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Doctors back Medicaid expansion in talks with Bullock
15 hours ago • By Tom Lutey
Billings-area residents living at or near the poverty level desperately need the improved medical access offered by Medicaid expansion, RiverStone Health officials told Montana’s governor Thursday.
Doctors say it has become increasingly frustrating to watch from the sidelines as Medicaid expansion bills founder in Republican-controlled committees.
Democratic Gov. Steve Bullock wants to extend Medicaid coverage to 70,000 low-income Montanans. The federal government is willing to pay for all expansion costs through 2016.
Afterward, the federal government would reduce its support to 90 percent by the end of the decade. Coverage would be extended to people earning up to 138 percent of federal poverty level, or $15,400 for a single person.
RiverStone sees a lot of working people who lack health insurance and don’t qualify for Medicaid, said Dr. Megan Littlefield, RiverStone medical director. Those patients often put off medical care because they can’t afford it and end up in worse health and needing more care.
“I was seeing patients this morning, and 50 percent of the patients I saw were uninsured. All of them were employed. And instead of being able to just make medical decisions based on the judgment they have, it becomes a negotiation,” Littlefield said.
“I recommend A. They can’t possibly afford A. So we have to think about well, can we do B? ‘No, we’re not sure if we can afford B right now. I’m saving up money. Maybe I’ll be able to in a couple months.'
“Their medical decision is truly not a medical decision. It becomes a decision about what a patient is able to afford, and it’s not providing the highest-quality care I could deliver. It’s frustrating.”
Bullock met with medical providers at Beartooth Billings Clinic in Red Lodge, RiverStone and St. Vincent Healthcare in Billings. The governor said he needs patients and health care providers to contact their Republican legislators and advocate for Medicaid expansion. Several key Republican lawmakers on the Medicaid issue come from Billings and Red Lodge.
Rep. Cary Smith, R-Billings, is vice-chairman of the House Human Services Committee, which will take up Medicaid expansion when it hears House Bill 590 on Monday. Smith strongly opposes the federal Affordable Care Act, which makes the Medicaid expansion possible. Billings Republican Dennis Lenz also sits on the committee.
Sen. Jason Priest, R-Red Lodge, is chairman of the Senate Public Health Committee. He also has been an outspoken critic of the Affordable Care Act, which Republicans call Obamacare.
Republicans ran campaigns on opposing the Affordable Care Act in 2010 as successful Tea Party candidates gave Republicans strong majorities in the House and Senate. They rallied in 2012 around national candidates like Republicans Mitt Romney and Paul Ryan, who advocated scrapping the Affordable Care Act.
However, Republicans in other states have done an about-face when it comes to securing Medicaid dollars that if rejected will be spent in other states.
For governors like "Jan Brewer in Arizona, opposing the Affordable Care Act is part of who she is. For Rick Scott in Florida. For John Kasich in Ohio. I mean, that was at their core and by and large what they were running campaigns on,” Bullock said. “Now, faced with the choice of covering their citizens and creating jobs, it’s become more sensible.”
It’s estimated that Medicaid expansion would bring $750 million in federal support to Montana over the next two years. Roughly 5,000 new jobs in health care related fields would also be created.
Those new jobs could bring needed general practitioners to Montana counties that have none, said Dr. Zach Meyers, RiverStone’s Montana Family Medicine Residency faculty physician. In Montana, 45 of 56 counties are underserved by doctors, Meyers said. Roughly half of those underserved counties have no doctor.
Read more: http://billingsgazette.com/news/local/doctors-back-medicaid-expansion-in-talks-with-bullock/article_34cb5521-5553-558b-8e3d-e281760984fb.html#ixzz2OHuUiEUv