The Montana Healthcare Foundation released a new report on Apr. 12 showing that Medicaid expansion, also known as the HELP Act, is changing how Montanans with low incomes use health care and supporting rural hospitals.
The findings matter because Medicaid provides coverage for many people in Montana who have serious illnesses or mental health conditions. The program covers more than 32,500 Montanans with at least one serious illness such as cancer or diabetes, and about 16,500 with a serious mental illness or substance use disorder.
According to the report, people enrolled in Medicaid for longer periods rely less on emergency rooms and more on preventive care. This shift has helped lower costs over time. “The longer someone stays enrolled in Medicaid, the more their care patterns shift — away from the emergency room and toward the kind of primary and preventive care that keeps people healthier and health care costs lower,” said Dr. Aaron Wernham, Chief Executive Officer at Montana Healthcare Foundation.
Among adults enrolled for at least three years, emergency room visits dropped by nearly 11 percent between their first and third years of enrollment. Emergency costs decreased by 28 percent while inpatient costs fell by 16 percent during this period. Costs per member stayed almost flat despite inflation averaging just over three percent each year.
Rural hospitals have benefited from expanded Medicaid funding by adding specialty services like orthopedic surgery and behavioral health programs—services available to all community members. For example, claims for behavioral health services at federally qualified centers increased sixfold since 2015 according to data shared in the report.
However, there are concerns as uncompensated hospital care rose sharply after eligibility reviews reduced enrollment following the end of the COVID-19 public health emergency. Uncompensated care at critical access hospitals increased by forty percent from $15 million to $21 million between 2023 and 2024.
Montana Healthcare Foundation relies on a charitable endowment from trust investments to fund its initiatives according to its official website. The foundation works across urban and rural areas of Montana as per its official website, collaborating with community organizations, tribal entities and healthcare providers according to its official website. It aims to enhance health across Montana through strategic investments as noted on its official website and offers grant funding along with policy analysis support as detailed online.
