July 14, 2006
Proposal Would Help Thousands of Uninsured Montanans
The Montana Department of Public Health and Human Services will submit a proposal to the federal government next week that would provide health-care benefits to more than 5,000 uninsured or underinsured low-income Montanans at no added cost to the state.
The proposal is known as a Health Insurance Flexibility and Accountability (HIFA) waiver. If approved by the Centers for Medicare and Medicaid Services (CMS), it would create a legitimate way for Medicaid to pay for services that have historically been funded entirely with state money. This would free up state dollars that could be used to leverage more federal Medicaid dollars.
Under the waiver, about 3,700 currently uninsured Montanans would get limited health-care benefits ranging from help paying insurance premiums to limited insurance coverage. Another 1,300 would get a better health-care benefit than they have now.
“I realize that even after this health care waiver is implemented in 2007, many Montanans will continue to lack access to adequate health care,” Gov. Brian Schweitzer said Friday. “However, I commend the department’s creativity and innovative strategies to provide health care coverage to 5,000 Montanans without increasing costs to the state by even one dollar.”
Joan Miles, director of DPHHS, noted that almost 20 percent of Montanans have no health insurance.
“We recognize that this proposal does not solve the problem,” she said. “But it is a step in the right direction. We wish we could offer a more comprehensive solution now, but we just can’t afford to expand the Medicaid program at this point. It’s already one of the most costly programs administered by the state.”
Miles said the department remains committed to exploring ways to reduce the number of Montanans who are uninsured or underinsured.
“We will work toward giving every Montanan access to basic health-care coverage,” she said.
She also noted that the proposal would not result in increased costs or reduced services to Montanans who are eligible for existing Medicaid benefits.
“Medicaid-eligible Montanans will continue to receive full Medicaid benefits,” she said.
Under the waiver, the state would use Medicaid money to pay for two components of existing health-care programs: the Mental Health Services Plan and the Montana Comprehensive Health Association.
It also would use money appropriated under House Bill 667 (which created a small business health-insurance purchasing pool) to leverage federal matching money. This would allow the state to expand tax incentives to employers and premium assistance to employees of small businesses that join the purchasing pool.
“Together, these steps will leverage about $15 million in additional federal matching funds at no cost to the state,” Miles explained.
The waiver would free up state money to pay for limited health-care benefits for the following populations:
- Up to 1,500 adults with serious mental illnesses who are enrolled in the Mental Health Services Plan;
- Up to 1,500 additional children who qualify for the Children’s Health Insurance Plan (CHIP);
- Up to 300 youth aged 18-20 who 1) have “graduated” from foster care, 2) are seriously emotionally disturbed, and 3) have lost Medicaid coverage because they have reached adulthood;
- Up to 600 uninsured working parents whose children are enrolled in Medicaid;
- Up to 1,200 people who are either 1) uninsured workers aged 18-20, or 2) uninsured working parents;
- Up to 260 people who are enrolled in the Montana Comprehensive Health Association premium assistance program.
CMS developed the HIFA waiver to allow states to explore innovative ways to provide health-care benefits to uninsured people who don’t qualify for Medicaid under federal rules.
Medicaid is a partnership of state and federal governments. Montana gets 69 cents from the federal government for every dollar the state spends on Medicaid services.
The state establishes eligibility guidelines for Medicaid, but the federal government defines categories of the population who can be covered. These are low-income Montanans who:
- Are age 65 or older,
- Are blind,
- Have been designated as disabled by the Social Security Administration,
- Are families with minor children,
- Are pregnant, or
- Have breast or cervical cancer.
Page last updated: 07/14/2006
