House panel backs 12‑month continuous Medicaid eligibility; sponsors cite reduced churn, opponents cite state cost

Representative Howell presented House Bill 386 to direct the Department of Public Health and Human Services to provide 12‑month continuous Medicaid eligibility for adults, which would prevent people from losing coverage for short income fluctuations and re‑enrolling later.

Howell said continuous eligibility smooths eligibility “bumps” caused by temporary changes in income, lets people keep access to care, reduces paperwork for the department and lowers uncompensated care for hospitals and clinics. He noted Montana previously had this policy for adults from 2016 until 2023 and that other populations (children, pregnant women) already use 12‑month continuous eligibility.

Opponents challenged the fiscal note. Representative Millett asked whether the fiscal note required additional state funds or more federal matching funds. The sponsor explained the change would increase state share costs somewhat but not change the federal funding coming into the state; Representative Mercer summarized the fiscal note later in the day: roughly $5 million in additional general fund spending in the first year of the next biennium and over $10 million annually in later years, with a multi‑year total on the fiscal note of about $37 million.

Some members opposed on principle to expanding federal‑linked programs; others said the policy supports work and continuity of care. The committee recommended the bill do pass on second reading by recorded vote: 53 yes, 47 no; Representative Fielder was recorded as voting no.