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Medicaid Expansion Repeal Impacts

Medicaid Expansion Repeal Impacts

New report analyzes the impacts for Montana if Medicaid expansion is repealed.


Bozeman, Mont., Mar 6, 2017 – An independent report released today projects that over 71,000 newly insured Montanans could lose access to medical care and that the state could lose over $284 million in critical health care funding if Congress repeals the Medicaid expansion. The Affordable Care Act (ACA or “Obamacare”) allowed states to extend Medicaid coverage to adults with incomes up to 138 percent of the federal poverty line. In 2015, Montana took advantage of this opportunity through the bipartisan Health and Economic Livelihood Partnership (HELP) Act. This report, commissioned by the Montana Healthcare Foundation (MHCF), analyzes the impacts of Montana’s recent Medicaid expansion, and the potential consequences if Congress repeals the program.

Other key findings in the report include:

  • Over 30,000 newly insured adults accessed preventive services (such as cancer and diabetes screening and dental visits) in the first year, which has the potential to prevent many more serious and costly illnesses in the future.
  • Montana’s hospitals experienced a 25 percent decline in bad debt and charity care. This is particularly important for many rural critical access hospitals that were struggling to keep their doors open to serve rural and frontier communities throughout the state.
  • Montana’s state government saved over $22 million in the first year as adults that previously received limited state benefits became eligible for the new program.
  • During the first six months of expansion, the Department of Corrections saved $1.3 million through Medicaid coverage for inmate hospitalizations, enabling the Department to reduce its supplemental budget request.
  • The Medicaid expansion created a new tool to combat substance abuse, one of the most deadly and expensive health problems in Montana as shown by criminal justice, foster care, and health statistics.
  • Prior to the Medicaid expansion, most Indian Health Service facilities in Montana were only able to refer patients for specialty care “when life or limb was at risk.” The Medicaid expansion has allowed access to cancer screenings and critically needed procedures for American Indians.


The HELP Act has strengthened Montana’s healthcare system, improved access to care, and provided a critical opportunity to make progress on substance abuse. This carefully researched report provides information that policymakers should consider in any plan to repeal or replace Montana’s Medicaid expansion.

Dr. Aaron Wernham,


MHCF contracted with nationally-recognized experts from Manatt Health to analyze the impact of a Medicaid repeal for Montana. “Like all 31 states that have expanded Medicaid under the ACA, Montana has seen the impact of expansion ripple through the economy and the state’s health care system, benefiting patients, providers and the state treasury,” said Deborah Bachrach, partner and co-author of the report. “All of the positive impacts detailed in the report are at stake in federal conversations about a possible repeal of Medicaid expansion.”

About Manatt Health

Manatt Health, a division of Manatt, Phelps & Phillips, LLP, is an integrated, multidisciplinary legal, regulatory, advocacy and strategic business advisory healthcare practice. Manatt Health’s experience spans the major issues re-inventing healthcare, including payment and delivery system transformation; Medicaid coverage, redesign and innovation; health IT strategy; health reform implementation; healthcare mergers and acquisitions; regulatory compliance; privacy and security; corporate governance and restructuring; pharmaceutical market access, coverage and reimbursement; and game-changing litigation shaping emerging law. With 90 professionals dedicated to healthcare—including attorneys, consultants, analysts, and policy advisors—Manatt Health has offices on both coasts and projects in more than 30 states. For more information, visit