Montana
In Montana, conservative groups see a chance to kill Medicaid expansion • Daily Montanan
Conservative groups are working to undermine support for Montana’s Medicaid expansion in hopes the state will abandon the program. The rollback would be the first in the decade since the Affordable Care Act began allowing states to cover more people with low incomes.
Montana’s expansion, which insures roughly 78,800 people, is set to expire next year unless the legislature and governor opt to renew it. Opponents see a rare opportunity to eliminate Medicaid expansion in one of the 40 states that have approved it.
The Foundation for Government Accountability and Paragon Health Institute, think tanks funded by conservative groups, told Montana lawmakers in September that the program’s enrollment and costs are bloated and that the overloaded system harms access to care for the most vulnerable.
Manatt, a consulting firm that has studied Montana’s Medicaid program for years, then presented legislators with the opposite take, stating that more people have access to critical treatment because of Medicaid expansion. Those who support the program say the conservative groups’ arguments are flawed.
State Rep. Bob Keenan, a Republican who chairs the Health and Human Services Interim Budget Committee, which heard the dueling arguments, said the decision to kill or continue Medicaid expansion “comes down to who believes what.”
The expansion program extends Medicaid coverage to adults with incomes up to 138% of the federal poverty level, or nearly $21,000 a year for a single person. Before, the program was largely reserved for children, people with disabilities, and pregnant women. The federal government covers 90% of the expansion cost while states pick up the rest.
National Medicaid researchers have said Montana is the only state considering shelving its expansion in 2025. Others could follow.
New Hampshire legislators in 2023 extended the state’s expansion for seven years and this year blocked legislation to make it permanent. Utah has provisions to scale back or end its Medicaid expansion program if federal contributions drop.
FGA and Paragon have long argued against Medicaid expansion. Tax records show their funders include some large organizations pushing conservative agendas. That includes the 85 Fund, which is backed by Leonard Leo, a conservative activist best known for his efforts to fill the courts with conservative judges.
The president of Paragon Health Institute is Brian Blase, who served as a special assistant to former President Donald Trump and is a visiting fellow at FGA, which quotes him as praising the organization for its “conservative policy wins” across states. He was also announced in 2019 as a visiting fellow at the Heritage Foundation, which was behind the Project 2025 presidential blueprint, which proposes restricting Medicaid eligibility and benefits.
Paragon spokesperson Anthony Wojtkowiak said its work isn’t directed by any political party or donor. He said Paragon is a nonpartisan nonprofit and responds to policymakers interested in learning more about its analyses.
“In the instance of Montana, Paragon does not have a role in the debate around Medicaid expansion, other than the testimony,” he said.
FGA declined an interview request. As early as last year, the organization began calling on Montana lawmakers to reject reauthorizing the program. It also released a video this year of Montana Republican Rep. Jane Gillette saying the state should allow its expansion to expire.
Gillette requested the FGA and Paragon presentations to state lawmakers, according to Keenan. He said Democratic lawmakers responded by requesting the Manatt presentation.
Manatt’s research was contracted by the Montana Healthcare Foundation, whose mission is to improve the health of Montanans. Its latest report also received support from the state’s hospital association.
The Montana Healthcare Foundation is a funder of KFF Health News, an independent national newsroom that is part of the health information nonprofit KFF.
Bryce Ward, a Montana health economist who studies Medicaid expansion, said some of the antiexpansion arguments don’t add up.
For example, Hayden Dublois, FGA’s data and analytics director, told Montana lawmakers that in 2022 72% of able-bodied adults on Montana’s Medicaid program weren’t working. If that data refers to adults without disabilities, that would come to 97,000 jobless Medicaid enrollees, Ward said. He said that’s just shy of the state’s total population who reported no income at the time, most of whom didn’t qualify for Medicaid.
“It’s simply not plausible,” Ward said.
A Manatt report, citing federal survey data, showed 66% of Montana adults on Medicaid have jobs and an additional 11% attend school.
FGA didn’t respond to a request for its data, which Dublois said in the committee hearing came through a state records request.
Jon Ebelt, a spokesperson for the Montana Department of Public Health and Human Services, also declined to comment. As of late October, a KFF Health News records request for the data the state provided FGA was pending.
In his presentation before Montana lawmakers, Blase said the most vulnerable people on Medicaid are worse off due to expansion as resources pool toward new enrollees.
“Some people got more medical care; some people got less medical care,” Blase said.
Reports released by the state show its standard monthly reimbursement per Medicaid enrollee remained relatively flat for seniors and adults who are blind or have disabilities.
Drew Gonshorowski, a researcher with Paragon, cited data from a federal Medicaid commission that shows that, overall, states spend more on adults who qualified through the expansion programs than they do on others on Medicaid. That data also shows states spend more on seniors and people with disabilities than on the broader adult population insured by Medicaid, which is also true in Montana.
Nationally, states with expansions spend more money on people enrolled in Medicaid across eligibility groups compared with nonexpansion states, according to a KFF report.
Zoe Barnard, a senior adviser for Manatt who worked for Montana’s health department for nearly 10 years, said not only has the state’s uninsured rate dropped by 30% since it expanded Medicaid, but also some specialty services have grown as more people access care.
FGA has long lobbied nonexpansion states, including Texas, Kansas, and Mississippi, to leave Medicaid expansion alone. In February, an FGA representative testified in support of an Idaho bill that included an expansion repeal trigger if the state couldn’t meet a set of rules, including instituting work requirements and capping enrollment. The bill failed.
Paragon produced an analysis titled “Resisting the Wave of Medicaid Expansion,” and Blase testified to Texas lawmakers this year on the value of continuing to keep expansion out of the Lone Star State.
On the federal level, Paragon recently proposed a Medicaid overhaul plan to phase out the federal 90% matching rate for expansion enrollees, among other changes to cut spending. The left-leaning Center on Budget and Policy Priorities has countered that such ideas would leave more people without care.
In Montana, Republicans are defending a supermajority they didn’t have when a bipartisan group passed the expansion in 2015 and renewed it in 2019. Also unlike before, there’s now a Republican in the governor’s office. Gov. Greg Gianforte is up for reelection and has said the safety net is important but shouldn’t get too big.
Keenan, the Republican lawmaker, predicted the expansion debate won’t be clear-cut when legislators convene in January.
“Medicaid expansion is not a yes or no. It’s going to be a negotiated decision,” he said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.
On a frosty morning in late December, Marce Hoffman backs two huge draft horses out of a barn at the historic 320 Ranch south of Big Sky.
“Step up, step up,” Hoffman instructs the horses as he maneuvers them toward a waiting sled. It’s time to take the animals out for a turn on a trail they’ll know well by the end of the winter season. They’ll tread the path up to seven days a week during the holidays and five days a week after that. The animals strain in their harnesses, eager to pull and run.
“They’re fresh. They won’t be fresh come New Year’s, though; they’ll be all muscled up, ready to go,” said Hoffman.
MTN News
The 320 has a long history. It was homesteaded as two separate ranches more than 125 years ago.
“1912 they combined them to form 320 acres That’s how the ranch became known as the 320,” explained Hoffman as he practiced the history lesson he gives while narrating the ride through the high, narrow valley the ranch is nestled in, just outside the boundary of Yellowstone National Park.
In 1936, Bozeman doctor Carolyn McGill purchased the ranch.
Hoffman said, “She fell in love with this area on different hunting trips, trips down into the Yellowstone Park.”
You might recognize McGill’s name from somewhere else.
“Caroline started the Museum of the Rockies in Bozeman; was actually called the McGill Museum when it first opened up,” said Hoffman.
Current owner Dave Bass purchased the ranch in 1985.
Hoffman explained that’s when the ranch really began to grow into a tourist Mecca. He said, “He (Bass) bought it up from a 20 gust capacity over 200 that we have today.” He pointed to cabins that drifted by, framed by the mountains and the Gallatin River. It’s the view guests get as they take a one-hour trail ride in the sleighs. Hoffman ticked off the sights: “You get to see Cinnamon Mountain, Burnt Top Mountain. We’ll be able to see the Spanish Peaks when we go along the Gallatin here. Looking back you’ve got a view of Monument.”
MTN News
As he drives onto a flat, straight stretch of the trail, the horses get frisky. “These guys are gonna air out right here,” he cautioned, just as the horses break into a run. It demonstrated the challenge of managing big Percheron horses around guests.
“Our number one priority is keeping everybody safe. So we always have to be constantly looking at the equipment. As far as the people, probably the hardest part is herding them up and getting them on the sleighs,” Hoffman laughed as he allowed that it is probably harder to manage the passengers than the animals.
Sitting next to him, Head Wrangler Logan McDaniel said she enjoyed working at the ranch.
MTN News
“I like, of course, to drive and work with the horses but also meeting people from all around the world. You get to meet people from all different parts of life, all kind of different places,” she said. “They’re here for vacation. You get to kind of realize a little bit of people’s life story. It’s pretty cool just to meet different people.”
And the horses?
Hoffman said, “We’re looking for good disposition, you know. We’re not looking for heavy pullers we’re just looking for horses that are pretty docile and easy-going horses. They’re not gonna win any pulling competitions here.”
But these workhorses are no slouches.
“We’ll pull 18 people no problem and these guys are big horses,” said Hoffman.
He said that translates to about 18 hands and nearly 2,000 pounds each. As the horses cool down after their workout, Hoffman wiped them down and explained how these animals cope with the harsh winters at the ranch.
“You know those horses are on hay, you know free choice grass hay and water. They do pretty well. We’ve got a lean-to for them to get out of the wind. But for the most part, you know, they’re pretty hearty animals,” he said.
MTN News
By late afternoon, as dusk descends on the ranch, guests begin to wander toward a pair of the big sleighs. They board the blanket covered seats for a ride out to the other end of the valley where a wood-floored canvass tent awaits. It’s heated and features a bar serving snacks, hot cocoa, cider, and more. A fire crackles in a pit surrounded by seats outside. After a bit of rest, the passengers will climb back into the sleds for a ride back to the ranch restaurant.
Taking in the view around them, Hoffman and McDaniel reflected on their jobs. Hoffman said, “There’s a lot of people that never seen a horse or been around horses, so it’s a good opportunity to you know, to introduce them to the horses.”
McDaniel added, “It’s cool watching people fall in love with the horses. That’s why I kind of do this. It’s to see people fall in love with horses like I do.”
MISSOULA — Montana State’s path to Frisco, Texas, for the FCS national championship has been built by Treasure State natives.
For Rylan Ortt, Adam Jones and Zac Crews, that road started with the decision to become Bobcats — and spurn the hometown Montana Grizzlies — after playing high school football at Missoula Sentinel.
Tom Wylie / MTN Sports
“Rylan was the first guy to grow up a Griz fan and make that jump over to Bozeman for a lot of different reasons,” Sentinel football coach Dane Oliver told MTN Sports. “And so that kind of laid the foundation. And I know Zac and Adam both looked up to Rylan.
“You know how recruiting works, if they’re having a positive experience wherever they’re at, it helps when they hear from a kid that they trust and know.”
Ortt joined Montana State in 2019 after a stellar Sentinel career playing quarterback and throwing the javelin. As the Spartans’ QB, Ortt threw for 2,098 yards and rushed for 750 yards as a senior in 2018.
In the javelin, he won the 2019 Class AA state championship with a throw of 208 feet, 8 inches.
Once in Bozeman, Ortt transitioned to safety. He redshirted in 2019, and the 2020 season was canceled due to the COVID-19 pandemic. In the four years since, he has emerged as one of the leaders on a defense full of Montana guys.
This season, he leads the Bobcats with 75 total tackles. He’s also caught one interception and forced and recovered a fumble.
“He sacrificed a lot for our (Sentinel) program just having to play quarterback,” said Oliver, who played for the Grizzlies and was a member of their last national title team in 2001. “And hopefully that’s helped him being a safety, and maybe the knowledge you gain from the quarterback perspective has allowed him to have success at that level.”
While Ortt has been a stalwart in MSU’s secondary, Jones has had a breakout season on offense. He burst onto the scene in the Bobcats’ season-opening come-from-behind win at FBS New Mexico when he rushed for 167 yards, including a 93-yard touchdown that sparked the fourth-quarter comeback.
Jones this season has become the most prolific freshman runner in program history, rushing for 1,134 yards and 14 touchdowns. Against Idaho in the quarterfinals of the FCS playoffs, Jones accounted for 95 yards and four touchdowns with starting running back Scottre Humphrey sidelined.
“He’s got all the traits of what it takes to be great,” Oliver said of Jones. “You know, (Jones is successful) maybe a little earlier than I expected. I think the thing that Adam had going for him (in high school) was he was a three-sport athlete. You know, he was a heck of a baseball player, did hockey and football.
“He was always physical. … He’s got the hockey nature, so he’s not afraid of contact. But he’s put on some weight. He can finish runs, always falls forward, he’s got great vision. He’s got all the qualities of a back.”
Slim Kimmel / MTN Sports
Jones, Crews and fellow Cats Dylan Rollins and J.J. Dolan each played a part in helping Sentinel win Class AA state football championships in 2020 and 2021. Prior to the 2020 title, the Spartans’ last championship came in 1972.
Crews, a sophomore, has turned into a contributor on the defensive line with 24 total tackles and 2.5 sacks.
Dolan is a redshirt freshman, and Rollins, the 2020 Gatorade Montana player of the year and a 2021 Sentinel grad, is a freshman after beginning his college career at BYU and serving an LDS mission.
Now they’re all part of an MSU program aiming to end its own drought and win its first national championship since 1984.
“It’s fun to see them go on to be successful, not just the ones that play college football,” Oliver said. “It’s made me realize why I do this. It takes a lot of time and energy to coach high school football.
“So, just to see them grow into young men and have success and be fulfilled in it, whatever career they choose, and those guys are doing it on a public stage, and so obviously super rewarding for myself and all our staff to see the success they’re having.”
Montana State (15-0) will play North Dakota State (13-2) for the FCS national championship on Jan. 6.
After a thrilling 2024 season, FCS football will crown a champion when North Dakota State and Montana State battle on a Monday night. As the Bison and Bobcats near the pinnacle of the sport, let’s take a look back at their journeys.
North Dakota State
Regular season
North Dakota State finished the regular season 10-2, losing its first game to Colorado out of the FBS and its final game to South Dakota out of the MVFC. The season-ending loss prevented the Bison from winning the MVFC outright, but it didn’t matter as NDSU still got the No. 2 overall seed in the playoffs.
FCS playoffs
North Dakota State fought off an early scare from Abilene Christian in the second round to win by 20 points. In the quarterfinals, the Bison beat Mercer 31-7 in a game they controlled from start to finish.
Semifinal round
In the semifinals, North Dakota State defeated South Dakota State for the second time this year to advance to the championship game. Click or tap here for more on the thrilling finish.
Bison schedule
| Opponent | Win/Loss | Score | Record | Ranking (AFCA) |
|---|---|---|---|---|
| at Colorado | L | 31-26 | 0-1 | No. 2 |
| vs. Tennessee State | W | 52-3 | 1-1 | No. 2 |
| at ETSU | W | 38-5 | 2-1 | No. 2 |
| vs. Towson | W | 41-24 | 3-1 | No. 2 |
| at No. 15 Illinois State | W | 42-10 | 4-1 | No. 2 |
| vs. No. 6 North Dakota | W | 41-17 | 5-1 | No. 2 |
| at Southern Illinois | W | 24-3 | 6-1 | No. 2 |
| vs. No. 1 South Dakota State | W | 13-9 | 7-1 | No. 2 |
| at Murray State | W | 59-6 | 8-1 | No. 1 |
| vs. Northern Iowa | W | 42-19 | 9-1 | No. 1 |
| vs. No. 14 Missouri State | W | 59-21 | 10-1 | No. 1 |
| at No. 4 South Dakota | L | 29-28 | 10-2 | No. 1 |
| vs. (15) Abilene Christian | W | 51-31 | 11-2 | No. 4 |
| vs. (7) Mercer | W | 31-7 | 12-2 | No. 4 |
| vs. (3) South Dakota State | W | 28-21 | 13-2 | No. 4 |
Key players this season
- QB Cam Miller
- RB CharMar Brown
- RB TK Marshall
- WR Bryce Lance
- WR Braylon Henderson
- TE Joe Stoffel
- OL Mason Miller
- OL Grey Zabel
- DL Eli Mostaert
- DL Kody Huisman
- DL Loshiaka Roques
- LB Logan Kopp
- DB Darius Givance
- K Griffin Crosa
North Dakota State has a reloaded roster under first-year head coach Tim Polasek. The Bison have the Jerry Rice Award winner CharMar Brown in the backfield along top-three Walter Payton Award finalist Cam Miller. The trenches are stout yet again with NFL prospect Grey Zabel on offense and All-American Eli Mostaert on defense.
Montana State
Regular season
Montana State finished the regular season 12-0 with the longest regular-season win streak in the FCS. Only two Bobcat games — an FBS win over New Mexico State and a Big Sky win over UC Davis — were within one possession.
FCS playoffs
Montana State’s dominance continued in the playoffs. The Bobcats didn’t play a close game in the first two rounds, averaging 50.5 points scored and a 32.5 margin of victory.
Semifinal round
In the semifinals, Montana State held off South Dakota to advance to the championship game. Tommy Mellott led the way offensively with 134 passing yards and a touchdown plus 125 rushing yards and two touchdowns. Click or tap here for more from the game.
Bobcat schedule
| Opponent | Win/Loss | Score | Record | Ranking (AFCA) |
|---|---|---|---|---|
| at New Mexico | W | 35-31 | 1-0 | No. 4 |
| at Utah Tech | W | 31-7 | 2-0 | No. 3 |
| vs. Maine | W | 41-24 | 3-0 | No. 3 |
| vs. Mercyhurst | W | 52-13 | 4-0 | No. 3 |
| at Idaho State | W | 37-17 | 5-0 | No. 3 |
| vs. Northern Colorado | W | 55-17 | 6-0 | No. 3 |
| vs. No. 8 Idaho | W | 38-7 | 7-0 | No. 3 |
| Portland State | W | 44-14 | 8-0 | No. 3 |
| at Eastern Washington | W | 42-28 | 9-0 | No. 2 |
| vs. Sacramento State | W | 49-7 | 10-0 | No. 2 |
| at No. 4 UC Davis | W | 30-28 | 11-0 | No. 2 |
| vs. No. 10 Montana | W | 34-11 | 12-0 | No. 2 |
| vs. UT Martin | W | 49-17 | 13-0 | No. 1 |
| vs. Idaho | W | 52-19 | 14-0 | No. 1 |
| vs. South Dakota | W | 31-17 | 15-0 | No. 1 |
Key players this season
- QB Tommy Mellott
- RB Scottre Humphrey
- RB Adam Jones
- WR Taco Dowler
- WR Ty McCullouch
- TE Rohan Jones
- OL Marcus Wehr
- OL Conner Moore
- OL Titan Fleischmann
- OL Cole Sain
- DL Brody Grebe
- DL Paul Brott
- LB McCade O’Reilly
- LB Danny Uluilakepa
- DB Andrew Powdrell
- DB Rylan Ortt
- P Brendan Hall
Montana State is an experienced group with a mix of young talent. Adam Jones was the runner-up for the Jerry Rice Award while senior Tommy Mellott is a top-three Walter Payton Award finalist. Brody Grebe leads the defense; he finished ninth in Buck Buchanan Award voting.
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