White House concerned that Montana's Medicaid expansion could hurt very low-income residents

The Obama administration said it has concerns about Montana's plan to expand Medicaid, such as charging premiums to very low-income residents, Mike Dennison reports for the Billings Gazette. Ben Wakana, spokesman for the U.S. Health and Human Services Department, said, “Our priority will be to make sure any . . . approval provides for coverage that is affordable and accessible for Montanans and does not impose significant cost-sharing or premiums on individuals with very low incomes."

Medicaid expansion in Montana was signed into law by Democratic Gov. Steve Bullock last week, Dennison writes. "Once the plan is up and running, it’s estimated Montana could receive at least $400 million in federal funds to finance the expanded coverage the next two years. However, because Montana’s plan has some unique requirements not seen in other states, it must get a 'waiver' from the federal government, which is funding 100 percent of the expansion through 2016. The feds’ share then gradually ramps down to 90 percent by 2020, with Montana picking up the cost burden for the remainder of the expansion."

"The expansion extends Medicaid health coverage to all able-bodied adults earning up to 138 percent of the federal poverty line, about $16,200 for a single person," Dennison writes. "Under Montana’s program, those eligible for the plan must pay a premium equal to 2 percent of their income. They also must pay higher fees if their financial resources exceed certain amounts." Obama administration officials said they "are concerned that the state plans to charge premiums even to people earning below 50 percent of the federal poverty line (about $5,900 a year for a single person) and that the plan has other 'cost-sharing' requirements for those covered." (Read more)