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Committee backs bill letting families buy into Medicaid for children with severe disabilities
Summary
House Bill 881, creating a Katie Beckett Medicaid buy‑in so parents can pay a premium for services not covered by private insurance, passed the committee after broad support from disability advocates, medical groups and families; sponsors said the program is a capped waiver with premium formulas and is intended to help children stay at home and reduce waiting lists for waiver services.
The House Health and Human Services Committee on Thursday approved House Bill 881, which would let parents of children with federally defined severe disabilities purchase Medicaid coverage for services—such as in‑home nursing, feeding‑tube care and durable medical equipment—that traditional private insurance often does not cover.
Representative Mary Cafaro, sponsor of HB 881, told the committee that the proposal extends to children the type of Medicaid buy‑in already available to adults with disabilities in Montana. "We are just asking for this coverage, for parents to have the opportunity to buy into Medicaid, to pay a premium for the services not covered by traditional health insurance," Cafaro said in opening remarks.
Multiple advocates and medical groups testified in favor. Ability Montana, NAMI Montana, the Montana Academy of Physician Assistants and Disability Rights Montana described families who are forced out of the workforce or who postpone needed care because children exceed income eligibility despite high medical costs. Dr. Lauren Wilson, advocacy chair for the American Academy of Pediatrics' Montana chapter, said the program would be "life changing" for patients whose families cannot otherwise access waiver services because of income rules and long wait lists.
Committee members probed program details: sponsors and witnesses said the buy‑in would be implemented as a capped waiver with both enrollment and financial caps. The bill includes a premium formula discussed on the committee record (page references in the bill text): examples in the bill point to roughly 5% of family income for families at or below 200% of poverty and 7.5% for those above that threshold as a way to scale premiums.
Supporters argued the buy‑in would help families keep children at home, reduce long waiver wait lists, and allow parents to remain employed. Several witnesses provided family examples of necessary services that private insurance does not cover. After committee discussion the roll call recorded the committee voting to report HB 881 as passed. The bill will now move forward for consideration by the full House.
