Montana鈥檚 Medicaid Expansion Conundrum
State lawmakers appear ready to preserve the state鈥檚 Medicaid expansion program without knowing what federal changes might be in store.
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State lawmakers appear ready to preserve the state鈥檚 Medicaid expansion program without knowing what federal changes might be in store.
Congressional Republicans are pushing plans that could make deep cuts to Medicaid to finance President Donald Trump鈥檚 tax cuts and other priorities. At stake is coverage for millions of low-income Americans, as well as a huge revenue source for hospitals 鈥 and every state.
As Republicans consider adding work requirements to Medicaid, Georgia and Arkansas 鈥 two states with experience running such programs 鈥 want to scale back the key parts supporters have argued encourage employment and personal responsibility.
Patients and providers say health insurers鈥 preapproval requirements lead to delays and denials of needed medical treatments. Insurers argue that prior authorization keeps costs down.
The Montana health department says the Board of Public Assistance is redundant and a bureaucratic hurdle that helps few people. Current and former board representatives say the rare cases in which the panel helps people are important.
Unsure how to help the troubled psychiatric facility, legislators look to shore up other parts of the state鈥檚 mental health system.
The moves under consideration include relocating a residential facility for people with developmental disabilities, renovating the state鈥檚 psychiatric hospital, and opening a new unit of the hospital in Helena.
Health leaders say a tool to boost medical coverage for Native Americans, a population that has long faced worse health outcomes than the rest of the nation, has been underused by many states and tribes since it was written into the Affordable Care Act more than a decade ago.
To deliver on pledges from the new Trump administration to make America healthy again, policymakers will need to close gaps in longevity among racial and ethnic groups.
The number of unhoused seniors in the U.S. is expected to triple by 2030. About half of this population is becoming homeless for the first time. Homeless services struggle to help. Finding affordable housing that鈥檚 also accessible for older Americans with medical conditions is an extra challenge.
Though abortion rights supporters prevailed on ballot measures in seven of the 10 states where abortion was up for a vote on Nov. 5, the state supreme courts voters have elected indicate legal fights to come aren鈥檛 clear-cut.
More medical schools say they will no longer charge tuition, in hopes that more students, graduating free of debt, will choose lower-paying primary care careers. But evidence suggests it will take a lot more than a free ride to replenish the primary care pipeline.
After rival hospitals in Terre Haute scuttled plans to merge, a state senator has introduced a bill to forbid similar mergers by repealing a state law he helped write.
Legislative leaders say the decision whether to renew Montana鈥檚 Medicaid expansion program this year will loom over behavioral health spending and hospital regulation, among other topics.
The number of new and returning enrollees using healthcare.gov 鈥 the federal marketplace that serves 31 states 鈥 is well below last year鈥檚 as of early December. Also, a Biden administration push to give 鈥淒reamers鈥 access to Obamacare coverage and subsidies is facing court challenges.
Federal law says Native Americans aren鈥檛 liable for medical bills the Indian Health Service promises to pay. Some are billed anyway as a result of backlogs or mistakes from the agency, financial middlemen, or health systems.
The push-pull in Montana reflects a national tension as states try to decide what counts as fair checks on tax-exempt hospitals and industry players weigh in. The debate centers on whether nonprofit hospitals do enough good to earn their charitable status.
A federal judge sided with 19 states seeking an injunction against a Biden administration rule allowing recipients of Deferred Action for Childhood Arrivals to enroll in Affordable Care Act coverage and qualify for subsidies amid the annual open enrollment period.
About 3.7 million people are at immediate risk of losing health coverage should the federal government cut funding for Medicaid expansions, as some allies of President-elect Donald Trump have proposed. Coverage could be at risk in the 40 states that have expanded Medicaid.
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