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Senate advances bill to speed Medicaid home‑and‑community services for seniors, citing potential savings
Summary
Senate Bill 72 would establish presumptive Medicaid eligibility for older and physically disabled Montanans to begin home and community services quickly; the revised fiscal note estimates first‑year costs of about $843,000 and proponents argue that preventing nursing‑home placements will generate net savings. The committee voted to pass SB 72.
Senator Mike Yakawich introduced Senate Bill 72, which would create a presumptive-eligibility pathway allowing older and physically disabled Montanans to receive temporary Medicaid services quickly based on a preliminary assessment rather than waiting weeks for a full determination. Yakawich said the revised fiscal note (02/03/2025) estimates costs of roughly $843,000 in 2026 and $498,000 in 2027, with an IT startup request of about $71,000.
Proponents from the Montana Healthcare Association, Ability Montana, AARP, NAMI and provider groups testified that earlier access to home‑and‑community based services (HCBS) can avert hospitalizations and nursing‑home placements and therefore create net savings. Rose Hughes (Montana Healthcare Association) and Kristen Paige Nye (AARP) cited department charts and external studies showing per-person savings when higher-cost institutional care is avoided.
Witnesses and committee members discussed fiscal-note methodology and whether the bill would bring people ‘out of the woodwork.’ Proponents said national and state data do not support a large influx and noted that modest diversion of residents from nursing homes could offset the program’s cost. Yakawich noted a projected 304 people would receive presumptive eligibility in the first year, declining thereafter in his fiscal projection.
Jean Hermanson, Medicaid chief financial manager, and DHHS staff were present for technical questions. After discussion the committee moved to executive action and a roll-call vote produced a majority in favor; the committee reported that SB 72 passed out of Senate Finance and Claims.
