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Montana bill would restore 12-month Medicaid eligibility and expand access help desks to prevent coverage gaps
Summary
Representative Mary Cafaro's HB230 would lift the Medicaid expansion sunset and add administrative reforms: 12-month continuous eligibility, improved DPHHS communications and hotline, reopening Offices of Public Assistance (OPA), and a client advisory board. Providers and advocates told the committee redetermination left people uninsured and delayed care.
Representative Mary Cafaro opened the committee hearing on House Bill 230 by describing the bill's twin goals: make the state's Medicaid expansion permanent and address operational failures that produced coverage gaps during the post-pandemic redetermination process.
"House Bill 2 30 continues Montana's successful Medicaid program by lifting the sunset because it's time to stop reevaluating this program," Cafaro said, describing provisions to reinstate 12-month continuous eligibility, reopen Offices of Public Assistance in rural counties and require plain-language notices and improved electronic communications.
Witnesses described widespread problems during the renewal ("redetermination") period. Heather O'Loughlin of the Montana Budget and Policy Center and several health providers testified that long phone hold times and delayed processing forced eligible Montanans off coverage and created care gaps for routine and urgent needs. Dr. Tess Augustine, a Helena pediatrician, said some children and families were without timely medication or vaccinations during the redetermination process.
Proponents included tribal and rural health leaders, hospital associations, behavioral-health advocates and aging and homelessness coalitions. Many called the bill an operational fix that prevents unnecessary churn and protects continuity of care. "Continuous eligibility lowers administrative costs, it reduces churn and it ensures that individuals can access the continuity of coverage we all need to stay healthy," said Heather O'Loughlin.
Informational witnesses from DPHHS described the agency's capacity constraints and the potential for technology-based ex parte determinations (automated data matches) to reduce paperwork. Fiscal staff told the committee reopening OPAs and restoring 12-month eligibility would increase administrative personnel costs for the department but could reduce emergency and uncompensated care downstream.
The hearing closed without a committee vote; sponsors said they would submit additional materials and requested legislative action ahead of the session timetable.
