Working folks need coverage

Since the 2013 Legislature rejected the federally offered Medicaid expansion, an estimated 69,000 Montana adults are in a health-insurance limbo. They don’t make enough money to qualify for tax credits or federal subsidies to help them purchase their own insurance on the federal and state exchanges, but they make too much income to be eligible for Medicaid. This coverage “gap” is forcing adults who work at low-paying jobs, often for small businesses that don’t offer health insurance, to risk medical bankruptcy, to overburden emergency rooms and to forego prevent active care. In Teton County, as of June 2014, an estimated686 people are covered under Medicaid, according to the state. The Montana Budget and Policy Center estimates that another 412 adults — those making up to 138 percent of the federal poverty level or about$16,100 a year — would be eligible for health-insurance coverage if the 2015 Legislature would adopt the federal Medicaid expansion. The Budget and Policy Center estimates that enrolling those people would generate an additional $2.3 million in Medicaid spending, which, going through the local economy would generate an additional 80 jobs per year and increase labor income by $3,257,000 a year. Teton County is hurting because people are going without coverage — and not just low-income working people. According to the most recent audit of Teton Medical Center’s financials, 42 percent of the people who use TMC for care do not have any insurance. The U.S. Census estimates that 25.3 percent of Teton County’s population (1,534 people) do not have health insurance and 15.1 percent of our county’s 6,065 residents live in poverty. With nearly half of its clientele without insurance, TMC in fiscal year 2013-14 wrote off $115,917 in charity care and another $98,556 in bad debt — a staggering $214,473 right off the top of the struggling facility’s revenue and nearly two-thirds of the facility’s $342,171 operating loss. Both the Democrats and the Republicans have proposals to extend health-insurance coverage options to those caught in this “gap.” We aren’t endorsing either plan at this time, but we want to encourage legislators to take action to make sure that hard-working, but low income Montanans have access to healthcare. Even the Montana Chamber of Commerce supports action as long as it is privately managed. The Chamber of Commerce cites a telephone poll it conducted last November, in which 800 voters were contacted and a majority supported providing healthcare coverage for childless, adult Montanans whose income is below $16,100 a year (according to a Bozeman Daily Chronicle article). The voters of Montana elected our legislators to govern the state and to address significant challenges facing its residents. This is one such challenge that the men and women serving in Helena now must rise to and come up with a plan that addresses the concerns of both Republicans and Democrats and, in the end, benefits these workers and their communities.