MT rejects federally-funded Medicaid expansion, possibly by accident

The Montana State House

The Montana State House

The 2013 session of the Montana state legislature ended last week, and now the state House and Senate will slumber until 2015. Legislators in Montana meet for 87 days every two years, which means that A) there’s a lot of pressure to get everything done and B) not everybody has had a ton of practice. The second phenomenon became evident earlier this month, when Rep. Tom Jacobson (D–Great Falls) accidentally voted the wrong way on a parliamentary objection, causing a tie in the House that allowed Speaker Mark Blasdel to reject federal funding for Medicaid expansion under the Affordable Care Act.

So 70,000 uninsured Montanans are not going to get Medicaid for at least two years. It’s possible they never will, as Republicans in Helena have proven remarkably opposed to Medicaid expansion, even though the first decade’s funding will come almost entirely from the federal government. Presumably owing to their opposition to Obamacare, Republicans blocked nearly every attempt this session to implement federally-funded expansion of Medicaid. The exception was HB623, a byzantine plan that initially would have used federal Medicaid money to provide “income grants” to uninsured Montanans, who could then buy private insurance on the subsidized state exchange.

Possibly because it was sponsored by Republican Liz Bangerter, HB623 made it out of the House Human Services Committee—previously the graveyard of all Medicaid expansion bills this session—who sent it to the Senate with the income grants scrapped. The Senate adopted a different private-insurance model, based on a plan in Arkansas, and returned the bill to the House.

It appeared to be the last, best chance for Medicaid expansion to actually happen in Montana, but Speaker Mark Blasdel took the unusual step of referring the amendend bill back to committee. With only seven working days left in the session, there it would certainly languish and die. House Minority Leader Chuck Hunter objected to the move, but the vote to overrule Blasdel’s decision ended at 50 to 50. It should have been 51-49, but the aforementioned Rep. Jacobson accidentally voted the wrong way. He later told reporters that he thought he was voting to uphold Hunter’s challenge, when in fact he voted to uphold Blasdel’s committee referral. The tie went to the presiding officer, and Medicaid expansion died.

It was a fitting capstone to a 2013 session that has seen Republicans vote against the interests of Montanans for nakedly ideological reasons, and seen Democrats demonstrate their utter incompetence at working the levers of legislative politics. Republicans held strong majorities in both houses during the 2013 session, and they abused them. The Montana GOP governed with an eye to Republican politics, producing bills to nullify a non-existent federal ban on assault weapons, restricitng electoral ballots to the top-two primary vote-getters regardless of party, and vigorously fighting repeal of an anti-sodomy law declared unconstitutional 15 years ago.

It was a legislative agenda more concerned with Tea Party orthodoxy than with Montanans’ well-being, and it reached its peak when it rejected free Medicaid money for a state where 17% of the population is uninsured. That was pig-headed, meaning both stupid and proud. I suppose that is one better than legislative Democrats, who showed themselves to be merely stupid.

Jacobson did not single-handedly deny health insurance to 176,000 Montanans when he failed to understand what he was voting on—or even to look and see how his Minority Leader had voted—but he did produce one hell of an objective-correlative. Armed with only their political cunning and understanding of parliamentary procedure, the 2013 Democratic caucus has wounded itself again and again. Earlier this month, they tried to exploit Senate rules to block the top-two primary bill but couldn’t resist announcing their surprise beforehand. It failed, and Democrats were embarrassed.

Not so embarrassed as they should be for failing to pass a law accepting free money from the federal government, though—that was pretty much the ne plus ultra of political ineptitude. A lot of poor people are going to go broke in the next two years because they got sick and their elected representatives were either two proud or too incompetent to let the federal government buy them insurance. It wasn’t because Tom Jacobson couldn’t understand a yes/no vote. It was because his party could neither compromise with nor outmaneuver a Republican caucus primarily concerned with establishing its bona fides for 2014.

That election is a long way away, and the 2015 session is even farther. In the meantime, Montana will have no legislative government and—signature achievement, here—no expanded Medicaid. In that time, the state will save zero dollars. Our representatives’ successful refusal of help for the poorest among us is purely symbolic. It symbolizes the meanness of one party and the stupidity of the other, and Montanans will have a long time to interpret that.

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