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Our Work Medicaid and Health Policy

Analyzing practical policy solutions to crucial health systems challenges.

We provide in-depth information on critical health issues and timely analysis of proposed policy solutions so Montanans can reach informed decisions on health system issues that may impact them.

State and federal health policy profoundly impacts the health and well-being of Montanans. Unfortunately, health policies are complex, the timing of the policy process is unpredictable, and the political rhetoric around health care can be divisive. The stakes are high. We know that good health policy decisions depend on access to high-quality, timely, and easy-to-understand information, which is often hard to find. In this initiative, we use three basic strategies:

  1. Policy Analysis: We work with state and national experts to analyze key health care policy proposals, and provide high-quality, non-partisan information to the public and policy-makers throughout our state.
  2. Supporting Health Policy Organizations: We provide operating support for a small number of organizations that have a strong track record of effective work on policies that benefit Montanan’s health.
  3. Planning and Adaptation: We help state and Tribal health agencies find strategies to adapt and maximize the benefits of important state and federal policy changes.

We are committed to using our resources and expertise to provide the best information possible to inform health policy decisions and contribute to a measurably healthier state.

Findings from our reports contributed to policy decisions such as:

Reauthorizing Medicaid expansion and reducing the number of beneficiaries likely to lose coverage due to work requirements.

Creating a new reinsurance program which helped lower the cost of private health insurance premiums by 12%-15% in 2019.

Helping the state create changes that support the prevention and treatment of substance use disorders.


Providing 25% of Montanans with access to health care benefits and services based on their medical needs and life circumstances.

Montana’s Medicaid Program

Montana’s Medicaid program provides coverage for one-in-four Montanans (265,000 people).

Medicaid Expansion

Medicaid expansion covers an additional 90,000 Montanans with incomes at or below 138% of the Federal Poverty Line.

Analysis of Proposed Policy Changes

We commission data and analysis so that Montanans can understand how proposed health policy changes could impact the state.

Behavioral Health

Medicaid plays a significant role in supporting Montana’s behavioral health system, including the prevention and treatment of substance use disorders.

Health Coverage

A series of reports looking at how many Montanans have health coverage and what factors contribute to fluctuations in the uninsured rate.

2020 Report on Health Coverage & Montana’s Uninsured

For 2020, Montana’s uninsured rate was at approximately 9.3%, although that number could be as high as 11.1% due to factors detailed in the report.

2019 Report on Health Coverage & Montana’s Uninsured

For 2019, Montana’s uninsured rate was approximately 8.6%.

2018 Report on Health Coverage & Montana’s Uninsured

In 2018, Montana’s uninsured rate was at approximately 7.8%. This represents a decrease from 15% in 2015 before the state expanded Medicaid.


Through funding background studies, actuarial analysis, and facilitated discussions among state leaders, we supported the creation of Montana’s reinsurance program in 2019, which lowered private insurance premiums by up to 15% in its first year.

1332 State Innovation Waivers

This report examines 1332 State Innovation Waivers as a solution to stabilize Montana’s individual health insurance market.

Individual Market Stabilization – Reinsurance Analysis

This report looks at how creating a state claims-based reinsurance program could save Montanans 10%-20% percent on individual health insurance premiums.

Individual Market Stabilization – Medicaid Expansion Analysis

This report finds that Medicaid expansion had a significant impact on the insurance market, likely resulting in lower premiums on the individual market.