Medicaid expansion has saved Montana $30 million – Great Falls Tribune

HELENA — Montana’s Medicaid expansion program has saved the state health department more than $30 million since its start in January 2016, mostly because the federal government paid a bigger share of the costs for some recipients, officials said.

Erica Johnston with the Department of Public Health and Human Services told a legislative oversight committee on Wednesday that the program covers nearly 84,000 residents and has paid for $574 million in health care services since it began.

Under the Affordable Care Act, the federal government began picking up all of the costs, rather than 65 percent of the costs, for families with children and an income between 24 and 50 percent of the federal poverty level as well as for people with severe mentally disabling conditions, people determined to be medically needy, and women in the breast and cervical cancer program.

Beginning in January, the state became responsible for 5 percent of those costs. The state will have to pick up 6 percent of the costs in 2018, 7 percent in 2019 and 10 percent starting in 2020.

Johnston told the Medicaid Expansion Oversight Committee that even as the state continues to pay a share of the costs for recipients under Medicaid expansion, Montana is still ahead of the game. “Our current budget crisis would be worse today in the absence of Medicaid expansion,” she said.

Enrollees are required to pay 2 percent of their monthly income in premiums. The state has collected $5.6 million in premiums, Johnston said.

The Department of Corrections reported Wednesday it has saved several million dollars on inmate hospital stays since January 2016 because of Medicaid expansion. The department automatically applies for Medicaid coverage for inmates. While they are not eligible to receive benefits while incarcerated, coverage begins if they are admitted to the hospital for more than 24 hours. Without the expansion, the department would have been responsible for those charges, Johnston said.

The billed charges were more than $8 million, but that’s not necessarily how much the department would have paid.

Corrections also began reimbursing other outside medical claims at the Medicaid rate, rather than the higher commercial rate, saving $7.66 million in the fiscal year that ended in June, the department said.

Bob Olsen, vice president of the Montana Hospital Association, told the committee that change hurts small hospitals near Montana’s corrections facilities. For example, the Deer Lodge Medical Center received $1.2 million less in payments from the prison over one year, he said.

Olsen suggested the Legislature might want to look at the effects of the payment model on smaller hospitals near correctional facilities when Medicaid expansion is up for renewal in 2019.

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