Montana House Advances Medicaid Expansion

HELENA -- The Montana House of Representatives voted 61-37 Saturday to pass a controversial bill to extend Medicaid expansion.

The expanded program has enrolled nearly 96,000 Montanans to receive subsidized health insurance. The federal-state partnership was first passed into law in 2015 and includes a 90 percent funding match from the federal government through the Affordable Care Act.

Rep. Ed Buttrey, R-Great Falls, is carrying House Bill 658. It includes new requirements for some recipients to work or complete some form of "community engagement" to continue to receive benefits. It would also test recipients for assets other than income.

"This is good policy, not just for our most needy but for all the taxpayers that fund this program in Montana," Buttrey said.

Rep. Dennis Lenz, R-Billings, is chair of the House Human Services Committee and said the bill had been rushed. The bill was introduced Mar. 12, had a hearing on Mar. 16 and was voted out of committee on Mar. 26.

"We needed to be able to look at this longer," Lenz said.

The original bill was significantly amended between the hearing and the committee vote.

Some of the amendments included putting the Department of Public Health and Human Services in charge of tracking the new requirements, and creating an six-year expiration date for the program if the work requirements are found to be unconstitutional.

A federal judge ruled work requirements unconstitutional last week in Kentucky and Arkansas, where similar programs have been implemented. The states will likely appeal to the U.S. Supreme Court, and it could take years to be resolved.

The committee voted on two competing expansion bills. Rep. Mary Caferro, D-Helena, sponsored House Bill 425, which would have kept the program similar to what it looks like now, but would have made it permanent. It was tabled in committee and is likely dead.

Bill Asks For Transparency In Prescription Cost Increases

As the cost of prescription drugs continues to rise, one bill moving through the Montana Legislature would require pharmaceutical manufacturers to provide information on why the price of a drug has increased.

Rep. Katie Sullivan, D-Missoula, is carrying House Bill 710. She says she has a personal motivation because her husband has a chronic pain condition that requires prescription drugs costing up to $9,000 a month.

Luckily, Sullivan said, their health insurance covers the cost. But she said that doesn't solve the high cost itself, meaning insurance companies, Medicaid and Medicare calculate that high cost into premiums.

"Even though insurance is paying for my husband's medication, the expense does not disappear," Sullivan said.

The bill would require drug manufacturers to submit a transparency report that justifies why a prescription has increased in price. The report would be required if a price is hiked 10 percent or more, and if the drug costs more than $100.

The bill passed its first vote in the House 87-13.

Sullivan made clear that these reports are for research purposes, not price fixing. She said the bill would help identify the key drivers of drug price inflation.

Representatives from the Montana Medical Association, BlueCross BlueShield of Montana, PacificSource Health Plans, AARP and the Office of the Montana State Auditor spoke in support of the bill in a Wednesday hearing in the House Business and Labor Committee.

Laura Vachowski spoke in support representing AARP. She cited a survey the organization conducted with likely voters on prescription drugs prices.

"Seventy-two percent of the respondents were concerned about the cost of the medications and nearly 40 percent of the respondents said they did not fill a prescription because of the high cost," Vachowski said.

Dana Malick, a lobbyist for Pharmaceutical Research and Manufacturers of America spoke in opposition to the bill. She says manufacturers already offer rebates and discount prices, but that patients don't see the benefits of those if their insurance premiums don't reflect the savings.

This isn't the only bill aiming to regulate prescription costs. Senate Bill 71, carried by Sen. Al Olszewski, R-Kalispell, would regulate pharmacy benefit managers who broker deals between insurers, manufacturers and pharmacies.

That bill has cleared the Senate and its first House committee vote.

"Real Meat Act"

The "Real Meat Act," which would prohibit lab-made products to be labeled as meat has passed both the House and the Senate and is heading to the governor's desk.

Rep. Alan Redfield, R-Livingston, is sponsoring the bill and said it was written to address a rising problem.

"Picture, if you will, on the grill a nice, juicy burger. Then, picture another thing on the grill that came from a petri dish," Redfield said.

House Bill 327 adds a definition for a cell-cultured edible product into the Montana code and redefines hamburger and ground beef to come "entirely" from the edible flesh of a slaughtered animal.

The House voted 75-21 last week to week to adopt Senate amendments to HB 327 and send it to the governor. The bill had passed the Senate 45-4 the week before.

Zuri Moreno with the ACLU Montana opposed the bill when it was in committee in February. Because the bill doesn't allow cell-cultured products to be labeled as meat, Moreno said it encroaches on First Amendment rights for free commercial speech.

"These restrictions on speech are neither necessary nor appropriate to prevent consumer deception. This bill is an unconstitutional solution in search of a problem," Moreno said at the February hearing.

HB 327 doesn't address plant-based "meat," like a similar bill passed by the Missouri Legislature in 2018. There, the ACLU, along with three other organizations, filed a lawsuit claiming the law violated First Amendment rights and attempted to stifle the meat-alternative industry.

House Passes Tax Incentive for Film Industry

The Montana House of Representatives passed a bill 82-16 last week that would give an income tax credit to film production companies.

Rep. David Bedey, R-Hamilton, supported House Bill 293, saying tapping into the film industry would only benefit Montana and the state has to incentivize filmmakers.

"If we wish to grow our economy and diversify our economy and attract his industry into our state, we must compete with other states. That's the fact of the matter in the film business now," Bedey said.

The bill would give a 20 percent income tax credit on all production expenses made in Montana, but production companies would have to spend at least $350,000 before receiving the credit. It would also require production companies to put a Montana promotion in their film.

The proposed law took Georgia's tax incentive as a model. Georgia also gives production companies a 20 percent tax credit, but requires filmmakers to spend at least $500,000. However, Georgia does not have a cap on how much companies can get in credit, and HB 293 puts a limit of $5 million per year.

According to the former governor of Georgia, Nathan Deal, production companies spent $2.7 billion in Georgia in 2017.

Rep. Bridget Smith, D-Wolf Point, says filmmakers would receive more credit if they hire Montana residents or university students.

"This is a jobs bill, let me tell you. It's immediate money to your small community. It's payroll for hiring Montanans," she said.

Smith introduced a similar bill last session, but it died in the Senate.

Shaylee Ragar and Tim Pierce are reporters with the UM Legislative News Service, a partnership of the University of Montana School of Journalism, the Montana Newspaper Association, the Montana Broadcasters Association and the Greater Montana Foundation. Shaylee can be reached at shaylee.ragar@umontana.edu. Tim can be reached at tim.pierce@umontana.edu.