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Initiative 185: Sides weigh in on pros and cons of proposal

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HELENA – One of the biggest issues on the November ballot is Initiative 185, which would extend Medicaid expansion in Montana — and raise tobacco taxes to help pay for it.

Opponents say extending the current Medicaid program would squeeze the state budget, by millions of dollars but supporters say the expansion has had a huge, positive effect in Montana — both medically, and economically.

Medicaid expansion, approved in 2015, is now providing government-funded health coverage to nearly 100,000 low-income adults in the state.

State money pays for part of the program – but supporters note that 90% is covered by the federal government – money they say has had a huge impact.

“It’s brought $500 million into the state, it has saved the state $50 million, it’s created 5,000 new jobs,” said Jesse Laslovich with SPL Health.

“I think it’s irrefutable in terms of bankruptcies that it has reduced. It’s been a lifeline to our rural hospitals, that so many people in this state rely on,” Laslovich added.

The program is set to expire next June.

I-185 would make Medicaid expansion permanent and raise tobacco taxes to help pay for the state’s share of the costs.

Two tobacco firms have spent $17 million to defeat I-185 – and hospitals and other health-care groups have spent nearly $8 million on the campaign to pass it.

Medical professionals say Medicaid expansion is improving health and saving money – such as diagnosing hundreds of cases of diabetes early.

“Almost 800 people have been diagnosed and treated for diabetes. Those are people who never would have known they had diabetes until they develop a complication from diabetes,” said Helena family physician Dr. Todd Wampler.

“Then they’re going to end up in the emergency room, the hospital, and if they don’t have insurance, well, then, the hospital is going to end up eating that cost.,” Dr. Wampler added.

But opponents of I-185 say the program has simply become too big, too wide-open and too expensive for taxpayers. They say defeating I-185 is necessary, to the next Legislature can trim back Medicaid expansion.

“It’s not the Legislature’s intent to simply turn our back on those 100,000 people. But it is our intent to make significant changes to the underlying policy, such that we would qualify the right people, that there are work requirements, that there are true asset tests,” said Rep. Nancy Ballance (R-Hamilton).

Supporters say they think the program is doing the job it’s meant to do now.

“In the long run, it’s a lot better for all of us, even if you ignore the fact that it’s just the right thing to do – to make sure that we have as many people with access to health care as possible,” Dr. Wampler said.

-Mike Dennison reporting for MTN News