neutrality.
Representative Staffman said prior fiscal work estimated net costs that could be covered by existing funds and reiterated that CMS has been encouraging states to apply for demonstrations. The committee requested a fiscal note and the sponsor’s amendment and did not vote on the bill. Staffman closed in support of a due pass; the chair closed the hearing and listed upcoming committee scheduling.
