In 2016, Montana implemented its Medicaid expansion program under the Affordable Care Act, resulting in thousands of able-bodied adults joining the Medicaid program. Despite voters’ clear indication that they were opposed to an extension of the program in 2019, Governor Steve Bullock reauthorized the expansion for another six years.
Since that time, Medicaid expansion has caused substantial harm to Montana by shattering enrollment and budget projections, crowding out other state spending, destroying hospital finances, reducing health care capacity, promoting welfare dependency, leaving behind the truly needy, and increasing fraud. So-called “studies” touted by proponents of expansion fail to examine the full consequences of Montana’s decision to expand Medicaid to able-bodied adults, as well as ignore and omit crucial data.
In reality, Montana’s Medicaid expansion program has been a disaster since the beginning. However, policymakers have the power to implement commonsense reforms to mitigate the negative effects of the program and control costs.