Montana to Test Medicaid Work Rules Amid Budget Strain
Montana is preparing to implement federal Medicaid work requirements on July 1, becoming the second state after Nebraska to do so — six months ahead of the federal deadline. The state faces a budget shortfall after lawmakers underfunded the health agency last year, before the federal spending law requiring work checks was passed. The law mandates states verify every six months that enrollees work, attend school, or volunteer at least 80 hours per month, or qualify for an exemption. Officials expect the law to reduce federal Medicaid spending by nearly $1 trillion over 10 years while shifting costs to states. Montana’s proposed budget fix includes stalling healthcare provider rate increases due July 1. Clinicians report struggles to hire staff amid growing waitlists, which they attribute to low Medicaid payments. The state health agency has been building its public assistance team but still awaits federal guidance on exempting vulnerable populations.
What’s reported
Montana plans to implement Medicaid work requirements on July 1, six months ahead of the federal deadline.
Montana is the second state after Nebraska to do so.
The state budget was underfunded for the health agency before the federal law passed.
The federal law requires checks every six months on work, school, or volunteer status (80 hours/month) or exemption.
The law is expected to reduce federal Medicaid spending by nearly $1 trillion over 10 years and shift costs to states.
Montana’s budget fix includes stalling provider rate increases due July 1.
Clinicians say low Medicaid payments make it hard to hire staff amid growing waitlists.
State data shows long waits for public assistance and coverage loss due to paperwork issues.
State officials plan to scan existing data to auto-confirm work rules and have been building their assistance team.
The state awaits federal answers on exempting vulnerable people.
Open questions
What specific unanswered questions from the federal government remain regarding exemptions for vulnerable people?
Key figures
Joan Alker, Georgetown University researcher focused on health coverage
Jean Branscum, CEO of the Montana Medical Association
Sources: kffhealthnews.org
