One Big Bad Bill for Montana Medicaid

As of this year, over 120,000 children are enrolled in the Healthy Montana Kids program statewide.

— May 19, 2025 —

In Montana, we made it clear. The State Legislature passed Medicaid expansion.

When it comes to Trump’s "Big Beautiful Bill," will our delegation in D.C. be cowards or will they stand up for the people?

As of 2025, more than 250,000 Montanans rely on Medicaid or related programs, including more than 120,000 children enrolled through Healthy Montana Kids and about 70,000 adults covered under Medicaid expansion.

Federal changes in this big, bad bill will have serious consequences for Montana, especially for Healthy Montana Kids (HMK), a cornerstone of children's health coverage across the state. HMK provides free or low-cost coverage to kids up to age 19 and has helped drastically cut the number of uninsured children across the state.

Governor Brian Schweitzer helped launch HMK by securing funding after voters approved a 2008 ballot initiative. Today, HMK combines Medicaid and the Children's Health insurance Program (CHIP) to cover children in working families where incomes are too high to qualify for traditional Medicaid, but too low to afford private insurance. A family of four earning up to $57,720 a year (185% of the federal poverty level) can qualify for Medicaid. Families earning up to $78,000 (250% FPL) may also be eligible for CHIP.

These programs ensure thousands of Montana kids from working families can get care like doctor visits, dental checkups, and eye exams, no matter their family’s income or where they live.

The Medicaid expansion passed by the legislature now also covers more than 70,000 adult residents. These programs are lifelines for families, especially in rural areas where healthcare options are limited.

If Trump's big, bad bill passes, already-strained communities will suffer. Mental health services, elder care, and local pharmacies will feel the impact. Added paperwork and red tape will disrupt care for those who have the least among us.

Cuts will hit rural hospitals hard. Some will scale back. Some may close. That means more delays, more risk, and less care for those who need it most. Increased state costs and guaranteed coverage losses are guaranteed,.

This bill means more government red tape and fewer jobs.

Medicaid expansion has been one of the most important economic drivers in Montana, supporting between 5,000 to 8,000 jobs and generating $350 to $560 million in personal income every year.

In nearly every rural community I visit, people still talk about the struggle to access medical care for families, veterans, and kids. Some travel miles for basic care. Some don’t make it in time. The Montana Farmers Union even offers, “Far Out and Waiting," a training program to help people respond to emergencies when no professionals are available.

This is life or death for Montana, for our families and for our kids.

State law includes a trigger: if federal contributions drop, Montana must find new funding for all of these Medicaid programs. If it can't, coverage will be reduced and tens of thousands, mostly kids, will lose health insurance.

Every Montanan should have access to timely, comprehensive care that keeps people healthier and reduces strain on emergency systems. Montanans want a healthier, more productive future.

This bad bill isn’t about “more jobs and less government.” It’s about fewer jobs, more suffering, and a mountain of federal red tape dumped on Montana’s working families and their kids. It’s a mistake for Montana and Daines needs to say so.

No Montanan asked for more bureaucracy in their doctor’s office. We didn’t ask for fewer nurses, fewer clinics, or fewer hospitals. We sure as hell didn’t ask for Washington politicians to gut a program we fought to pass here at home.

Medicaid expansion has saved lives, supported jobs, and kept rural healthcare afloat. Steve Daines and our Montana congressional delegation won't stand up to this betrayal of Montana values. I am and I will.