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At MNA, we believe that we cannot create vibrant, healthy communities when people are left behind – when policies benefit the few at the expense of the many. Or when programs meant to support people through their hardest times are filled with barriers and exclusions. Yet increasingly, it feels like our world is moving away from the values of belonging and inclusion that nonprofits work every day to uphold.
Right now, Medicaid is at the center of both national and state debates, with upcoming policy changes expected to leave 34,000 Montanans without health coverage. Through the federal reconciliation bill passed this summer, Congress advanced the most significant cuts to Medicaid in the program’s history, cutting more than $900 billion by adding new bureaucracy and red tape that will push millions of people, including those who are working, acting as caregivers, and facing significant health challenges, off the program.
Work reporting requirements do not support employment. Instead, they serve as barriers, requiring people living on low incomes, who often have limited transportation, inconsistent work schedules, and reduced access to technology, to navigate complex reporting systems – making it easy to lose coverage despite meeting the requirements. Additionally, state processing delays and long wait times on the state helpline increase the risk of eligible Montanans becoming lost in bureaucracy and losing Medicaid coverage. Cruelly, if an individual falls off Medicaid because they are not able to navigate new work reporting requirements, they are also barred from receiving subsidized Marketplace coverage, leaving them with no options for affordable health coverage.
Just as families prepare to navigate extensive new requirements and complex systems, the support available to them is being dismantled. Earlier this year, the federal government eliminated nearly all funding for healthcare navigators – people trained to help individuals understand their options and enroll in coverage. In Montana, that means a devastating loss for Cover Montana, a trusted program that has helped tens of thousands of Montanans access care.
At the same time, Montana DPHHS is advancing a waiver that would allow the state to move even faster than federal rules require in implementing new barriers and costs for Montanans enrolled in Medicaid. The state of Montana will shoulder the costs to make these changes, with DPHHS requiring an estimated 40 to 50 new employees, along with technology and systems upgrades – all to implement policy changes that will leave more Montanans uninsured. MNA submitted public comments to the state on this proposed waiver, voicing our concerns for what these changes will mean for families and rural communities in our state. We are preparing comments for the open federal comment period now.
The effects of these policy changes will be felt deeply here in Montana. Cuts to Medicaid are not just about healthcare. They are about whether Montanans can care for their families, whether our neighbors can contribute fully to their communities, whether our rural hospitals can afford to provide care and remain open – and whether our policies and systems are grounded in equity and inclusion.
Our work across the nonprofit sector is interconnected and every part of our communities will feel the impacts of Medicaid cuts, along with funding losses and program cuts affecting the arts, conservation, food assistance programs, education, and so many other areas.
As we see policy changes coming at us quickly and seemingly indiscriminately, one thing that we continue to hear from you, our members, is that we are stronger together – and we couldn’t agree more.
At MNA, we are striving to use our voice more loudly and more often, advocating on issues that go to the heart of our values and our role as a sector. Together, nonprofits can tell the story of what is happening on the ground, elevate the voices of those most impacted by policy decisions, and continue to advocate for communities that value and uplift all Montanans. This work is more important than ever.
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