State lawmakers have kicked off this legislative session’s debate over Medicaid expansion, introducing three bills with different visions for preserving — or eliminating — the federally subsidized healthcare program.

Policymakers, advocates and medical professionals have long been bracing for a fight over Medicaid this year. In 2015, a bipartisan coalition of legislators expanded Medicaid to adults with incomes up to 138 percent of the federal poverty level, newly allowed following the passage of the Affordable Care Act. Four years later, lawmakers voted to extend the program to 2025, while also adding work requirements. (Those requirements were blocked by the Biden administration and never took effect, though that could change with a Republican White House). Rep. Ed Buttrey, R-Great Falls, known for cross-aisle coalition building, carried both bills.

Now, the moderate Republican is carrying one of the proposals to eliminate the program’s sunset and preserve Medicaid expansion in Montana.

“If as legislators we choose to bury our heads in the sand and ignore the physical and mental needs of our low-income population in Montana, to ignore the addiction issues that we have and ignore the value of a healthy and unaddicted workforce, we will pay for it down the road,” Buttrey said during a committee hearing on his bill, House Bill 245, on Jan. 20. “And we’ll pay a heck of a lot more than we’re paying now.”

Rep. Ed Buttrey, R-Great Falls, opens a hearing on House Bill 245 last week.

No matter what happens, huge swaths of the state will be impacted. Almost 77,000 Montanans rely on Medicaid expansion for healthcare, according to data from the state Department of Public Health and Human Services. Some healthcare providers — particularly in rural areas — rely on billing through Medicaid expansion to stay afloat. And the federal government pays for almost all of it — about 90 percent of what was a $2.4 billion program last fiscal year.

The city of Missoula is also closely watching the Medicaid debate.

“It would have implications for the city,” Mayor Andrea Davis previously told The Pulp. “When people don’t have consistent access to healthcare, you start to see their lives unravel.”

She noted that Medicaid access is especially important for homeless Missoulians. The city’s mobile support team, for example, can bill Medicaid.

“When people don’t have consistent access to healthcare, you start to see their lives unravel.”

Other visions for Medicaid expansion include Helena Democratic Rep. Mary Caferro’s House Bill 230, which removes the sunset, strips the work requirements and provides 12 months of continuous eligibility. The bill also calls for reopening shuttered public assistance offices in rural Montana.

Republicans hold a solid majority in the Legislature, but are not unified around Medicaid expansion, a dynamic that has long required pro-Medicaid Republicans to build coalitions with Democrats. Caferro and Buttrey have worked together on several Medicaid-related efforts.

The split in the GOP is evident in Senate Bill 62, carried by Sen. Carl Glimm, R-Kila. His bill would phase out Medicaid expansion, halting new enrollment beginning Sept. 1. His comments in support of the bill echo common arguments among Republican hard-liners — that Medicaid expansion is too expensive and that it discourages people from finding work.

“People that don’t qualify anymore will start to work themselves off and eventually we would not have anybody on Medicaid expansion,” Glimm told a committee this week. The bill, if passed, could potentially cause the state to lose $1.5 billion in federal funds over the next two years.

For more in-depth reporting on Medicaid expansion, check out these stories from Montana Free Press and the Helena Independent Record.

Missoula-area legislators, meanwhile, have been busy with several property tax relief proposals, another major focus of this year’s legislative session. Property taxes in Montana have risen dramatically in recent years as real estate values have spiked and, due to the state’s zero-sum approach to tax collection, shifted the burden to residential property owners — which only further exacerbates the housing crisis. In Missoula, the median property tax bill was 18 percent higher in 2023 than it was in 2022, according to a Montana Free Press analysis from December of 2023.

Democratic Rep. Jonathan Karlen’s House Bill 154 would distribute income tax credits to renters and homeowners making up to $150,000 a year. The size of the credit would depend on the individual’s property taxes relative to income. Renters would receive credit based on their rent relative to income.

“This bill is the backstop that ensures our constituents don’t receive a property tax burden that exceeds their ability to pay,” Karlen said during a committee hearing this week.

Another Missoula Democrat, Rep. Mark Thane, has brought forth House Bill 155, which would exempt the first $50,000 of the market value of a piece of residential property from taxation and the first $200,000 for commercial property.

History and the partisan split of the Legislature indicate that while the Democratic bills might make it out of committee, they are unlikely to receive a passing vote from the whole body. That’s especially true when Republican Gov. Greg Gianforte is throwing his weight behind House Bill 231, a proposal carried by longtime legislative budget architect Rep. Llew Jones, R-Conrad, that would slash property taxes on primary residences while shifting the burden to short-term rentals and second-home owners.

The governor has asked legislators to fast track the bill, though it has drawn opposition both from progressives who argue the bill won’t go far enough to help low-income Montanans and chamber-of-commerce types who worry about the impact to tourism. The Helena Independent Record has more on the property tax debate here.

Another shake-up at the Missoulian

The Missoulian last week named Laura Scheer, previously the paper’s city editor, as its new editor.

Scheer began her tenure at the paper in 2016 as an assistant news editor then worked several reporting beats before being tapped as city editor in March of 2021, according to the Missoulian.

“I’ve been part of the Missoulian staff for almost 10 years now, and I feel incredibly lucky to be able to lead such a talented and dedicated group of journalists,” Scheer said in a Missoulian story announcing her promotion. “We remain committed to the truth and serving as a watchdog over our community, which feels more important than ever.”

Anne Cruikshank, who previously worked as the digital editor for all of Lee Enterprises’ Montana newspapers, was promoted to city editor.

In announcing Scheer’s new job, the Missoulian story also quietly noted the departure of her predecessor, Steve Kiggins, after just over a year at his post. Kiggins also had an extra job title or two — not only was he the Missoulian’s editor, he was also named director of all Lee’s Montana papers and “director of local news on a seven-person news leadership team, a position that additionally has oversight of news operations in eight other states,” according to a Missoulian story from December 2023.

It’s not clear why Kiggins “recently left the company,” as this week’s story put it, or what will become of his statewide responsibilities. Neither Kiggins or Scheer returned requests for comment from The Pulp.

A spokesperson for Lee Enterprises says the company does not comment on personnel matters.

“We can’t think of a better news editor to serve our Missoula readers than Laura Scheer,” Marc Chase, senior director of local news for Lee Enterprises, said in the Missoulian story. “Laura cares deeply for and understands the community, her newsroom and Montana as a whole. She already commands the respect of her staff, and we’re thrilled to have her as the one leading the charge for journalism in Missoula.”

Plower to the people

The city of Missoula is asking residents to help name three of its snowplows.

Missoulians submitted 388 names to the city earlier this winter. That list has since been narrowed to a hallowed 20. There’s “the Big Leplowski,” “Austin Plowers,” “Thaw Enforcement” and more – you get the drift.

You can choose three favorites of the 20 names here. Voting is open until Feb. 4, and the city will announce the winner during the Feb. 10 city council meeting.

The ledger #️⃣

$1.12M

This year’s opioid settlement funds a joint city-county board is in the process of divvying up — “simply not enough money for the harm that has been caused,” Missoula City Council President Amber Sherrill said last week, as quoted by the Missoulian.