HELENA — On Friday, the Montana lawmakers weighed in on one of the most debated issues of the 2025 legislative session, Medicaid Expansion. House Bill 245, which effectively continues the current program, passed a key vote in the House of Representatives with bipartisan support.
“We did something really special for the people in Montana in 2015 and again in 2019. We created a system that unlike in other states actually moves people out of poverty and onto the road to success,” said Rep. Ed Buttrey, R-Great Falls, sponsor of HB 245.
Montana’s Medicaid Expansion – initially passed in 2015 and then renewed in 2019 – is currently scheduled to “sunset” on June 30.
Medicaid is a joint state and federal health insurance program for families with low income, Montana’s Medicaid expansion allows adults 18 to 65 and making less than 138% of the federal poverty level to qualify for coverage.
In 2023, an average of 288,000 Montanans were enrolled in Medicaid. About 38% of those enrolled were under Medicaid expansion.
HB 245, sponsored by Buttrey, effectively renews the program as it is now while making some changes in how the state connects people on Medicaid Expansion with workforce development services. The bill also removes the sunset date.
Proponents of the bill say Medicaid Expansion has been key to funding rural medical facilities and helping people improve their lives.
“I’m going to rise in support of Medicaid Expansion. Medicaid has been a critical source for people in our communities across the state, rural communities, tribal communities and a lot of farming communities,” said Rep. Donavon Hawk, D-Butte, on the House floor.
Hawk also shared his own personal experience with the program after he had to file for medical bankruptcy.
“If it wasn’t for Medicaid expansion I wouldn’t have been able to get financially secure,” said Hawk. “Had I not been able to do that I would not have been able to adopt and start taking care of my niece and nephew.”
Opponents of HB 245 said other options are being proposed this year at the legislature and are concerned about the program's cost.
“This is not your only bite at the apple,” said Rep. Jane Gillette, R-Three Forks, “There are a lot of bills in play right now that have to do with improving Medicaid Expansion not just sitting with our old version of Medicaid Expansion which clearly has failed.”
Rep. Bill Mercer, R-Billings, said, “I hope we really consider where we’re going to be if the [federal] match changes. And if the match isn’t 90-10%, if it is like every other part of traditional Medicaid right around 62-38%, it is a financial burden that we could not afford to bear. “
HB 245 passed second reading in the House on a vote of 63 to 37, with 21 Republicans voting with the full Democrat caucus in support.
There are a couple of bills on Medicaid expansion that have been introduced on the Senate side as well, including a bill from Sen. Carl Glimm, R-Kila, that would sunset the Medicaid Expansion program.
