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Committee hears broad support for restoring 12‑month continuous Medicaid eligibility for adults
Summary
Representative Howell told the House Health and Human Services Committee HB 386 would reduce churn and administrative costs by reinstating 12‑month continuous Medicaid eligibility for adults via a waiver. Tribes, hospitals, providers and advocates urged a yes vote; DPHHS informational witnesses answered technical questions about implementation and waivers.
Representative S.J. Howell opened House Bill 386 by describing continuous eligibility as a tool to reduce churn in Medicaid and improve continuity of care. Howell said the bill would direct the Department of Public Health and Human Services to implement 12‑month continuous eligibility for adults through an 1115 waiver and estimated program and administrative savings (she cited a projected reduction of 2.5 FTE processing applications in the fiscal note).
Support was extensive and bipartisan among provider groups and tribal leaders. Alyssa Snow (representing several tribal communities) told the committee HB 386 ‘‘prevents gaps in health insurance coverage, especially for those with fluctuating incomes’’ and urged a due pass. Tribal and rural health witnesses, including Joe Durglo (Confederated Salish and Kootenai Tribal health) and Stacy Summers (Fort Peck Tribal leader), emphasized the stability continuous eligibility would bring to reservation clinics and critical access hospitals.
Health systems and clinical advocates raised administrative and patient‑care reasons for support. Jean Branscum (Montana Medical Association) said Medicaid stability reduces uncompensated care and helps addiction‑medicine and chronic‑care patients stay in treatment. Hospital and behavioral‑health representatives, Benefis and the Behavioral Health Alliance of Montana among them, described how brief coverage lapses can interrupt prescriptions and treatment.
Policy experts and advocates cited evidence on churn and processing delays. Heather O’Loughlin (Montana Budget & Policy Center) noted Montana currently has a high share of MAGI applications exceeding 45 days to process and argued continuous eligibility would improve efficiency and outcomes.
DPHHS administrators Chappelle Smith and Mary Lemieux appeared as informational witnesses to explain waiver mechanics and program administration. Committee members questioned the sponsor and DPHHS about renewal frequency, reporting requirements for income changes, how a waiver would be structured, and what fiscal‑note assumptions underlie the projected savings. Representative Howell said the bill would create a waiver rather than amending non‑existent waivers and that the department could choose how to deploy any FTE savings.
Witnesses urged a due pass. The committee closed the HB 386 hearing; DPHHS provided informational testimony and the bill proceeded toward executive action and floor scheduling.
