Montana

Montana could be a model as more GOP states weigh Medicaid work requirements • Stateline

Published

2 years ago

May 7, 2024

Montana could be a model as more GOP states weigh Medicaid work requirements • Stateline

Two decades ago, Jeff Beisecker and his family returned to Great Falls, Montana, from a religious mission to the Philippines. Beisecker had no health insurance and no steady source of income, and neither did his wife. Fearful of being without coverage, Beisecker enrolled himself, his wife and their four children in Medicaid for nearly a decade while he worked his way to a steady, full-time job.

Having the extra help made a difference for his family, recalled Beisecker, 53. “And people might have looked down on us. I don’t really care, because it was there to help us along the journey.”

For Beisecker, Medicaid coverage was a launching pad to stable work; now he helps others make that leap. As an employment and training coordinator for Opportunities Inc., a Great Falls-based nonprofit, Beisecker connects Montana Medicaid recipients to job training, career counseling, transportation and child care. Opportunities Inc. is one of several nonprofits that run a state-created voluntary program called the Health and Economic Livelihood Partnership Link, known as HELP-Link.

“When folks come in, we can meet with them and say, ‘Hey, maybe you can take this training that we can help pay for, and you can come out and start making 28 or 29 dollars an hour,” Beisecker said.

An increasing number of Republican-led states want to require Medicaid recipients to work, arguing that doing so will help them rise out of poverty. Democrats and health advocates note that most people on Medicaid already work either full time or part time. They argue that states shouldn’t deny health care coverage to people who don’t have jobs, especially since many face serious barriers to employment.

With HELP-Link, Montana might have found middle ground.

Holdout states consider expanding Medicaid — with work requirements

When Montanans enroll in Medicaid, nonprofit organizations such as Opportunities Inc., which receives state funding, can offer career guidance and job training from professionals like Beisecker. A key part of that process is identifying barriers to work — such as a lack of training, child care or transportation — and finding ways to overcome them.

“There are ways to support work without taking away people’s health coverage,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families, which researches health care issues.

“Montana is the most concrete example of a work-support connection,” she said. “That’s one place to look to make sure people are connected to work supports and job training.”

Montana Republican state Rep. Edward Buttrey, who crafted the HELP-Link program with Democratic state Rep. Mary Caffero in 2015, said it adheres to GOP principles.

“Republican administrations typically want to ensure that if somebody’s getting a benefit from the taxpayers, that they’re earning it and in return providing a benefit back to the state and themselves,” Buttrey told Stateline. “I think that’s what this is about.”

Caffero said that in reaching a compromise, legislators “put the people of Montana above party politics.”

“We created our own majority,” she said, “and extremists were kind of out on a plank.”

Increasing interest

Medicaid is a program that provides health insurance for low-income people and is jointly run by states and the U.S. government. Any state that wants to add a work requirement to Medicaid must ask the federal government for permission.

Grassroots groups help Medicaid recipients regain lost coverage

The Biden administration has repeatedly turned down states’ requests to impose work requirements. It also has rescinded the approvals granted by its predecessor, which signed off on 13 of them. (Only one state, Arkansas, implemented its rule before courts blocked states from imposing them.) But with the election fast approaching, the prospect of a second Trump administration has prompted more GOP states to reconsider the idea.

That includes states such as Arkansas, Idaho and Louisiana that opted to expand Medicaid to more people under the Affordable Care Act, commonly known as Obamacare. It also includes states that are still debating whether to expand Medicaid under Obamacare, among them Kansas and Mississippi.

Georgia and South Carolina, neither of which has expanded Medicaid under the ACA, both have sought federal permission to include work requirements in partial expansions of Medicaid that are more limited than what is envisioned under Obamacare. Only Georgia, which is fighting the Biden administration in court, currently has a strict work rule for any of its Medicaid enrollees.

How it works

Montana, which expanded Medicaid during the Obama administration, in 2019 sought federal permission to apply work requirements to the roughly 100,000 adults who were newly eligible for the program. Under the proposal, beneficiaries would have had to work at least 80 hours each month, be looking for a job, or be doing volunteer work. There would have been exemptions for pregnancy, disabilities and mental illness.

In 2021, however, the Biden administration rejected Montana’s request. Buttrey told Stateline that if former President Donald Trump wins in November, it is likely that Montana will try again. But whatever the outcome of the election, the voluntary workforce training in HELP-Link has emerged as a possible compromise.

Beisecker said that Opportunities Inc. has been working with the Help-Link program for about a year and a half. The nonprofit has been able to help people do things such as get a commercial driver’s license, start a welding certificate program, take classes on medical coding, and join construction training programs.

When folks come in, we can meet with them and say, ‘Hey, maybe you can take this training that we can help pay for, and you can come out and start making 28 or 29 dollars an hour.

– Jeff Beisecker, employment and training coordinator for Opportunities Inc., a Montana nonprofit

The nonprofit also has a community resource center that can help Medicaid recipients get access to vouchers for food, laundry facilities and other needs.

“We get referrals from other nonprofits we work with,” Beisecker said. “We have flyers that we send out so people know about the program. We go to job fairs.”

According to data from the Montana Department of Labor and Industry, more than 2,200 people have participated in the HELP-Link program since its inception. Many have gone on to get jobs as registered nurses, dental hygienists, real estate agents and computer programmers, among many other professions.

HELP-Link has built relationships with large local employers such as manufacturers and health care providers, said Heather O’Loughlin, executive director of the Montana Budget & Policy Center, a nonprofit group that examines budget and tax issues. O’Loughlin said a dip in participation since 2021 is evidence that the program has moved many participants into stable jobs.

Caffero, the Democratic lawmaker, agreed.

“The program was doing exactly what we intended. People get jobs and jobs with benefits, jobs where they make a living wage, because they have education and training through HELP-Link,” she said. “That’s the goal. We don’t want the [Medicaid] rolls to go up.”

Buttrey noted that prior to the pandemic, Montanans stayed on Medicaid for an average of less than two years. “We’ve given people some job skills,” he said. “We’ve gotten them preventative care and help with addiction.”

Despite federal warnings, red and blue states aggressively cull Medicaid rolls

Robin Rudowitz, who oversees Medicaid research at KFF, a nonpartisan health research organization, praised Montana’s program for encouraging people to find a job — and get off government assistance — without denying them health care while they do it.

She contrasted HELP-Link with the strict work requirements Arkansas briefly had in place for Medicaid recipients during the Trump administration, before a federal court struck them down. Those rules knocked roughly 18,000 people off the rolls. “Arkansas was really the only state that actually implemented to the point of where individuals were disenrolled for failing to comply,” she said.

Rudowitz and other health experts also have been critical of Georgia’s Pathways to Coverage program, launched last summer, which extended Medicaid coverage to some low-income Georgians on the condition that they work or participate in another qualifying activity 80 hours each month. Under that program, which is not considered full expansion under Obamacare, 4,000 people have gained coverage, out of the roughly 350,000 who would qualify based on their income.

Georgia Republican Gov. Brian Kemp has defended the program and blamed the Biden administration for its slow start. The program is set to expire next fall, but several months ago, Georgia sued the federal government in a bid to extend it.

“It’s fiscally foolish, and anti-family,” Georgetown’s Alker said of the Georgia program. She noted that the state is leaving federal dollars on the table by eschewing a full-fledged expansion under Obamacare.

“It’s not been a pathway to coverage for anybody,” she said.

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Montana

Evacuation orders issued as 5,000-acre wildfire burns near Roundup, Montana

Published

9 hours ago

February 27, 2026

Press Room

Evacuation orders issued as 5,000-acre wildfire burns near Roundup, Montana

ROUNDUP, Mont. —
The Rehder Creek Fire is burning 16 miles southeast of Roundup has grown to about 5,000 acres, prompting evacuation orders for residents in the Bruner Mountain Area/Subdivision.

The fire started Feb. 26, the cause is unknown and containment was at 0%.

Evacuation orders are in effect for all residents in the Bruner Mountain Area/Subdivision. The Musselshell County Sheriff’s Office is coordinating the evacuation orders, and 911 reverse calls have been sent out to advise people in the area.

A shelter is opening at the Roundup Community Center. Residents were told to contact Musselshell County DES for further information.

Firefighter and public safety remain the top priority. The public is asked to avoid the Fattig Creek and Rehder Road area so emergency personnel can safely and effectively perform their work.

Fire resources assigned to the incident include 40 total personnel, 11 engines, one Type 2 helicopter, three tenders and two dozers.

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Montana

February 26 recap: Missoula and Western Montana news you may have missed today

Published

21 hours ago

February 27, 2026

Press Room

February 26 recap: Missoula and Western Montana news you may have missed today

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Montana

Escobar, Jayapal, Members of Congress Call on Camp East Montana to be Shut Down – Congresswoman Pramila Jayapal

Published

1 day ago

February 26, 2026

Press Room

Escobar, Jayapal, Members of Congress Call on Camp East Montana to be Shut Down – Congresswoman Pramila Jayapal

(Washington, D.C.) – Today, Congresswoman Veronica Escobar (TX-16) – joined by Representative Pramila Jayapal, the Ranking Member of the Immigration Integrity, Security, and Enforcement Subcommittee, and 22 other Members of Congress – sent a letter to Department of Homeland Security (DHS) Secretary Kristi Noem and Immigration and Customs Enforcement (ICE) Acting Director Todd Lyons calling for the immediate closure of Camp East Montana in El Paso. They cite urgent humanitarian concerns following multiple deaths in custody, documented unsafe conditions, and serious deficiencies in medical care.

This marks the fourth letter Congresswoman Escobar has sent to DHS and ICE leadership. The previous three letters have gone unanswered.

The letter can be found in its entirety below and here.

“Secretary Noem and Acting Director Lyons:

We are urgently calling on the Department of Homeland Security (DHS or the Department) and U.S. Immigration and Customs Enforcement (ICE) to shut down Camp East Montana in El Paso, Texas.

Camp East Montana has been operational for six months, and at least three people have died at the site since December 2025: Francisco Gaspar-Andres, Geraldo Lunas Campos, and Victor Manuel Diaz. The El Paso County Medical Examiner has officially ruled Lunas Campos’ death a homicide, citing “asphyxia due to neck and torso compression.”

Camp East Montana was constructed in a matter of weeks and opened before construction was complete and it does not have enough federal staff on-site to provide adequate oversight. Over the last several months, Congresswoman Veronica Escobar, in whose district this facility is located, has sent multiple letters to DHS and ICE regarding concerns about the conditions at Camp East Montana, and has received no responses.

According to detainees, there have been constant and consistent problems at the facility since it opened, beginning with the facility’s poor construction and poor ambient temperature control. Upon opening, the drinking water at Camp East Montana tasted foul and made some detainees sick. Detainees continue to be served inadequate meals, including food that is rotten or frozen; last fall, the facility was also consistently failing to make dietary accommodations for detainees. Detainees have shared that they have sporadic access to outside spaces and recreational areas, and that their dormitory pods are cleaned only once every eight days, despite pods housing up to 72 people at a time. Laundry services are not consistent, and people are washing their clothes in the facility showers. Additionally, the facility experiences flooding and sewage backups when it rains, leading to stagnant water.

One of the biggest concerns with the Camp East Montana facility is the inadequate medical care being provided to detainees. Our offices have heard that only the most ill detainees are referred to the medical unit and that there are inconsistencies as to how soon after arriving detainees are able to undergo initial medical screenings. Detainees with chronic health issues who rely on regimented medications for their health have had difficulty accessing necessary medications, including blood pressure medication and insulin.

At least one of the deaths that occurred in ICE custody, the death of Francisco Gaspar-Andres, appears to partially be the result of poor medical care by staff at the facility. According to ICE’s own account, Gaspar-Andres sought medical attention from facility staff for increasingly serious symptoms, but was only transferred to an area hospital once his condition had severely deteriorated.

In addition to our concerns about poor medical care, we are also aware that detainees have experienced irregular access to their legal counsel, including instances of detainees having only two minutes allotted per phone call every 8 days, which is contrary to ICE’s Detention Standards on access to counsel, and that the belatedly created law library lacks adequate resources for the amount of people currently held at the facility. In January 2026, ICE announced the on-site death of Geraldo Lunas Campos “after experiencing medical distress.” ICE opened an investigation into the death, but did not provide a cause of death. However, The Washington Post later reported that another man detained at Camp East Montana had witnessed guards choking Lunas Campos when he refused to enter a segregated housing unit. Weeks later, the El Paso County Medical Examiner ruled that Lunas Campos had experienced “asphyxia due to neck and torso compression” and ruled his death a homicide.

Lunas Campos is the first detainee to die at Camp East Montana as a result of a use-of-force incident, but we are strongly concerned that he will not be the last if ICE is allowed to continue operating Camp East Montana.

ICE was given $45 billion in taxpayer dollars in the reconciliation bill, $1.2 billion of which were awarded to Acquisition Logistics, LLC, a company with no previous experience managing immigration detention facilities, to build and oversee Camp East Montana. However, in the wake of three deaths in custody so far, continued concerns about conditions at the facility, and ICE’s apparent disinterest in responding to oversight letters from Congress, we do not believe Camp East Montana is being run professionally or responsibly.

Camp East Montana must be shut down. For the safety of everyone at the facility, for an end to abuses to detainees, and for fiscal responsibility to the American people, the site cannot continue to operate. We are calling on DHS and ICE to move to immediately close operations at Camp East Montana.

We look forward to hearing from the Department promptly on this matter.

The other co-signers include Representatives Yassamin Ansari, Nanette Barragán, Yvette Clarke, Lloyd Doggett, Maxwell Frost, Jesús “Chuy” García, Sylvia Garcia, Daniel Goldman, Jimmy Gomez, Henry Johnson, Stephen Lynch, Seth Moulton, Eleanor Holmes Norton, Delia Ramirez, Andrea Salinas, Janice Schakowsky, Darren Soto, Rashida Tlaib, Paul Tonko, Lauren Underwood, Gabe Vasquez, and Nydia Velázquez.

Issues: Immigration

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