The Billings Outpost

Medicaid plan helps state

Other states have found their initiatives to expand Medicaid similar to Montana’s SB 405, the Montana Health and Economic Livelihood Partnership (HELP) Act, have produced significant budget savings. Providing health insurance for low-income, working Montanans will result in state budget savings and economic growth.

Kentucky estimates their expanded Medicaid program will result in net state budget savings of $820 million from state fiscal year 2014 to state fiscal year 2021. And Arkansas estimates savings of $370 million during that time.

The savings Kentucky and Arkansas realized are available to all states. Providing health insurance coverage in SB 405 through private premiums and federal contributions will result in less need for state-funded mental and behavioral health programs. Other current specialized Medicaid programs would be to initiatives where the federal government is providing a greater contribution. Montana’s corrections program would achieve savings from released inmates receiving needed mental health and substance abuse treatment resulting in fewer re-offenders.

Research found that Connecticut, New Mexico and Washington also realized budget savings in the first year of expanded Medicaid programs. SB 405 is not a budget buster, and will result in economic growth to Montana.

Steph Larsen

Lyons, Neb.

Last Updated on Thursday, 02 April 2015 10:19

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SB 405 a bad idea

Over the past 65 days, there have been numerous proposals presented to the Legislature that can aptly be described as “take-it-or-leave-it.” But one proposal tops all others when it comes to the audacity of a “take-it-or-leave-it” offer—Senate Bill 405.

Just a few short weeks ago, a new concept for Medicaid expansion was brought before the Legislature that some claim is a “collaborative effort” exemplifying statesmanship. The bill, SB 405, has been lauded as a “compromise” that will benefit tens of thousands of Montanans if enacted.  But while policymakers get caught up in the emotional cloud that dominates the debate surrounding Medicaid expansion, it’s important to keep things in perspective—particularly the long-term sustainability of any plan that the Legislature chooses to adopt.

First, it’s important to recognize that SB 405 is not a compromise. When numerous amendments were offered to improve the proposal, the sponsor, after acknowledging that the amendments were good, asked the Senate to reject each and every one of them.  Does that sound like “compromise” to you? Does that sound like a “Montana Solution” to you?

Second, regardless of the proponents’ claim that SB 405 is a “Republican solution,” it is the implementation of Obamacare, plain and simple — something few Montanans are eager to support. SB 405 accepts hundreds of millions of dollars in federal funds offered through the Affordable Care Act to create a new entitlement program. And, in addition to spending hundreds of millions of dollars to expand entitlements, SB 405 also creates a massive new state bureaucracy that will cost the state millions of dollars every year. Simply put, SB 405 is uniquely this country’s most enhanced Medicaid expansion proposal yet. But, can we really rely on federal money to be there?

The federal funds that cover a portion of the costs of Medicaid expansion have proven to be laden with restrictions. We already know that these particular funds will be reduced after the first few years, and the program is expected to cost the state of Montana almost $40 million by the year 2020, with that number increasing exponentially every year.

 Even though many members of the Legislature will not vote for full expansion of Medicaid, it’s important to remember that real Republican alternatives are currently still in play in the last weeks of Montana’s 64th legislative session.

HB 455, introduced by Rep. Nancy Ballance, would cover nearly 10,000 low-income Montanans currently unable to receive coverage under Medicaid. That bill would expand coverage eligibility to the blind, disabled, young parents and veterans.  Unfortunately, those legislators rushing to get their hands on the federal dollars cannot see the benefit of a proposal that targets public resources to help the most vulnerable in our communities.

We must be cautious when formulating our public policies. Creating a massive program that throws money at the problem is not responsible policymaking, and will almost certainly put our state’s financial health in jeopardy. SB 405 is not an example of a Republican solution, and to claim otherwise is insulting.  It’s time that proponents of full Medicaid expansion drop their “take-it-or-leave-it” mentality and consider for the first time a true compromise — because that is the only way we can ensure protection of Montana’s most vulnerable without jeopardizing our state’s financial health.

Sen. Debby Barrett

R-Dillon

 

Last Updated on Thursday, 02 April 2015 10:18

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End oil, gas tax break

In Montana, we believe in fairness and a level playing field. But right now, oil and gas companies extracting Montana resources are not paying their fair share. From 2008 to 2014, these companies received a tax break of more than $126 million, costing local communities and the state critical revenue to meet infrastructure, social service, and public safety needs.

In 1999, the Legislature created a huge tax break for oil and gas companies. It lowers the taxation of oil and gas production to almost nothing during the most profitable period of extraction – the first 12 to 18 months. At the time, proponents of the tax break claimed that it would encourage development. Studies show, however, that oil companies do not base their decisions on state taxes. Quite simply, these out-of-state corporations operate where there is oil, period. We know now that this tax policy has cost Montana hundreds of millions in lost revenue, but the costs have been especially high to the communities who feel the strain on their public services and infrastructure.

Let’s compare. In North Dakota, during times when oil prices are high, a typical Bakken well producer is taxed at an average rate of 10.6 percent. However, Montana taxes these companies at less than 1 percent during the first 12 to 18 months.

The money Montana hands over to oil and gas companies as a tax break should instead be invested in our communities, on maintaining critical public services like education, water systems, housing, and roads. Increasing population in oil- and gas-impacted counties has overwhelmed local police, firefighters, domestic violence shelters, and child abuse officials.

We can fix this. I am proposing Senate Bill 374 to ensure oil companies pay their fair share. The bill will place a “trigger” on the tax holiday. When oil prices are high, the state and communities are ensured a revenue stream. North Dakota, experiencing a similar oil boom, has had a similar tax structure in place for several years.

My bill will also ensure that the majority of this revenue goes to where it is needed most – the communities in Eastern Montana. A fund will be set up to address the ongoing infrastructure, safety, and social service needs of the communities hit the hardest by the production.

The oil and gas tax holiday is costing Montana millions in revenue for public services and infrastructure. It’s time to fix it and put those dollars to better use.

Sen. Christine Kaufmann

D-Helena.

Last Updated on Thursday, 26 March 2015 13:01

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Beware of e-cigarettes

Data drives public health policy since it informs how we respond to community issues. The National Institute of Drug Abuse’s Monitoring the Future survey recently questioned 50,000 middle school and high school students about drug and cigarette use. The figures show that tobacco prevention programs are effective. In 1997, one-quarter of 12th graders smoked cigarettes daily. Just under 7 percent do today. 

But the figures show a disturbing trend toward electronic cigarette use.  E-cigarettes are clearly gaining a foothold in youth culture. More than 8 percent of eighth-graders had used e-cigarettes in the past month; 16 percent of 10th graders, and 17 percent of seniors.

Equally alarming, just over 14 percent of 12th graders in the survey perceived e-cigarettes as harmful. 

More than 85 percent of those seniors did not perceive regular use of electronic cigarettes as harmful, which may be a testament to the powerful effect that the use of celebrity “role models,” advertising and marketing plays in youth perception. In Montana, the tobacco industry spends $27 million a year to promote tobacco products with the intent of recruiting new users and retaining current ones.

The survey also found that 23 percent of 12th graders had used “hookah” in the past year.

Unfortunately, hookah pipes are often perceived as less harmful than traditional tobacco cigarettes since the specially made and flavored tobacco is smoked through a water filtering pipe. But a 45-minute hookah session delivers about 100 to 200 times the smoke of a single cigarette, containing 36 times more tar and 15 times more carbon monoxide.

We must not let up on prevention efforts to warn students of the highly addictive nature of nicotine and the chronic disease burden imposed by tobacco in all forms.

For more information, call the Montana Quit Line 1-800-QUIT-NOW.

Claire R. Oakley

RiverStone Health

Last Updated on Thursday, 19 March 2015 12:11

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End gas, oil tax holiday

When it comes to helping Montana communities pay for the impacts caused by oil and gas development, the Legislature has ignored the obvious solution for years.

Taxes on mineral extraction are intended in large part to help deal with the impacts caused by such development. But the Legislature has refused to tax the majority of new oil and gas extraction in Montana.

The tax-free holiday on oil and gas production was enacted in the 1990s. The Legislature at that time made that foolish decision not to tax oil companies on most of their production, Of course, lobbyists for the oil and gas industry had a hand in the 18-month oil and gas tax holiday. After 18 months the production from an oil and gas well naturally is dramatically less than when the well started producing.

And with that decision to let the oil and gas companies avoid paying their fair share the Legislature also made the decision not to pay for impacts to Montana communities. Because of that, we are now left arguing over how to come up with the money to address those impacts.

Legislators, the solution is simple and clear. End the oil and gas tax holiday. Support SB 374. As a taxpayer and a Montanan wanting to invest in Montana, not the oil and gas company fat cats, I thank you.

David Lehnherr

Red Lodge

Last Updated on Thursday, 19 March 2015 12:09

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New technology needed

It is widely recognized that we have a child safety crisis in the state of Montana. Since 2008, there has been a 60 percent increase in child abuse and neglect cases. Drugs, untreated mental illness, and domestic violence have all been cited as contributors to this alarming trend.

Montana will never be able to address these tragedies, however, without ensuring that child welfare caseworkers have the tools necessary to do their difficult jobs. These hardworking men and women are charged with stepping in to protect the 2,400 vulnerable children currently served by the Montana child welfare system and must have access to modern technology tools that will help them make better, more evidence-based decisions.

Right now, there is a real opportunity to protect children in danger, because members of the Legislature and the governor are already taking a serious look at our child welfare system. One idea that should be pursued is putting modern technologies in the hands of caseworkers.

The systems caseworkers use now do not match the technology most of us are using in our business and social lives. The screens caseworkers interact with are daunting and outdated, and it is difficult for them to navigate the system to find information or enter new information.

These systems are not data-driven. Data provided can be months old and deprive caseworkers and administrators of the ability to spot trends and patterns that would enable them to make informed decisions about the welfare of the children they serve – and thereby to help those children succeed in life.

The state Department of Public Health and Human Services has made positive strides in retaining caseworkers, but we shouldn’t stop there. How long can we expect someone to stay in a difficult job if we’re not willing to make the work experience better? In business, investments are made in technology to increase efficiency, productivity and competiveness. Why shouldn’t caseworkers be similarly supported?

The lack of effective technology has profound consequences for agencies and the families they serve. Caseworkers spend too much time on paperwork rather than with families. And, there’s little doubt that frustration with dated technology is partly to blame for the turnover rates of Montana’s caseworkers.

The good news is that modern technology products can help address these challenges – and that DPHHS wants to see that happen, too. New web-based case management tools combine social networking design with data-driven analytics.  Staff at DPHHS estimate these new products could reduce administration time by 20 percent, allowing caseworkers to spend more time with children.

The systems are easy for caseworkers to learn and use, and can be updated quickly and easily. Additionally, these case management tools run on all mobile devices, thereby enabling caseworkers to work anywhere. The result is an enhanced work experience and, ultimately, better results for vulnerable children.

The need for this type of technology is clear. It is critical that we look for opportunities to improve the technology our state uses to protect vulnerable children. Montana’s foster kids are in dire need of assistance. Updated technology for caseworkers is the logical first step toward helping them.

This should be a cause we can all get behind.

Sen. Roger Webb

R-Billings

 

Last Updated on Friday, 06 March 2015 13:15

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