Provide for phaseout of Medicaid expansion program
Summary
SB 62 would phase out Montana’s Medicaid expansion program for able-bodied adults by prohibiting new enrollments on or after September 1, 2025, while allowing people already enrolled as of August 31, 2025 to remain covered if they stay continuously enrolled. The bill also directs the Department of Public Health and Human Services to seek a federal waiver from the Centers for Medicare and Medicaid Services to preserve federal matching funds and existing eligibility for current participants after the enrollment freeze takes effect.
The bill further states that if federal matching funds are reduced or lost, the department retains discretion to impose additional program-integrity and cost-control measures, including community engagement requirements, more frequent eligibility redeterminations, limits on automatic renewals, and a lifetime benefit limit for able-bodied adults. It also amends prior 2015 and 2019 laws tied to Montana’s Medicaid expansion and its termination provisions, and it takes effect immediately upon passage and approval.
Impact
SB 62 would materially change Montana law governing Medicaid expansion by ending future enrollment in the expanded adult coverage category and tying the program’s continuation for current enrollees to a federal waiver and ongoing federal funding. It amends Section 53-6-1304, MCA, and revises earlier session laws from 2015 and 2019 that established and later modified the Montana Health and Economic Livelihood Partnership Act, shifting the program toward a managed phaseout rather than continued expansion. The bill would primarily affect able-bodied adults eligible under the expansion, the Department of Public Health and Human Services, and the state’s administration of Medicaid-funded services.
Sentiment
The available voting history suggests the bill was controversial and ultimately unsuccessful. It received initial support in the Senate Public Health, Welfare and Safety Committee by a narrow 6-5 vote, but a later floor motion to pass the bill on second reading failed 20-30. The Senate then voted 31-19 to indefinitely postpone the bill, indicating that a majority opposed advancing the phaseout proposal even though a substantial minority supported it.
Contention
The main point of contention was whether Montana should continue Medicaid expansion for able-bodied adults or begin winding it down. Supporters of the bill appear to have favored limiting enrollment, increasing program integrity, and reducing long-term state exposure to costs, while opponents likely viewed the phaseout as a rollback of health coverage for low-income adults and a threat to continuity of care. The bill’s references to community engagement requirements, redeterminations, and benefit limits also suggest disagreement over whether such restrictions are appropriate safeguards or unnecessary barriers to coverage.
Relating to the development and implementation of the Live Well Texas program and the expansion of Medicaid eligibility to provide health benefit coverage to certain individuals; imposing penalties.