Medicaid expansion, the economy and the fight against cancer

Bill Underriner
Thursday, February 7, 2019

As a business owner for the past 18 years in Billings, I know what a good deal looks like and continuing Medicaid expansion is not just a good deal – it is a great deal. Through my service on the national board of the American Cancer Society Cancer Action Network (ACS CAN), I also know we are making significant progress in addressing cancer incidence and mortality in Montana. Medicaid expansion has played a large role in that achievement by helping avert nearly 2,500 cases of colon cancer and providing more than 7,500 breast cancer screenings since January 2016.

In 2015, our state policymakers did the right thing for families and our communities by passing Medicaid expansion. After three years, the numbers speak for themselves –95,000 Montanans now have access to affordable health coverage and that has helped spur hundreds of millions of dollars in economic activity in local economies.

Medicaid expansion is also good for business. Over 18,000 businesses have at least one worker that now has access to health care through Medicaid expansion. Medicaid has created good-paying jobs around the state and has injected over a billion dollars in federal funds into our state’s economy, helping to keep the doors of critical access hospitals open in Montana’s rural communities.

Policymakers must again do the right thing and preserving access to health care coverage for our friends, family and neighbors across the state. The Medicaid expansion will sunset in June unless the Montana Legislature takes action in the coming weeks. Some legislators predict it will be extended because they are not likely to leave Montanans out in the cold. But, there are caveats that could be added that spell a public health disaster.

Some lawmakers are considering proposals that would condition a person’s eligibility for Medicaid on work or community engagement requirements. These new administrative reporting requirements will limit or restrict eligibility, significantly reducing and denying enrollees access to preventive and treatment services. Cancer patients, survivors and those facing a cancer diagnosis could be seriously disadvantaged and find themselves without Medicaid coverage because they are physically unable to comply with these new requirements.

Over the past few years, Montana has been a national leader in workforce development and meaningful job training programs for Medicaid enrollees. Rather that waste money on simply monitoring the hours of people who are already working and take coverage away from those who cannot work, Montana’s HELPLink program invests in job training and workforce development programs. By addressing actual barriers to work, HELP-Link has been successfully connecting low-income Montanans to employment as well as higher wage job opportunities. These programs have connected over 25,000 Medicaid participants with workforce support, with more than 3,000 receiving more intensive help. As a result, participants see higher wages, with an average $8,057 wage gain.

The fact of the matter is that most Medicaid expansion participants are already working. And those who are not, often cannot, because they are battling complex, chronic conditions, are caregivers or students. States have tried to structure similar programs to exempt certain populations or individuals from these reporting requirements, but these efforts have failed, resulting in thousands of people needlessly being kicked off of Medicaid. These programs are not structured to help enrollees find work and don’t improve the health of state residents, all the while the states is spending millions of dollars and creating a new bureaucracy.

As both a business owner and board member of ACS CAN, I urge our legislators to reauthorize Medicaid expansion and simply eliminate the sunset. It is the right thing to do for Montana and Montanans.

( Bill Underriner is the CEO and President of Underriner Motors in Billings and the Secretary of the American Cancer Society Cancer Action Network National Board of Directors.)