In May, the U.S. House of Representatives passed the American Health Care Act (AHCA), which includes two changes to Medicaid that would have far-reaching consequences for the Montana Medicaid program, its participants, healthcare providers and the state budget. Specifically, it would cap federal financial support for state Medicaid programs and effectively eliminate Medicaid expansion by removing the enhanced federal funding promised in the Affordable Care Act. On June 22, the Senate released an initial draft bill of its own, the Better Care Reconciliation Act (BCRA), which would impose per capita caps and eliminate enhanced federal funding for Medicaid as well.
In light of the potential health consequences of the proposed provisions, the Montana Healthcare Foundation commissioned Manatt Health to model the combined impact of the proposed Medicaid changes in Montana. Notably, Montana is expected to lose $4.8 billion in federal Medicaid funds between FY 2020 and FY 2026 under the AHCA, and $5.3 billion over the same period under the BCRA. In addition, coverage is at risk for 79,000 expansion adults in Montana if the AHCA or BCRA legislation is enacted.