Montana plans to be one of the first states to enforce President Donald Trump’s work mandate for Medicaid enrollees, adding another challenge for state health officials trying to plug a massive budget hole.
Clinicians and patient advocates say the incoming changes will deliver a twofold blow: They expect the work requirements to kick more patients off Medicaid, meaning fewer can afford care, while the health department’s budget problems make it harder for doctors to serve those who keep the coverage.
It’s a tumultuous time for state health departments. Additional federal changes are forcing states to perform more checks on who qualifies for food assistance, better monitor doctors’ compliance with Medicaid rules, and set up new programs to access a share of $50 billion in federal funds meant to improve rural health services.
“Our concern is, is the department ready?” said Jean Branscum, CEO of the Montana Medical Association. “Does the capacity exist for all this to be done right and ensure that patients don’t pay the price?”
Already, some Montanans struggle to access the government health coverage amid state backlogs. Meanwhile, clinicians struggle with staffing, attributing the issue to low Medicaid payments. Those problems reflect a national challenge to connect people to care through strained public assistance programs.
