Medicaid Expansion Works for Every County in Montana

Tara Jensen | March 2019 | Presented by the Montana Budget & Policy Center

Since Montana passed the bi-partisan Health and Economic Livelihood Partnership (HELP) Act in 2015, Medicaid expansion has been a vital source of health care coverage for nearly 100,000 Montanans. Each of Montana’s 56 counties is home to individuals, families, and workers who have benefitted from both preventive health services that detect treatable health concerns early and access to behavioral health services, such as counseling, addiction treatment services, and medications for mental illness.

All corners of our state benefit from Medicaid expansion. The program has been critical for the 18,000 businesses – large and small – across the state that have at least one employee enrolled. It has also helped thousands of Montanans find new and better employment opportunities and brought in millions of federal dollars now flowing through local economies.

Highlights of the data include:

County enrollment in Medicaid expansion ranges from 27 enrollees in Petroleum County (Winnet county seat with total county population of 523) to 14,118 enrollees in Yellowstone County;
In Ravalli County alone, 1,440 Montanans have accessed inpatient and outpatient treatment services for mental health needs;
Over 44,000 Montanans accessed counselors, doctors, support groups, or medication to treat and manage mental health issues or addiction;
7,034 have received colon cancer screening, averting 2,554 possible cases of colon cancer;
More than 92,380 Montanans have accessed 300,000 preventive care services;^[1]
Every county had at least 30 percent of their businesses employing at least one Medicaid-covered worker;^[2] and
The Department of Labor and Industry provided approximately 29,000 Montana Medicaid clients with a variety of workforce services.^[3]

Montana Medicaid expansion has proven to be a successful program, one that helps working families, employers, and the broader economy. From Carter County to Lincoln County, Medicaid expansion is working for Montana. The 2019 Legislature has all the facts it needs to reauthorize this bi-partisan, Montana-made health insurance program in its current form.

Appendix A provides county-specific data for Medicaid expansion total enrollment and percent of county population.^[4]

Appendix B provides county-specific data for the number of Medicaid enrollees who have received preventive screenings, and the total number of total preventive health care services for Medicaid enrollees.^[5]

Appendix C provides county-specific data for the number of Medicaid enrollees who have accessed inpatient and outpatient mental health services and substance use disorder treatment services.^[6]

Appendix D provides county-specific data for the number of Medicaid enrollees in Montana who use HELP-Link.^[7],[8],[9]

Appendix A: Medicaid Expansion Total Enrollment and as Percent of County Population, January 2019

	Total Enrollment	As Percent of Population		Total Enrollment	As Percent of Population
Beaverhead	771	8.3%	Madison	394	5.0%
Big Horn	2229	16.8%	Meagher	243	13.1%
Blaine	780	11.8%	Mineral	507	11.9%
Broadwater	349	6.2%	Missoula	11,314	10.0%
Carbon	762	7.3%	Musselshell	499	10.9%
Carter	48	4.1%	Park	1,507	9.5%
Cascade	7322	8.9%	Petroleum	27	5.6%
Chouteau	332	5.6%	Phillips	353	8.4%
Custer	896	7.4%	Pondera	823	13.2%
Daniels	60	3.4%	Powder River	74	4.2%
Dawson	493	5.2%	Powell	631	9.1%
Deer Lodge	961	10.5%	Prairie	62	5.4%
Fallon	160	5.2%	Ravalli	4,024	9.8%
Fergus	821	7.2%	Richland	648	5.6%
Flathead	8,905	9.4%	Roosevelt	1,837	16.2%
Gallatin	6,501	6.7%	Rosebud	1,086	11.6%
Garfield	72	5.5%	Sanders	1,322	11.6%
Glacier	2,690	19.6%	Sheridan	180	4.9%
Golden Valley	120	14.1%	Silver Bow	4,192	12.1%
Granite	194	6.1%	Stillwater	520	5.6%
Hill	2,085	12.6%	Sweet Grass	196	5.4%
Jefferson	619	5.4%	Teton	570	9.4%
Judith Basin	149	7.5%	Toole	499	9.7%
Lake	3,784	13.0%	Treasure	60	8.7%
Lewis and Clark	5,639	8.6%	Valley	527	6.9%
Liberty	218	9.2%	Wheatland	279	13.3%
Lincoln	2,317	12.1%	Wibaux	39	3.5%
McCone	165	9.7%	Yellowstone	14,118	9.1%

Total Statewide Medicaid Expansion Enrollment 95,973 adults; 9.4% of the state population.

Appendix B: Medicaid Expansion Enrollees Who Have Accessed Preventive Screenings and Total Preventive Health Care Services, January 2019

	Breast Cancer Screening	Colon Cancer Screening	Preventive Services		Breast Cancer Screening	Colon Cancer Screening	Preventive Services
Beaverhead	86	71	836	Madison	45	37	405
Big Horn	73	142	2,012	Meagher	27	25	257
Blaine	61	54	780	Mineral	42	37	499
Broadwater	38	27	386	Missoula	870	666	11,689
Carbon	88	71	806	Musselshell	44	44	559
Carter	5	5	44	Park	100	114	1,520
Cascade	931	678	8,069	Petroleum	5	< 5	25
Chouteau	42	32	348	Phillips	31	25	390
Custer	86	65	922	Pondera	67	53	776
Daniels	< 5	< 5	66	Powder River	< 5	< 5	73
Dawson	33	31	530	Powell	60	54	662
Deer Lodge	62	93	1,027	Prairie	7	< 5	51
Fallon	11	9	153	Ravalli	323	352	4,123
Fergus	75	98	910	Richland	76	45	660
Flathead	1,024	813	9,547	Roosevelt	69	92	1,590
Gallatin	424	407	6,249	Rosebud	37	43	848
Garfield	7	5	71	Sanders	153	135	1,316
Glacier	103	102	2,021	Sheridan	19	10	185
Golden Valley	22	13	127	Silver Bow	336	280	4,399
Granite	20	16	211	Stillwater	53	40	512
Hill	169	113	2,156	Sweet Grass	13	16	174
Jefferson	64	60	760	Teton	62	36	576
Judith Basin	22	16	137	Toole	38	25	429
Lake	356	293	3,904	Treasure	< 5	< 5	46
Lewis and Clark	434	514	5,989	Valley	45	49	595
Liberty	56	38	241	Wheatland	31	24	284
Lincoln	257	197	2,428	Wibaux	< 5	< 5	38
McCone	15	11	144	Yellowstone	1,022	1,004	14,748

Total Preventive Screenings and Total Preventive Health Care Services for Medicaid Enrollees

7,901 have received breast cancer screenings and 7,034 adults have received colon cancer screenings

Appendix C: Medicaid Expansion Enrollees Who Have Accessed Inpatient and Outpatient Services for Mental Health and Substance Use Disorders, January 2019

	Mental Health Outpatient	Mental Health Inpatient	SUD Outpatient	SUD Inpatient		Mental Health Outpatient	Mental Health Inpatient	SUD Outpatient	SUD Inpatient
Beaverhead	272	16	67	15	Madison	88	< 5	15	< 5
Big Horn	448	38	126	38	Meagher	28	9	5	< 5
Blaine	224	16	23	16	Mineral	176	16	56	< 5
Broadwater	107	6	18	< 5	Missoula	5,109	554	883	225
Carbon	226	40	37	10	Musselshell	123	10	49	6
Carter	8	< 5	< 5	< 5	Park	544	38	170	37
Cascade	2,716	315	752	204	Petroleum	0	< 5	< 5	< 5
Chouteau	49	11	8	< 5	Phillips	68	6	24	< 5
Custer	413	39	155	25	Pondera	141	15	13	9
Daniels	6	< 5	< 5	< 5	Powder River	10	< 5	7	< 5
Dawson	211	22	122	21	Powell	166	15	49	14
Deer Lodge	359	21	155	17	Prairie	14	< 5	< 5	< 5
Fallon	38	6	15	< 5	Ravalli	1,340	100	277	51
Fergus	240	32	66	20	Richland	186	22	113	36
Flathead	2,829	381	471	116	Roosevelt	446	21	61	34
Gallatin	2,147	89	443	98	Rosebud	254	48	62	38
Garfield	12	< 5	< 5	< 5	Sanders	326	36	71	19
Glacier	569	40	28	35	Sheridan	47	8	21	< 5
Golden Valley	15	6	6	< 5	Silver Bow	1,611	81	760	100
Granite	35	5	10	< 5	Stillwater	127	13	26	8
Hill	759	39	271	92	Sweet Grass	47	5	16	6
Jefferson	215	13	60	6	Teton	101	13	14	< 5
Judith Basin	19	< 5	< 5	< 5	Toole	122	12	16	7
Lake	1,211	83	361	106	Treasure	11	< 5	< 5	< 5
Lewis and Clark	2,239	200	606	125	Valley	176	23	71	< 5
Liberty	23	5	5	< 5	Wheatland	42	12	10	< 5
Lincoln	738	52	174	31	Wibaux	8	< 5	< 5	< 5
McCone	22	< 5	6	< 5	Yellowstone	5,836	878	1,708	560

Total Medicaid Enrollees Who Have Accessed Inpatient and Outpatient Services for Mental Health and Substance Use Disorders

30,980 adults have received outpatient mental health services

3,291 adults have received inpatient mental health services

7,837 adults have received substance use outpatient services

2,099 adults have received substance use residential services

Appendix D: Businesses Employing Medicaid Expansion Clients by Total Number and as Percentage of All Businesses, and Total Number of HELP-Link Clients, January 2019

	Businesses Employing Enrollees	Percent of Businesses	HELP-Link Clients		Businesses Employing Enrollees	Percent of Businesses	HELP-Link Clients
Beaverhead	179	60.1%	203	Madison	156	56.5%	74
Big Horn	87	55.8%	560	Meagher	38	61.3%	22
Blaine	65	65.7%	162	Mineral	52	74.3%	88
Broadwater	60	52.2%	83	Missoula	1,836	61.8%	3,508
Carbon	151	57.9%	96	Musselshell	51	55.4%	87
Carter	9	37.5%	6	Park	316	57.6%	339
Cascade	998	60.8%	2,942	Petroleum	6	75.0%	3
Chouteau	57	55.9%	48	Phillips	57	55.9%	62
Custer	177	61.9%	448	Pondera	57	45.6%	129
Daniels	17	34.7%	4	Powder River	28	49.1%	7
Dawson	96	48.5%	288	Powell	63	56.8%	161
Deer Lodge	89	59.3%	317	Prairie	13	54.2%	18
Fallon	50	45.5%	25	Ravalli	555	58.7%	1,056
Fergus	164	56.9%	345	Richland	151	41.0%	358
Flathead	1,614	60.8%	2,401	Roosevelt	97	64.7%	613
Gallatin	1,873	51.5%	1,360	Rosebud	76	57.1%	175
Garfield	15	53.6%	7	Sanders	168	69.7%	391
Glacier	94	63.9%	705	Sheridan	52	46.0%	24
Golden Valley	11	91.7%	6	Silver Bow	457	64.0%	1,334
Granite	39	62.9%	28	Stillwater	70	43.5%	101
Hill	210	63.6%	850	Sweet Grass	55	47.0%	18
Jefferson	104	54.5%	151	Teton	88	56.4%	73
Judith Basin	22	44.0%	18	Toole	64	54.7%	102
Lake	360	67.3%	1,629	Treasure	5	31.3%	5
Lewis and Clark	845	54.7%	1,930	Valley	110	62.1%	200
Liberty	23	46.9%	17	Wheatland	35	57.4%	19
Lincoln	302	67.7%	924	Wibaux	6	30.0%	8
McCone	16	40.0%	10	Yellowstone	2,009	53.3%	4,207

Endnotes

^[1]Department of Health and Human Services, “Montana Medicaid Expansion Dashboard,” accessed Mar. 7, 2019.

^[2] Department of Labor and Industry, “Montana Medicaid and Montana Employers,” Jan. 8, 2019.

^[3]Department of Labor and Industry, “DLI Clients by County 1-16-19,” MBPC information request, received on Jan 16, 2019, on file with author.

^[4] Department of Health and Human Services, “Montana Medicaid Expansion Dashboard,” accessed Mar. 7, 2019.

^[5] Department of Health and Human Services, “Montana Medicaid Expansion Dashboard,” accessed Mar. 7, 2019.

^[6] Department of Health and Human Services, “Montana Medicaid Expansion Dashboard,” accessed Mar. 7, 2019.

^[7] Department of Labor and Industry, “HELP-Link Program 2018 Fiscal Year End Report,” Dec. 2018.

^[8] Department of Labor and Industry, “Montana Medicaid and Montana Employers,” Jan. 8, 2019.

^[9]Department of Labor and Industry, “DLI Clients by County 1-16-19,” MBPC information request, received on Jan 16, 2019, on file with author.

Medicaid Expansion Works for Every County in Montana

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