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House committee advances bill to let Medicaid explore direct primary care memberships
Summary
A House panel voted to move HB 953 to the floor after hearing proponents who said direct primary care (DPC) could expand access and lower costs for Montanans on Medicaid; the bill authorizes DPHHS to adopt rules to test DPC arrangements but does not require immediate payments on behalf of enrollees.
Representative Ed Butchery introduced House Bill 953 on behalf of House District 21, saying the measure would let the Department of Public Health and Human Services explore how direct primary care (DPC) membership models might work for Medicaid enrollees. "Direct primary care is an innovative healthcare model where patients pay for healthcare services directly in the form of a transparent low cost membership plan," Butchery said during the committee hearing.
Mary Lemieux, administrator of the Health Resources Division at DPHHS, told the committee the department supports HB 953 because it "expands access to primary care services within Montana Medicaid by allowing patients the option to direct primary care providers." Proponents including the Frontier Institute and the Montana Medical Association emphasized potential benefits such as increased access, more clinician time with patients, and cost savings. Kendall Cotton of the Frontier Institute cautioned that "the devil is gonna be in the details" and warned that adding billing or coding requirements could undermine the simplicity of many DPC practices.
Committee members pressed witnesses about practical implementation, asking how preventive services such as colonoscopies and mammograms would be coordinated and whether data show reduced emergency visits or imaging. Cotton and other proponents said many DPC practices refer to cash‑pay imaging and that employers purchasing memberships have reported overall savings and fewer ER visits, but they emphasized that the specifics would need to be resolved through rulemaking.
Representative Butchery offered a technical amendment to replace certain terminology and closed by reiterating that the bill does not require DPHHS to pay membership fees for enrollees; it only authorizes the department to develop rules and study how DPC agreements could integrate with Medicaid. In executive action the committee amended and then passed HB 953 as amended; the committee report notes the motion passed 18 to 3.
The bill now advances to the House floor for further consideration. The department will be responsible for any subsequent rulemaking if the Legislature approves the measure.
