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Strong Opposition to New Restrictions in Medicaid 54 Montana Patient, Provider Groups Aim to Prevent Barriers to Care

Helena, MT, March 14, 2019 – As federal judge James Boasberg of the U.S. District Court for the District of Columbia prepares to hear oral arguments on the legality of Medicaid work requirements in Arkansas and Kentucky on Thursday, March 14, a coalition of Montana health providers, patient advocates and community leaders are urging legislators to continue Medicaid expansion without imposing unreasonable barriers to coverage.

“Access to health care helps working Montanans keep and find good jobs, and helps workers succeed in today’s economy,” said Amanda Cahill, Director of Quality and Systems Improvement for American Heart Association in Montana. “The reporting requirements would jeopardize working patients’ access to care and upend a program that by all accounts is working.”

The Arkansas work requirement program took effect June 1, 2018, resulting in approximately 18,000 people losing Medicaid coverage so far; it is estimated an additional 30,000 people will lose coverage if the program continues in 2019. Kentucky’s work program will take effect July 1, 2019, and it is estimated that at least 90,000 individuals will lose coverage, if the court allows the program to go forward. 

In Montana, an independent analysis by Milken Institute researchers found that work requirements and administrative barriers in Montana could cause between 31,000-43,000 low-income adults to lose Medicaid coverage (30% to 41% of the 87,000 beneficiaries aged 19 to 59 years old).

These changes are especially problematic since Montana has already pioneered HELP-Link, its successful bi-partisan work promotion system for those on Medicaid, that has provided training and helped increase employment. HELP-Link has been viewed as a national leader. Montana is the only state in the nation that can show it has increased work.  For example, a study done by The Heartland Institute –showed that twenty years of work requirements in SNAP and TANF in Montana have only resulted in increased poverty and loss of benefits. The changes in these programs failed to increase employment. 

Republican-controlled state legislatures in Wyoming and West Virginia rejected legislation that would mandate Medicaid work reporting waivers on those states.

Those who lose insurance coverage will have worse access to health care, which could harm both their health and financial well-being. In addition, hospitals, community health centers and similar facilities, particularly those in rural areas, will lose Medicaid revenue and have to care for more uninsured patients. This will destabilize them financially, increasing the risks of service cutbacks or closures.

A coalition of hospitals, health care providers and health care advocates also wrote, “Without health insurance, Montanans are more likely to seek the wrong care, at the wrong time and at the wrong place — with poorer outcomes and higher costs. . . . Coverage is the keystone to improving the health of our residents, increasing the efficiency of our health care system and decreasing costs for consumers, businesses and the state.”

The proposal makes other changes too. Milken Institute researchers also found that raising the monthly premiums that must be paid will also lower participation, leading about 9% to drop coverage, which would be 5,000 to 7,000 people in addition to those lost due to work requirements. Combining the two policies, between 31,000 and 43,000 low-income Montanans would lose Medicaid coverage due to the policies proposed. 

The following groups have expressed opposition to adding new, unnecessary barriers to Medicaid health care coverage:

AARP of Montana

ACLU of Montana

American Academy of Family Physicians

American Academy of Pediatrics

American Cancer Society

American College of Obstetricians and Gynecologists

American College of Physicians

American Diabetes Association

America’s Frontline Physicians

American Heart Association

American Liver Foundations

American Lung Association

American Medical Association

American Osteopathic Association

American Psychiatric Association

Arthritis Foundation

Behavioral Health Alliance of Montana

Big Sky 55+

Cancer Action Network

Cancer Support Community

Center on Budget and Policy Priorities

Cystic Fibrosis Foundation

Epilepsy Foundation

Family Voices

Global Healthy Living Foundation

Helena Food Share

Hemophilia Federation of America

Leukemia and Lymphoma Society

Lutheran Services in America

March of Dimes

Mended Little Hearts

Montana AFL-CIO

Montana Budget and Policy Center

Montana Human Rights Network

Montana Federation of Public Employees

Montana Nurses Association

Montana Primary Care Association

Montana Women Vote

National Alliance on Mental Illness

National Multiple Sclerosis Society

National Organizations for Rare Disorders

National Patient Advocate Foundation

National Psoriasis Foundation

Planned Parenthood Advocates of Montana

Pulmonary Hypertension Association

Rocky Mountain Hemophilia and Bleeding Disorders Association

Rocky Mountain Tribal Leaders Council

SEIU 775

United Way

Western Native Voice

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The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us at, Facebook or by calling (406) 220-0063.


For media inquiries please contact:

Heather Wadia – 503-820-5309; email Heather
Amanda Cahill – 406-220-0063; email Amanda

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