Indian Country politics and public policy

Commentary by Mark Trahant

MARK TRAHANT

Montana will be the next state to expand Medicaid. Gov. Steve Bullock is expected to sign the bill authorizing expansion into law on Wednesday at noon.

Remember this is a Republican-controlled legislature — so I think it demonstrates that when people really look at the numbers, the number of jobs, the number of people insured, the reduction in uncompensated care for health facilities, the case for expansion is overwhelming.

The Montana Budget and Policy Center reports that there remains work to be done. From the Center’s post: “Next, the state will have to submit a section 1115 waiver to the federal government to expand coverage and receive increased federal funds. Section 1115 waivers allow states to pursue experimental, pilot, or demonstration projects that promote the objectives of Medicaid, namely to keep low-income families healthy. (It’s called “1115 waiver” for short, because of the section in the Social Security Act where this flexibility is provided.)” That process will require approval from the Centers for Medicaid and Medicare Services (or CMS). “The 1115 waiver process is an important step, and we will be closely following it. 70,000 Montanans are depending on it.”

The Montana Budget and Policy Center also submitted an op-ed for publication. I’ll post that shortly.

Western Native Voice reports: Native Americans working for progressive change in Montana Indian communities will rally before the Medicaid expansion bill signing ceremony Wednesday, April 29th, at 11:30 AM on the stairs of the Capitol. Coming together to celebrate Medicaid expansion and all the other important legislative achievements for Montana Indians, the rally will also focus on the road ahead to building civic power in Native communities

In Alaska the outcome over Medicaid expansion is still unknown. The Alaska Legislature has not been keen on expansion despite a push from the Gov. Bill Walker.

The Republican strategy against Medicaid expansion focuses on reimbursement rates for Medicare, pitting seniors against those eligible for Medicaid (including the Alaska Native medical system). What’s interesting to me is that the job picture has not been a part of the debate when the evidence in every other state that has expanded Medicaid is that new jobs were added.

Two other Montana legislative developments: Enacting a water rights settlement and improving the funding for tribal colleges. The new law authorizes an 8% increase to the per-student funding that tribal colleges receive for non-Indian resident students, subject to appropriations, changing the distribution rate from $3,024 to $3,280 per non-Indian student. This is the first increase to the statute since 2006.

“In Montana, tribal colleges and universities benefit the state economy and provide an affordable option for quality post-secondary education,” said Laura John, State-Tribal Policy Analyst for the Montana Budget and Policy Center. “House Bill 196 takes us one step closer to reaching adequate funding levels needed to support Montana’s non-tribal students.”

The governor called the legislature back into special session. So there will be more twists and turns ahead.

I also wrote a few weeks ago about price of oil and its impact on Keystone, the tar sands, and other debates over energy policy versus the environment.

Two pieces are worth looking at. First, a Brookings report that says low oil prices are here to stay. (The reason is simple: Excess capacity, reduced consumption and lots of oil being pumped by every concern.) As the report points out: “The U.S. and its neighbor Canada have both increased oil output, and their response to the fall in oil prices has been to reduce the pace of production growth by reducing capital investment, but output and capacity continues to grow.”

Today Bloomberg posted five charts that tell the story quickly.  “Before deciding prices will race back to $100, here are five charts worth keeping in mind.”

2 thoughts on “Updates: Medicaid expansion in Alaska, Montana — and oil prices.

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