Growing the size of government to fix a problem caused by government is like trying to dig yourself out of a hole. That is exactly what Ballot Initiative 185 would do. On the steps of the Capitol in 2015, the proponents of Medicaid Expansion rallied supporters under the banner of “70,000 Can’t Wait.” They were referring to the number of Montanans estimated to be enrolled in the Medicaid Expansion program by 2022.
That estimate has proven wrong. Today, nearly 100,000 Montanans are enrolled in Medicaid Expansion, and costs are nearly double what they were estimated to be just three years ago.
To qualify for Medicaid Expansion, an individual’s income needs to fall below 138 percent of the federal poverty level, making this program far different from Medicare and traditional Montana Medicaid. It’s no surprise that a program given away for nearly free has surpassed even the most liberal estimates.
Montana taxpayers should be concerned by the amount of money I-185 would obligate Montana taxpayers to spend. The Initiative would lock in more than $60 million per year in permanent spending. However, that spending would not be subject to legislative review or cost controls because I-185 would permanently extend a statutory appropriation. That means that the Legislature will be obligated to fund whatever the bureaucrats running Medicaid Expansion say they need.
When Montana lawmakers expanded the state’s Medicaid program in 2015, they included a sunset provision. The sunset provision created a de facto plan to evaluate the program’s effectiveness and provide the Legislature with an opportunity to implement any reforms identified during the program’s first four years. But I-185 bypasses the Legislature’s planned evaluations and locks the program in place without much-needed reforms or cost controls.
This is unacceptable. It is entirely unreasonable to permanently extend with no changes a program that, in less than four years, has already been nearly twice as expensive as originally projected.
But while the premise of I-185 is unacceptable, its supporters are downright deceitful. The truth is that while I-185 permanently locks in a massive government entitlement program, it fails to pay for itself.
Medicaid Expansion is projected to cost Montana taxpayers more than $60 million per year (and we know how reliable cost projections for Medicaid Expansion have been in the past). At the same time, I-185 caps new funding for the program at just $26 million per year. That leaves a $34 million per year unfunded mandate that all Montana taxpayers will have to pay for.
Bottom line: Montana doesn’t need I-185 to preserve the Medicaid Expansion status quo. We need the Legislature to control costs and protect Montana taxpayers.
Preserving the Legislature’s ability to reform Medicaid Expansion is crucial to the fiscal health of our state. If I-185 passes, that will disappear. I-185 is just a recipe for more taxes and bigger government. Vote No on I-185.
Barry Usher is a Republican representing Montana House District 40.