Medicaid Expansion is Also a Workforce Development Tool

Medicaid expansion’s benefits in Montana are well-documented – from increased revenue and jobs, better health, and a stronger behavioral health system, to shoring up rural hospitals and benefiting private businesses. Montana Healthcare Foundation’s recently released Medicaid in Montana 2022 annual report adds to the pile of evidence showing how Montana’s version of expansion, the HELP Plan, has been good for Montana’s workforce and the economy.

As the state prepares for the end of the public health emergency and the great “unwinding” of Medicaid enrollment, let’s not forget the role that Medicaid has played, and continues to play, in workforce development. Under pandemic continuous enrollment rules, HELP Plan enrollment grew to 113,850 by January 2022, at the same time that unemployment dropped to a new record low of 2.3% in March of 2022.

Even before the pandemic, Montana’s workforce and economy looked different from the rest of the nation, with needs that Medicaid expansion was uniquely poised to meet.

• Montana had the highest share of residents employed by small businesses of any state in 2019.
• Montana has more seasonal and part-time businesses compared to other states, with ~50,000 more jobs in the summer months, primarily in the tourism and service industries.
• Only 40.8% of employers in Montana offered healthcare insurance in 2019 (sixth lowest in the nation, higher than only Wyoming, Alaska, Utah, Vermont, and Florida).
• A 2019 study revealed that 60% of Montana businesses had at least one employee enrolled in the HELP Plan, and 41% had more than 25% of staff enrolled, “representing significant reliance by these employers on Medicaid to provide employee health insurance.”

Medicaid expansion has been crucial to the health of Montana’s workforce during the pandemic; sick, absent workers aren’t the most productive employees. Medicaid expansion allows those sick workers caught in the coverage gap to access the healthcare they need to stay healthy and on the job. And when businesses closed down at the start of the pandemic, Medicaid largely filled the coverage gap created by employment losses. Expansion also supports higher workforce participation rates and increased job mobility that may just be the key to giving workers the security they need to upskill and fill the 10,000 new jobs over $50,000 that the Gianforte administration aims to bring to the state.

Don’t believe the numbers? I’m here to tell you that it worked for me. During the Great Recession, I went back to school and would have qualified for Medicaid expansion coverage if not for the school’s health insurance. Upon graduating I moved cross-country for a position that aligned perfectly with my new skills and interests but offered no benefits. I could take that risk because there was a safety net available, and it paid off six months later when I moved into a full-time position with benefits. I ended up staying with the same employer for another seven years, advancing up the ranks before bringing my skills and experience to Montana.

Did access to affordable healthcare improve my health? Maybe. I was young and healthy to start, with few healthcare needs. What it did do, without a doubt, is provide the security I needed to improve my job prospects and economic situation. The resulting economic security has had a longer-term impact on my health than any clinical care I’ve ever received.

As Montana’s economy continues to recover from the pandemic, let’s not forget the critical role Medicaid expansion has played, and continues to play, in workforce development and economic prosperity.