Update: The Economic Effects of Medicaid Expansion in Montana

The most recent in a series of studies analyzing the economic impacts of Medicaid Expansion in Montana shows that “Medicaid expansion generates health, well-being, and economic opportunity for Montanans at minimal (or no) cost to the state budget.” (page 1) The expansion increases health insurance coverage and healthcare access which improves the physical and financial health of individuals and families, while creating jobs and income for Montanans, and increasing revenue for healthcare providers and the state. 

The 2023 report update includes two new analyses – an examination of the impact of Medicaid expansion across Montana counties, and a deeper look at employment and barriers to employment among Medicaid beneficiaries. Here’s what we learned: 

When looking at impact by county, enrollment by share of population, decline in uninsurance and number of jobs supported by the Expansion vary, with healthcare centers (like Yellowstone and Missoula counties) benefiting most. Look up your county here.   

When looking at employment and barriers to employment amongst Montana’s Medicaid expansion beneficiaries, 

• 60% of beneficiaries work full time, hope to work full time, or are in school. 
• Nearly all of the remaining 40% work part-time or report a plausible impediment to full-time work such as disability or caregiving responsibilities. 
• Only 4% of beneficiaries report no work and no impediments to work. 
• People move into and out of Medicaid, with 25% of Montana’s adult population reporting Medicaid coverage at any point in the 4-year period from 2017 to 2021. (Most beneficiaries are enrolled for less than two years.) 
• Many of Montana’s essential workers report enrollment in Medicaid, including 31.8% of childcare workers, 31.5% of food preparation workers, and 26.3% of personal care aides. 

The fact that most Medicaid beneficiaries are working and don’t stay on the program for long periods tells us that Medicaid is indeed a safety net program as people transition in and out of private or employer-sponsored insurance. This safety net is of particular importance to people who work in essential yet underpaid industries that were under acute stress during the pandemic. 

Take a deeper dive into the updated (2023) report here. 

This updated study is especially relevant now because: 

• Starting on April 1, the continuous enrollment provision which was enacted during the pandemic will begin to unwind. In order to maintain improvements in uninsurance, healthcare access, and economic resilience, it is imperative that people don’t lose coverage in the transition and are able to enroll in whatever insurance is right for them.
• Up for debate for Montana state leaders during the legislative session is increasing Medicaid reimbursement rates to healthcare providers, who are still stressed from the pandemic and historically low reimbursement rates.  
• Montana’s childcare system, which was already struggling pre-pandemic is especially in crisis and Medicaid is a crucial support to that workforce. 

Headwaters Foundation is committed to reducing barriers to health alongside those who face them most, including Montana’s Medicaid beneficiaries. That’s why, since 2018, Headwaters Foundation has partnered with Montana Healthcare Foundation to commission a biannual report on the economic impacts of Medicaid Expansion in Montana. This is the fourth update of the original report. 

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Share this important information on social media! Sample posts: 

• Report update confirms that Medicaid expansion in Montana continues to generate health, well-being, and economic opportunity for Montanans at minimal (or no) cost to the state budget. Learn more here! 
• Did you know? 60% of Montana’s Medicaid expansion beneficiaries work full time, hope to work full time, or are in school. Nearly all of the remaining 40% work part-time or report a plausible impediment to full-time work (such as disability or caregiving responsibilities). Learn more here! 
• Did you know? Many of Montana’s essential workers report enrollment in Medicaid, including 31.8% of childcare workers. Learn more here!