Medicaid expansion debate drives other health issues

A last-minute change to a 2019 bill put an end date on Montana’s Medicaid expansion program, setting the stage for what is anticipated to be the most significant health care debate of the 2025 Montana Legislature.

In recent interviews, legislative leaders predicted a vigorous debate over keeping the Medicaid expansion program, which pays the medical bills of more than 75,000 low-income Montanans at an annual cost of about $1 billion to the federal and state governments. They also expect the topic to seep into other health policy decisions, such as the approval of new spending on Montana’s behavioral health system and regulation of hospital tax-exempt status.

“It all kind of links together,” said state Sen. Dennis Lenz, a Billings Republican and chair of the Senate Public Health, Welfare, and Safety Committee.