Montana has begun enforcing Medicaid work requirements, affecting nearly 71,000 people in the state. The new rules require enrollees to document that they're working, volunteering, or studying 80 hours per month, or show that they qualify for exemptions such as being "medically frail" or primary caretaker for a family member. The state started with a soft launch in July and gave enrollees until Oct 1 to comply.
Many patients, including Bethany Zulick, a Missoula resident, received letters from the Montana Department of Public Health and Human Services outlining the new requirements, causing confusion about when they need to prove compliance. Zulick's letter gave conflicting information on when she would have to prove she was meeting the requirements, leaving her uncertain about her insurance coverage.
Medicaid advocates worry that the expedited timeline in Montana and other states will lead to thousands of people losing coverage due to confusion about the new rules. State health department officials claim they are well-prepared and plan to process roughly 5,000 enrollees monthly. However, critics argue that the state hasn't finished setting up new computer systems or hiring sufficient staff, with only about 20 of 59 positions filled.
State Rep. SJ Howell has received dozens of calls from confused constituents about letters like the one Zulick received. She noted that the notices from the department are very confusing, making it hard for people to find help figuring out what's going on. State health officials have updated the letters to be clearer, but concerns remain about the state's ability to handle the new requirements.
The state operates a helpline, but federal data shows that Montanans stay on hold much longer than the national average, and many callers hang up before connecting with a state employee. Additionally, Cover Montana, a nonprofit that helps Montanans fill out paperwork, lost federal funding last year, reducing its staff from 18 to two part-time employees.
Montana Senate President Matt Regier supports the work requirements, saying they create accountability for people who rely on the social safety net. However, others, like Heather Reel, who relies on Medicaid for mental health coverage, are concerned about losing coverage due to the new rules. Reel attended a rally at the state capitol in July to push back against Montana's early rollout.
The implementation of work requirements in Montana and other states has raised concerns about the potential impact on vulnerable populations. The state's experience may offer a preview of what will happen nationwide next year, when all states must implement the new work requirements.
Key points
- Nearly 71,000 people in Montana are subject to the new Medicaid work requirements.
- The state has started enforcing the requirements on Oct 1, after a soft launch in July.
- Medicaid advocates worry that the expedited timeline will lead to thousands of people losing coverage due to confusion about the new rules.
