Montana’s Medicaid expansion work requirements delayed

The work requirements that state lawmakers added to Montana’s Medicaid expansion program as a compromise to keep the program alive won’t go into effect in January as planned.

The bill that passed earlier this year calls for able-bodied people receiving coverage under Medicaid expansion to work or participate in community engagement activities for at least 80 hours a month. Those requirements were to begin with the new year, under the legislation.

But federal health officials must authorize the provision for it to take effect, and they have not yet done so. Even if they do, there would still be a delay for the state health department to write administrative rules and build computer systems to implement the changes.

State Department of Public Health and Human Services officials told Montana Public Radio it could be a year or more before the requirements take effect.

The agency said it will call and send letters to people covered under Medicaid expansion when they do.

As of Sept. 1, more than 88,000 adults in Montana were covered through Medicaid expansion, a provision of the federal Affordable Care Act that extended Medicaid eligibility to working-age adults who make up to 138% of the federal poverty level.

A U.S. Supreme Court ruling made it optional for states, and Montana first approved it in 2015.

The program was to expire unless the Legislature acted this year. Adding the work requirements as a compromise between Democrats and some Republicans allowed the extension to narrowly pass.

Montana officials estimate between 4% and 12% of people enrolled in the program could lose their health coverage because they fail to meet the work requirement.

A federal judge has blocked similar work requirements in Arkansas, Kentucky and New Hampshire.