Montana Expands Healthcare Access to Thousands of Low-Income Residents

A few weeks ago, a new law went into effect in Montana that will expand access to affordable healthcare to between 45,000 and 70,000 Montanans.

At the end of this year’s legislative session, Montana lawmakers—after three years and much heated debate—finally passed Medicaid expansion. This significant victory will ensure that all Montana residents living at or below 138% of the federal poverty level, an income of $16,000 or less, are able to get the healthcare they need and deserve.

For thousands of people like Lisa, who work hard every day and give back to the community, Medicaid expansion is the only way they’ll be able to afford healthcare coverage. Lisa shared her story with legislators in a recent hearing:

“I have a Bachelor of Fine Arts and a Master of Arts and I am a Master Potter. I was married for twenty-five years; I am a new grandmother and a healthy sixty years of age. My former husband and I decided to divorce, which caused a huge setback in all facets of my life; the studio business, with relocation costs, renovation costs, and time. I have been self-employed since 1991 and a substitute teacher since 2005. Neither is a high paying job, but I love what I do. Unfortunately, my income isn’t always predictable. It is, however, stable. As a contributing member to my community, I donate when asked, to many charities and fundraisers. With the expansion of Medicaid, I would have coverage. Please take a look more closely at those of us who are self-employed, and/or independent contractors, and the many folks who are invisible in the community. We are part of the community that makes this state great, the “Made in Montana” folks. It’s important that lawmakers support those of us who give so much to this state by ensuring our access to life-saving healthcare.”

In addition to the benefit of providing more people with access to healthcare, Medicaid expansion will also give Montana’s economy a significant boost—bringing important jobs into the healthcare field. More people covered by insurance will reduce the financial burden on hospitals as well. As people are able to access the preventative care they need, it’s less likely that they’ll end up the Emergency Room for costly, last-minute treatment.

Expanding Medicaid in Montana will greatly benefit many in our community. Given the lack of statewide legal protections, many LGBTQ people across our state—and the country—are struggling with unemployment, poverty, and access to healthcare. A recent national report found that single LGBTQ adults with children are three times as likely to have incomes near the poverty line as their non-LGBTQ peers, and that transgender Americans are almost four times more likely than the general population to have a household income under $10,000 per year (you can learn more about the impact of Medicaid expansion on the LGBTQ community in my full testimony, here).

All Montanan’s deserve the right to healthcare, regardless of their income level. It’s a basic human right. As I travel around the state, I have the opportunity to talk with many individuals and families in our community and there is always an underlying sense of the challenges and barriers LGBTQ people face when accessing resources. People often put off seeking healthcare services due to discrimination and mistreatment, or as a result of income disparities. I hear stories of homophobia, transphobia, and the struggle to make ends meet.

Even though there are clear and straightforward benefits to Medicaid expansion in Montana, the issue has still been controversial, and it took dedicated coalition building and advocacy work to finally get the bill passed this session. Some Montana legislators have done everything they can to stall the bill’s progress and to keep it from moving forward. The initial hearing in the House in early March turned out approximately 250 supporters and less than 15 opponents. However, even after a seven-hour hearing filled with public support, the committee voted down the bill on a party line vote. A procedural move tabled the bill, effectively halting it from moving forward.

While most of the advocates, organizers, and supportive elected officials expected this action—especially due to the vocal opposition from the Chair of the committee as well as the other opponents who sat on that committee—it was still heart-wrenching when the vote came down after seven hours of testimony and discussion. The numbers of supporters compared to opponents was staggering and overwhelming. People drove many hours to stand in line for several additional hours, many of whom suffer from debilitating illness and support their families by working more than one job. By the eleventh hour, it felt like the majority of the committee was unwilling to acknowledge the stories and struggles shared, only voting against what they believed to be an extension of the Affordable Care Act. It was a floodgate of anger, frustration, and heartbreak.

Meanwhile, a Republican Senator (Edward Buttrey– Great Falls) was drafting a compromise bill, with the understanding that the House Bill might not make it to the floor. While Senator Buttrey’s bill ultimately passed, several obstacles came up along the way. After extensive debate, multiple legislators attempting to add unwanted amendments to the bill, and numerous meetings—the bill finally passed both chambers and was sent to the Governor’s desk to sign.

Even though it didn’t always feel welcome or necessarily safe, the personal testimonials and comprehensive information shared with legislators ultimately led to the passage of this policy. The importance and need for this legislation was clearly displayed through the sheer number of people who attended hearings, sat through hours of testimony, and volunteered making phone calls. It was a reminder about how critical it is to share our stories and to elevate the voices of everyone in our community.

With Medicaid expansion, Lisa, along with thousands of other Montanans will be able to receive the care they need to live longer and healthier lives. While access to healthcare is critically important, we know that the healthcare needs in our community go much deeper than simply having insurance. We’ll continue working with community members and coalition partners to ensure LGBTQ people are also protected from discrimination and have access to culturally-competent care.

Kim Leighton is Pride Foundation’s Regional Development Organizer in Montana. Email Kim.

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