Medicaid Expansion Information for Stakeholders

Reports and Data

• Medicaid Expansion Dashboard
  This dashboard includes enrollment data, member demographics, and a summary of services provided to Expansion enrollees.
• Reports to the 2021 Legislature

Medicaid Expansion Section 1115 Demonstration Waiver Information

Montana’s Medicaid expansion program is provided through a Section 1115 Demonstration Waiver, which is approved by the Centers for Medicare and Medicaid Services (CMS). Documentation related to Montana’s application for this waiver, and CMS’ approval of it, are available at the following links:

• 2021 Waiver Amendment Submission documents
• 2020 and prior Waiver documents

This Medicaid Expansion Section 1115 Demonstration Waiver expires 12/31/2022.  Member benefits will not change but will be provided under a non-waiver program, with the same title, "Medicaid Expansion also known as HELP."

Relevant State Legislation

HB 658

In 2019, the legislature passed House Bill (HB) 658, which authorized the continuation of Medicaid expansion and directed DPHHS to seek federal approval for some program changes. The application submitted for federal approval is posted on this Medicaid Expansion Waiver Submission page. 

SB 261

The 2017 Montana Legislature passed Senate Bill (SB) 261 , which required state agencies to make a variety of changes related to state revenues.

As mandated in Section 14 (1) of SB 261, the Department terminated its contract with the Third Party Administrator (TPA) of the Health and Economic Livelihood Partnership (HELP) Plan.

SB 405

The 2015 Montana Legislature passed Senate Bill (SB) 405, the Health and Economic Livelihood Partnership (HELP) Act, which authorized the expansion of Montana’s Medicaid program to cover Montana adults with incomes up to 138% of the federal poverty level. 

Medicaid Expansion (HELP Act) Oversight Committee

SB 405 established a Montana HELP Act oversight committee which met from 2015-2018. The committee consisted of nine voting members, including legislative members, industry experts, a representative of the state auditor’s office, and a member of the general public or staff member of the Governor’s Office.

The Committee reviewed the implementation of the programs established in the HELP Act. The committee prepared a final report to the governor and to the legislative finance committee by August 15 of each even-numbered year.

Reports and other meeting materials are posted below.

• HELP Act Oversight Committee: 2018 Report to the Governor and Legislative Finance Committee
• Montana HELP Act Summary Findings and Recommendations Approved 8-7-18
• HELP Act Oversight Committee:  2016 Report to the Governor and Legislative Finance Committee
• Report to Legislative Finance Committee 9-29-16: Health and Economic Livelihood Plan Progress Report
• Report to Legislative Finance Committee 9-29-16: Health and Economic Livelihood Partnership Report
• July 2015 Medicaid Expansion (HELP Plan) Waiver Submission

Additional Resources

• Medicaid State Plan and Waiver Amendment Public Notices
• Montana Health Coalition webpage