Montana
Missoula and Western Montana speaks up: Letters to the editor for the week of Jul. 21, 2023
Andrea Davis is the right person at the right time
Missoula has long been home to artists and builders, musicians and plumbers, students and bakers, problem-solvers and dreamers. Our lack of affordable housing has not only seen our community lose valued employees with valued skills and services but essential community members who made the impossible possible and cultivated the soul and spirit of our home. The challenge before us is daunting and the solutions must be swift, comprehensive and specific to our community.
We are fortunate to have three strong candidates running for mayor. Jordan Hess has been a capable interim mayor Missoula needed after losing our four-term mayor. Mike Nugent has shown himself to be a capable and caring City Council person. The role now requires a leader. A leader with experience and connections (both locally and statewide) to address our housing crisis head on.
Missoula Mayoral candidate Andrea’ Davis has 22 years of experience working with the city, state, public, and private investors on housing issues. She has 15 years of executive experience as the director of Homeword. She knows that this issue must be addressed on all fronts, through collaboration, cooperation, and decisive directed action.
She is the right person at the right time.
Christine and Marco Littig, former owners Bernice’s Bakery and RedBird
respectively, Missoula
Zinke, Daines and global warming
In June, 16 Montana youth testified in state district court in Helena about how global warming and resulting climate change have impacted their lives, their health, and Montana’s future. The 16 youth put their lives on hold in order to prepare and testify in court, leading an effort that serves to benefit their communities and the entire state.
Their lawsuit demands state government reduce greenhouse gas emissions by changing state government’s preferential treatment for the extraction, transportation, refining, and combustion of fossil fuels to meet state energy needs.
In July, Rep. Zinke and Sen. Daines likewise responded to global warming. They announced they were requesting the U.S. Bureau of Reclamation begin an early release of water from Hungry Horse Reservoir into Flathead Lake due to low winter snowpack, reduced spring stream flows, and the low level of the lake this summer.
It’s good to know our elected representatives in Washington are finally taking action on global warming and climate change and demanding federal action to protect Flathead Lake from “adverse environmental” impacts as they save the summer boating season and recreation. Let’s hope they can impact the upcoming winter ski season as well.
Hal Schmid,
Missoula
Flathead Lake water levels
In the past two years, Flathead Lake has experienced dramatically different water levels that can be (always are) determined by the snowpack in the the mountains that constitute the Flathead drainage. Last year’s high water levels resulted in complaints of water coming over private docks. This year the lake is down at least 22 inches rendering complaints from personal boaters and businesses as the low level impedes, and in some cases prevents, docking.
This year’s phenomenon (not experienced in over 80 years) has led to a vast range of conjecture and explanations, most of which cannot be verified nor supported by facts. Examples of finger-pointing targets include the Bureau of Reclamation, the Bonneville Power Administration, the Confederated Salish Kootenai Tribe, the Federal Energy Regulatory Commission and the Columbia River Technical Management Team.
The Missoulian reports the daily level of Flathead Lake. But readers would be better informed if the paper were to, in addition, report the daily inflow to the lake from the Flathead River and the daily outflow at Seli’š Ksanka Qlispe’ Dam (formerly Kerr Dam) at Polson.
Jerome Connolly,
Somers
Consider donating refund
Many, if not most, of us recently received an unexpected tax refund from the state. At the same time, our governor turned down $10 million dollars in federal funding that would have paid for lunches for our kids. Those of you who can afford to, please consider sending some of that refund to the Missoula Food Bank. If enough of us do this it will help make up a little bit for this unbelievable and inconsiderate decision by our governor.
Chris Ryan,
Missoula
Rosendale’s ignorance
Matt Rosendale’s rant on the floor of the House over drag queens/transgender people with their fingers on the missile triggers at Malmstrom Air Force Base exposed his multiple layers of ignorance and resultant prejudices in just of few shining moments of oratory. Montana deserves better than hate filled rhetoric from the Freedom Caucus clown.
John Grant,
Hamilton
See more opinion pieces online
See more opinion pieces online Missoulian readers will now receive a print edition on Tuesdays, Thursdays and Saturdays. On the other four days a week, the Missoulian will present guest columns and letters to the editor on our digital platforms. Visit missoulian.com/opinion.
Montana
Chefs Montana Houston and Ja’mir Wimberly-Cole to Lead at New Restaurant Eleven Social
In a surprise move, the two lead chefs of Restaurant Aleksandar tells Eater Philly they’ve moved on to now head cuisine at the highly-anticipated Eleven Social in Old City that’s set to open this summer.
Montana Houston will be the executive chef of Eleven Social and Ja’mir Wimberly-Cole will be their chef de cuisine. The new restaurant, co-owned by Phillies legend Jimmy Rollins, is focused on contemporary New American cuisine. After nearly two years at the helm of the European-inspired cuisine of Restaurant Aleksandar in Rittenhouse Square, the two chefs say they’re looking forward to new opportunities.
“I’m honored and blessed to be able to showcase another side of my culinary talents at Eleven Social,” says Houston, age 27. “The past year has been filled with many surprises, and this role is just another sign to keep going.”
In December 2023, Houston was named Eater Philly’s Chef of the Year for “applying his flavorful approach to every dish” as Restaurant Aleksander’s executive chef. This June, he will be an Iconoclast Dinner Honoree chef at the James Beard House.
“Montana has invited me to join him at Eleven Social as his chef de cuisine and I’m thrilled to collaborate with him again,” says Wimberly-Cole, age 24. “We aim to create a contemporary New American fine dining experience, reminiscent of the wonderful dinner we had at Crown Shy during a trip in NYC.”
Wimberly-Cole, who was formerly the chef de cuisine at Restaurant Aleksander since its opening in August 2022, will also be launching the Modern Trail Supper Club this summer.
“The pandemic put my initial plans for the Modern Trail on hold, but I’m eager to revive it,” Wimberly-Cole says on “gathering insights and refining my vision for the club.” “I plan to host private dinners featuring themed menus inspired by various cookbooks and share my journey as a young chef exploring innovative techniques. My goal is to host these dinners monthly or bi-monthly.”
As for Eleven Social — located at 117 Chestnut Street (the former 2nd Story Brewing Company) — Houston says the menu will be looking at “the Afro roots of all the places, as well as highlighting the region’s culinary favorites.”
“It will be elevated cuisine at this new restaurant and big bold flavors without white table cloth,” Houston adds. “So all the good service and food of an upscale, high-end, fine dining restaurant without the stuffiness of having to wear suit jackets and sit a certain way.”
The new restaurant’s soft launch is currently slated for the third week of July (around the 15-18th).
Montana
Montana Technologies Announces First Quarter 2024 Results
RONAN, Mont., May 20, 2024 /PRNewswire/ — Montana Technologies Corporation (NASDAQ: AIRJ) (“Montana Technologies”), the developer of AirJoule®, a transformational atmospheric thermal energy and water harvesting technology, today announced its first quarter results.
Key Highlights
- Closed business combination (the “Business Combination”) with Montana Technologies LLC (“Legacy Montana”) and renamed the combined company “Montana Technologies Corporation”
- $50 million minimum cash condition was exceeded by securing private investments led by Carrier Global Corporation (“Carrier”), Rice Investment Group, and GE Vernova, among other third parties (the “Capital Raise”)
- Upon completion of the Business Combination, Montana Technologies’ common stock and warrants began trading on the Nasdaq Capital Market under new ticker symbols “AIRJ” and “AIRJW,” respectively
- Formed a joint venture with GE Vernova to advance and commercialize transformational air conditioning and atmospheric water harvesting products featuring AirJoule® technology
- The joint venture is led by Bryan Barton, formerly the Senior Director of Marketing, Ventures, and Incubation at GE Vernova
- Entered into joint commercialization agreement term sheets with Carrier to develop and commercialize the AirJoule® dehumidifying and cooling technology for heating, ventilation, and air conditioning (“HVAC”) solutions in the Americas, Europe, India, and the Middle East
- Ended the quarter with $37 million of cash on the balance sheet
Executive Commentary
Matt Jore, Chief Executive Officer of Montana Technologies stated, “We are excited to have completed our Business Combination and for Montana Technologies to be listed on Nasdaq. This represents a critical milestone for the company and will enable us, along with our strategic partners, to focus on developing and deploying our atmospheric thermal energy and water harvesting systems worldwide as a response to climate change and water scarcity. In addition, the recently announced partnerships with GE Vernova and Carrier showcase how our proprietary AirJoule® technology has been embraced by industry leaders; these partnerships will open our company and technology into two enormous target markets, HVAC and atmospheric water harvesting. We believe these actions place the company on a path to create a more equitable and sustainable future by fundamentally changing how we optimize increasingly scarce energy and water resources to create a better quality of life for all.”
Pat Eilers, Executive Chairman, stated, “Montana Technologies met the core criteria of a clean tech solutions provider we were searching for when we started the process with Power & Digital Infrastructure Acquisition II Corp. Montana Technologies, through its proprietary AirJoule® units, has created a transformational technology that provides significant energy efficiency gains in HVAC and atmospheric water harvesting applications, and it addresses two of the world’s most problematic issues, energy efficiency and water scarcity. We are thrilled to have completed this transaction, and I am excited to take on the role of Executive Chairman. I look forward to partnering with our newly announced management team to deliver value in the public markets.”
Commercialization Agreement with Carrier
On January 8, 2024, Legacy Montana and Carrier, a global leader in intelligent climate and energy solutions, announced that they had entered into a binding term sheet related to a commercial collaboration to develop and commercialize the AirJoule® dehumidification and cooling technology. Subject to certain milestones, Legacy Montana granted Carrier the exclusive right to commercialize the AirJoule® technology into HVAC equipment in the Americas for a period of three years. Legacy Montana, acting through an affiliated joint venture, also provided Carrier with a non-exclusive right to commercialize the AirJoule® technology into HVAC equipment in Europe, India, and the Middle East.
Carrier also committed $10 million in growth equity to Legacy Montana, which was conditional upon the successful raise of at least $50 million in aggregate capital commitments. This condition was achieved with the successful Capital Raise that occurred in conjunction with the closing of the Business Combination in March 2024. Following the Business Combination, Montana Technologies expanded its Board of Directors with the appointment of Ajay Agrawal, Senior Vice President, Global Services, Business Development and Chief Strategy Officer at Carrier.
Joint Venture Agreement with GE Vernova
On January 29, 2024, Legacy Montana announced an agreement to form a joint venture with GE Vernova, a global leader in electrification, decarbonization, and energy solutions, to incorporate GE Vernova’s proprietary sorbent materials into systems that utilize Montana’s patented AirJoule® dehumidification, air conditioning, and atmospheric water harvesting technology.
The AirJoule® technology utilizes advanced sorbents and a self-regenerating pressure swing adsorption system to harvest thermal energy and pure water from air. GE Vernova, a recognized leader in the development of advanced materials technology for industrial systems, also seeks to deploy novel sorbent-based solutions that can enable a zero-carbon emissions future. Incorporating GE Vernova’s sorbent innovations into AirJoule® technology will enhance the performance of the joint venture’s energy-saving HVAC components as well as its atmospheric water harvesting products.
The joint venture closed on March 4, 2024. In addition, GE Vernova made an equity investment in Montana Technologies in conjunction with the Capital Raise. GE Vernova’s Advanced Research team is providing support to the joint venture’s R&D function, and Bryan Barton, formerly the Senior Director of Marketing, Ventures, and Incubation at GE Vernova, joined the joint venture full-time as its Chief Executive Officer. Dr. Barton is currently focused on expanding the joint venture team, advancing AirJoule® prototypes, and managing initial pilot projects with key potential customers for the HVAC components and atmospheric water harvesting products.
Completion of Business Combination
On March 14, 2024, Power & Digital Infrastructure Acquisition II Corp. (“XPDB”) completed the Business Combination with Legacy Montana, which was originally announced on June 5, 2023. Upon completion of the Business Combination, the combined entity was renamed “Montana Technologies Corporation,” and its common stock and warrants began trading on the Nasdaq Capital Market under new ticker symbols “AIRJ” and “AIRJW”, respectively.
In conjunction with the Business Combination, the Capital Raise, led by investments from Carrier, the Rice Investment Group, and GE Vernova, and, together with amounts from XPDB’s trust account, exceeded the $50 million cash required to satisfy the related closing condition.
Recent Additions to the Board of Directors and Management Team
As part of the XPDB shareholder approval of the Business Combination, XPDB shareholders elected the following individuals as directors of Montana Technologies:
- Pat Eilers, Founder and Managing Partner of Transition Equity Partners;
- Max Baucus, Former Ambassador to China and Six-Term United States Senator from the State of Montana;
- Paul Dabbar, Former Undersecretary of the Department of Energy for Science and current Chief Executive Officer and Co-Founder of Bohr Quantum Technology;
- Matt Jore, Chief Executive Officer of Montana Technologies;
- Stu Porter, Founder, Chief Executive Officer and Chief Investment Officer of Denham Capital; and
- Marwa Zaatari, Founder and Chief Scientist of D-Zine Partners
Subsequent to the completion of the Business Combination, the following individuals were appointed as directors of Montana Technologies:
- Ajay Agrawal, Senior Vice President, Global Services, Business Development and Chief Strategy Officer at Carrier Global Corporation; and
- Kyle Derham, Partner at Rice Investment Group
On May 7, 2024, Montana Technologies named Pat Eilers as Executive Chairman and appointed the following executives to its management team:
- Stephen Pang, Chief Financial Officer;
- Chad MacDonald, Chief Legal Officer; and
- Tom Divine, Vice President, Investor Relations and Finance
Quarterly Report on Form 10-Q
Montana Technologies’ financial statements and related footnotes will be available in its Quarterly Report on Form 10-Q for the quarter ended March 31, 2024, which is expected to be filed with the Securities and Exchange Commission on May 20, 2024.
Investor Update Webcast
Montana Technologies has provided investors with an earnings call webcast. Interested parties may view the webcast by visiting the investor section of Montana Technologies’ website at www.mt.energy and clicking on the webcast link.
About Montana Technologies Corporation
Montana Technologies Corporation is a publicly traded company that holds the intellectual properties that make up the AirJoule® system, an atmospheric thermal energy and water harvesting technology that provides efficient and sustainable air conditioning and pure water from air. For more information, visit www.mt.energy.
Forward Looking Statements
The information in this press release includes “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. All statements, other than statements of present or historical fact included in this press release, regarding Montana Technologies and its future financial and operational performance, as well as its strategy, future operations, estimated financial position, estimated revenues, and losses, projected costs, prospects, plans and objectives of management are forward looking statements. When used in this press release, including any oral statements made in connection therewith, the words “could,” “may,” “will,” “should,” “anticipate,” “believe,” “intend,” “estimate,” “expect,” “project,” the negative of such terms and other similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain such identifying words. These forward-looking statements are based on management’s current expectations and assumptions about future events and are based on currently available information as to the outcome and timing of future events. Except as otherwise required by applicable law, Montana Technologies expressly disclaims any duty to update any forward-looking statements, all of which are expressly qualified by the statements herein, to reflect events or circumstances after the date of this press release.
Montana Technologies cautions you that these forward-looking statements are subject to numerous risks and uncertainties, most of which are difficult to predict and many of which are beyond Montana Technology’s control. These risks include, but are not limited to, our status as an early stage Company with limited operating history, which may make it difficult to evaluate the prospects for our future viability; our initial dependence on revenue generated from a single product; significant barriers we face to deploy our technology; the dependence of our commercialization strategy on our relationships with BASF, CATL, Carrier, GE Vernova, and other third parties history of losses, and the other risks and uncertainties described under the heading “Risk Factors” in our SEC filings including in our Registration Statement (See Risk Factors) on Form S-1 filed with the Securities and Exchange Commission (the “SEC”) on April 11, 2024. Given these risks and uncertainties, readers are cautioned not to place undue reliance on such forward-looking statements. Should one or more of the risks or uncertainties described in this press release occur, or should underlying assumptions prove incorrect, actual results and plans could differ materially from those expressed in any forward-looking statements. Montana Technology’s SEC Filings are available publicly on the SEC’s website at www.sec.gov, and readers are urged to carefully review and consider the various disclosures made in such filings.
MONTANA TECHNOLOGIES CORPORATION |
||||||||
March 31, |
December 31, |
|||||||
2024 |
2023 |
|||||||
Assets |
||||||||
Current assets |
||||||||
Cash |
$ |
37,429,270 |
$ |
375,796 |
||||
Prepaid expenses and other assets |
486,338 |
126,971 |
||||||
Total current assets |
37,915,608 |
502,767 |
||||||
Operating lease right-of-use asset |
170,117 |
49,536 |
||||||
Property and equipment, net |
4,137 |
3,832 |
||||||
In-process research and development |
365,300,000 |
— |
||||||
Goodwill |
247,233,000 |
— |
||||||
Total assets |
$ |
650,622,862 |
$ |
556,135 |
||||
Liabilities and Stockholders’ equity (deficit) |
||||||||
Current liabilities |
||||||||
Accounts payable |
$ |
431,774 |
$ |
2,518,763 |
||||
Accrued transaction fees |
3,077,107 |
3,644,100 |
||||||
Other accrued expenses |
6,781,239 |
244,440 |
||||||
Due to related parties |
1,440,000 |
— |
||||||
Operating lease liability, current |
22,981 |
22,237 |
||||||
Total current liabilities |
11,753,101 |
6,429,540 |
||||||
Earnout Shares liability |
61,393,000 |
— |
||||||
True Up Shares liability |
286,000 |
— |
||||||
Subject Vesting Shares liability |
14,217,000 |
— |
||||||
Operating lease liability, non-current |
147,858 |
27,299 |
||||||
Total liabilities |
$ |
87,796,959 |
$ |
6,456,839 |
||||
Commitments and contingencies (Note 12) |
||||||||
Stockholders’ equity (deficit) |
||||||||
Preferred stock, $0.0001 par value; 25,000,000 authorized shares and 0 shares |
$ |
— |
$ |
— |
||||
Class A Common stock, $0.0001 par value; 600,000,000 authorized shares and |
4,907 |
3,274 |
||||||
Class B Common stock, $0.0001 par value; 50,000,000 authorized shares and |
476 |
476 |
||||||
Subscription receivable |
(6,000,000) |
— |
||||||
Additional paid-in capital |
— |
11,263,647 |
||||||
Accumulated deficit |
(43,686,098) |
(17,168,101) |
||||||
Total Montana Technologies Corporation stockholders’ equity (deficit) |
49,680,715 |
(5,900,704) |
||||||
Non-controlling interests |
612,506,618 |
— |
||||||
Total stockholders’ equity (deficit) |
562,825,903 |
(5,900,704) |
||||||
Total liabilities and stockholders’ equity (deficit) |
$ |
650,622,862 |
$ |
556,135 |
MONTANA TECHNOLOGIES CORPORATION |
||||||||
Three Months Ended |
||||||||
2024 |
2023 |
|||||||
Costs and expenses: |
||||||||
General and administrative |
$ |
827,576 |
$ |
218,175 |
||||
Research and development |
896,613 |
604,944 |
||||||
Sales and marketing |
37,725 |
10,423 |
||||||
Depreciation and amortization |
1,145 |
1,085 |
||||||
Loss from operations |
(1,763,059) |
(834,627) |
||||||
Other expenses, net: |
||||||||
Interest income |
38,236 |
— |
||||||
Change in fair value of Earnout Shares liability |
(7,672,000) |
— |
||||||
Change in fair value of True Up Shares liability |
269,000 |
|||||||
Change in fair value of Subject Vesting Shares |
(2,425,000) |
— |
||||||
Total other expenses, net |
(9,789,764) |
— |
||||||
Loss before income taxes |
(11,552,823) |
(834,627) |
||||||
Income tax expense |
— |
— |
||||||
Net loss |
$ |
(11,552,823) |
$ |
(834,627) |
||||
Net loss attributable to non-controlling interests |
(26,382) |
— |
||||||
Net loss attributable to common stockholders of the Company |
$ |
(11,526,441) |
$ |
(834,627) |
||||
Weighted average Class A common stock outstanding, basic and diluted |
36,916,955 |
32,599,213 |
||||||
Basic and diluted net loss attributable to common stockholders, Class A common stock |
$ |
(0.28) |
$ |
(0.02) |
||||
Weighted average Class B common stock outstanding, basic and diluted |
4,759,642 |
4,759,642 |
||||||
Basic and diluted net loss attributable to common stockholders, Class B common stock |
$ |
(0.28) |
$ |
(0.02) |
MONTANA TECHNOLOGIES CORPORATION |
||||||||
For the Three Months Ended March 31, |
||||||||
2024 |
2023 |
|||||||
Cash Flows from Operating Activities |
||||||||
Net loss |
$ |
(11,552,823) |
$ |
(834,627) |
||||
Adjustment to reconcile net loss to cash used in operating activities |
||||||||
Depreciation and amortization |
1,145 |
1,085 |
||||||
Amortization of operating lease right-of-use assets |
52,068 |
5,211 |
||||||
Change in fair value of Earnout Shares liability |
7,672,000 |
— |
||||||
Change in fair value of True Up Shares liability |
(269,000) |
— |
||||||
Change in fair value of Subject Vesting Shares liability |
2,425,000 |
— |
||||||
Changes in operating assets and liabilities: |
||||||||
Prepaid Expenses and Other Assets |
15,010 |
12,576 |
||||||
Operating lease liabilities |
(51,346) |
(5,211) |
||||||
Accounts payable |
(2,674,319) |
40,279 |
||||||
Accrued expenses, accrued transaction costs and other liabilities |
(1,057,718) |
(22,948) |
||||||
Net cash used in operating activities |
(5,439,983) |
(803,635) |
||||||
Cash flows from Investing Activities |
||||||||
Purchases of fixed assets |
(1,450) |
— |
||||||
Net cash used in investing activities |
(1,450) |
— |
||||||
Cash flows from Financing Activities |
||||||||
Proceeds from the exercise of warrants |
45,760 |
— |
||||||
Proceeds from the exercise of options |
56,250 |
— |
||||||
Proceeds from the issuance of common stock |
43,365,000 |
255,861 |
||||||
Transaction costs – recapitalization |
(972,103) |
— |
||||||
Net cash provided by financing activities |
42,494,907 |
255,861 |
||||||
Net increase (decrease) in cash |
37,053,474 |
(547,774) |
||||||
Cash, beginning of period |
375,796 |
5,211,486 |
||||||
Cash, end of the period |
$ |
37,429,270 |
4,663,712 |
|||||
Non-Cash investing and financing activities: |
||||||||
Initial recognition of earnout shares liability |
$ |
53,721,000 |
$ |
— |
||||
Initial recognition of True Up Shares liability |
555,000 |
— |
||||||
Initial recognition of Subject Vesting Shares liability |
11,792,000 |
— |
||||||
Initial recognition of ROU asset and operating lease liability |
172,649 |
— |
||||||
Liabilities combined in recapitalization, net |
8,680,477 |
— |
||||||
Acquisition of business from GE Vernova in exchange for issuing non-controlling interests |
612,533,000 |
— |
||||||
Supplemental Cash flow information: |
||||||||
Taxes paid |
— |
— |
Contacts
Investor Relations
Tom Divine – Vice President, Investor Relations and Finance
[email protected]
Media:
Kekst CNC
[email protected]
SOURCE Montana Technologies
Montana
Medicaid unwinding deals blow to Native care in Montana
Jazmin Orozco Rodriguez
(KFF) About a year into the process of redetermining Medicaid eligibility after the covid-19 public health emergency, more than 20 million people have been kicked off the joint federal-state program for low-income families.
A chorus of stories recount the ways the unwinding has upended people’s lives, but Native Americans are proving particularly vulnerable to losing coverage and face greater obstacles to reenrolling in Medicaid or finding other coverage.
“From my perspective, it did not work how it should,” said Kristin Melli, a pediatric nurse practitioner in rural Kalispell, Montana, who also provides telehealth services to tribal members on the Fort Peck Reservation.
The redetermination process has compounded long-existing problems people on the reservation face when seeking care, she said. She saw several patients who were still eligible for benefits disenrolled. And a rise in uninsured tribal members undercuts their health systems, threatening the already tenuous access to care in Native communities.
One teenager, Melli recalled, lost coverage while seeking lifesaving care. Routine lab work raised flags, and in follow-ups Melli discovered the girl had a condition that could have killed her if untreated. Melli did not disclose details, to protect the patient’s privacy.
Melli said she spent weeks working with tribal nurses to coordinate lab monitoring and consultations with specialists for her patient. It wasn’t until the teen went to a specialist that Melli received a call saying she had been dropped from Medicaid coverage.
The girl’s parents told Melli they had reapplied to Medicaid a month earlier but hadn’t heard back. Melli’s patient eventually got the medication she needed with help from a pharmacist. The unwinding presented an unnecessary and burdensome obstacle to care.
Pat Flowers, Montana Democratic Senate minority leader, said during a political event in early April that 13,000 tribal members had been disenrolled in the state.
Native American and Alaska Native adults are enrolled in Medicaid at higher rates than their white counterparts, yet some tribal leaders still didn’t know exactly how many of their members had been disenrolled as of a survey conducted in February and March. The Tribal Self-Governance Advisory Committee of the Indian Health Service conducted and published the survey. Respondents included tribal leaders from Alaska, Arizona, Idaho, Montana, and New Mexico, among other states.
Tribal leaders reported many challenges related to the redetermination, including a lack of timely information provided to tribal members, patients unaware of the process or their disenrollment, long processing times, lack of staffing at the tribal level, lack of communication from their states, concerns with obtaining accurate tribal data, and in cases in which states have shared data, difficulties interpreting it.
Research and policy experts initially feared that vulnerable populations, including rural Indigenous communities and families of color, would experience greater and unique obstacles to renewing their health coverage and would be disproportionately harmed.
“They have a lot at stake and a lot to lose in this process,” said Joan Alker, executive director of the Georgetown University Center for Children and Families and a research professor at the McCourt School of Public Policy. “I fear that that prediction is coming true.”
Cammie DuPuis-Pablo, tribal health communications director for the Confederated Salish and Kootenai Tribes in Montana, said the tribes don’t have an exact number of their members disenrolled since the redetermination began, but know some who lost coverage as far back as July still haven’t been reenrolled.
The tribes hosted their first outreach event in late April as part of their effort to help members through the process. The health care resource division is meeting people at home, making calls, and planning more events.
The tribes receive a list of members’ Medicaid status each month, DuPuis-Pablo said, but a list of those no longer insured by Medicaid would be more helpful.
Because of those data deficits, it’s unclear how many tribal members have been disenrolled.
“We are at the mercy of state Medicaid agencies on what they’re willing to share,” said Yvonne Myers, consultant on the Affordable Care Act and Medicaid for Citizen Potawatomi Nation Health Services in Oklahoma.
In Alaska, tribal health leaders struck a data-sharing agreement with the state in July but didn’t begin receiving information about their members’ coverage for about a month — at which point more than 9,500 Alaskans had already been disenrolled for procedural reasons.
“We already lost those people,” said Gennifer Moreau-Johnson, senior policy adviser in the Department of Intergovernmental Affairs at the Alaska Native Tribal Health Consortium, a nonprofit organization. “That’s a real impact.”
Because federal regulations don’t require states to track or report race and ethnicity data for people they disenroll, fewer than 10 states collect such information. While the data from these states does not show a higher rate of loss of coverage by race, a KFF report states that the data is limited and that a more accurate picture would require more demographic reporting from more states.
Tribal health leaders are concerned that a high number of disenrollments among their members is financially undercutting their health systems and ability to provide care.
“Just because they’ve fallen off Medicaid doesn’t mean we stop serving them,” said Jim Roberts, senior executive liaison in the Department of Intergovernmental Affairs of the Alaska Native Tribal Health Consortium. “It means we’re more reliant on other sources of funding to provide that care that are already underresourced.”
Three in 10 Native American and Alaska Native people younger than 65 rely on Medicaid, compared with 15% of their white counterparts. The Indian Health Service is responsible for providing care to approximately 2.6 million of the 9.7 million Native Americans and Alaska Natives in the U.S., but services vary across regions, clinics, and health centers. The agency itself has been chronically underfunded and unable to meet the needs of the population. For fiscal year 2024, Congress approved $6.96 billion for IHS, far less than the $51.4 billion tribal leaders called for.
Because of that historical deficit, tribal health systems lean on Medicaid reimbursement and other third-party payers, like Medicare, the Department of Veterans Affairs, and private insurance, to help fill the gap. Medicaid accounted for two-thirds of third-party IHS revenues as of 2021.
Some tribal health systems receive more federal funding through Medicaid than from IHS, Roberts said.
Tribal health leaders fear diminishing Medicaid dollars will exacerbate the long-standing health disparities — such as lower life expectancy, higher rates of chronic disease, and inferior access to care — that plague Native Americans.
The unwinding has become “all-consuming,” said Monique Martin, vice president of intergovernmental affairs for the Alaska Native Tribal Health Consortium.
“The state’s really having that focus be right into the minutiae of administrative tasks, like: How do we send text messages to 7,000 people?” Martin said. “We would much rather be talking about: How do we address social determinants of health?”
Melli said she has stopped hearing of tribal members on the Fort Peck Reservation losing their Medicaid coverage, but she wonders if that means disenrolled people didn’t seek help.
“Those are the ones that we really worry about,” she said, “all of these silent cases. … We only know about the ones we actually see.”
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