Montana Senate turns down bill that would phase out Medicaid expansion

Yahoo

11-02-2025

Photo illustration by Getty Images.
The Montana Senate turned down a bill on a 20-30 vote Tuesday that would have phased out Medicaid expansion after pointed debate about the need for the federal money for vulnerable Montanans and small hospitals on thin margins — and the potential for federal funds to dry up.
Sen. Carl Glimm, R-Kila, sponsored Senate Bill 62, which he said wouldn't accept new people, but would allow current participants to remain on the program until they didn't qualify anymore, a 'soft unwind.'
Glimm also said his bill would prepare the state budget for inevitable contractions at the federal level — ones he said the Senate recently said it wanted in a 43-6 vote to send a message to the federal government that spending is out of control.
The joint resolution, SJ 9, calls on Congress to 'discipline itself' given the state of the federal budget, citing an increase in the federal debt from $21.2 trillion in 2016 to $36.3 trillion as of 2025, 'equaling 121% of the nation's gross domestic product.'
'This bill is one that we can do to help make sure that Montana doesn't end up in that same situation,' Glimm said.
Medicaid expansion will sunset in June 2025 without action from the Montana Legislature.
The Montana House just passed a bill sponsored by Rep. Ed Buttrey, R-Great Falls, to continue Medicaid expansion as it currently stands, with a 90% match from the federal government, and it will start to make its way through the Senate.
Buttrey has argued House Bill 245 returns money to the general fund and is a necessary partnership between healthcare and economic development in Montana.
Democrats and some more moderate Republicans also argue Medicaid expansion, with an estimated 80,000 people insured, is a deal for Montana and necessary especially for smaller hospitals and communities.
Sen. Russ Tempel, R-Chester, said one hospital in his district operates on a 2% margin. Without Medicaid expansion, he said, the hospital would lose more than $500,000, and it and other small hospitals in his area would be in trouble.
Sen. Butch Gillespie, R-Ethridge, said certainly there's a chance the federal government will make changes to Medicaid expansion.
'But until then, are we willing to give up 90% of whatever it's costing? That would be a huge blow to the state of Montana,' Gillespie said.
Sen. Emma Kerr-Carpenter, D-Billings, said some people don't make enough money to qualify for insurance through the marketplace, and retaining the program is important given instability at the federal level.
'To me, it seems absurd that we would be making a giant fiscal and policy decision … in such a volatile environment,' Kerr-Carpenter said. 'To me, my constituents sent me up here for a reason, and that was to make life better for them.'
Sen. Chris Pope, D-Bozeman, said terminating Medicaid expansion won't save money, it will cost the state millions, and it would hurt people including seasonal employees.
'Medicaid expansion is a vital program that keeps us healthy, keeps our communities economically vibrant, that provides an important hand up to our most vulnerable, hard working constituents,' Pope said.
Sen. Jeremy Trebas, R-Great Falls, however, said changes at the federal level, such as a lower reimbursement rate, will happen regardless, and Montana should be realistic about the financial road ahead.
'We can get our state adjusted to the coming reality and plan to become sustainable on our own, or we can live in this fiscal fantasy. And that's really what this is all about,' Trebas said.
Trebas has his own bill, Senate Bill 199, which he has described as in alignment with the direction of the Trump administration when it comes to work requirements for participants. It passed out of committee, according to a legislative bill tracker, and has yet to be heard on the floor.