Gianforte signs the state budget, increasing Medicaid reimbursements by hundreds of millions


Gov. Greg Gianforte on Wednesday announced the signing of the state’s primary budget bill of about $14.3 billion, creating a roadmap for state government funding for the next two years and substantially increasing repayment rates. for healthcare professionals caring for Medicaid patients.

In a news release Wednesday afternoon, the governor’s office touted many aspects included in House Bill 2, including income and property tax cuts, investments in state infrastructure, increases in child care programs and affordable housing. affordable and a historic increase in Medicaid provider rates.

Each of these achievements would be historic in their own right. Collectively, we passed one of the most revolutionary budgets in state history, Gianforte said.

The governor’s deputy communications director Brooke Stroyke later confirmed that Gianforte approved of Medicaid rate hikes approved by the legislature, despite a suggestion in May by House Majority Leader Steve Fitzpatrick, R-Great Falls, to cut $15 million. by increases in overall tariffs. The latest available analysis of the Legislative Tax Division’s final rates calculated an increase of $339.4 million in combined state and federal funds in fiscal years 2024 and 2025.

Advocates for behavioral health providers and other affected services heralded the governor’s announcement.


The Montana mental health system and our citizens who rely on it desperately needed better reimbursements, said Matt Kuntz, director of NAMI Montana, a mental health advocacy group, in a text message Wednesday. It’s wonderful to pass them on.

The fight over how much to raise Medicaid reimbursements for certain types of providers dominated much of the 2023 legislature. Republicans and Democrats alike, responding to a recently commissioned study that found the state underpays for behavioral health, developmental disabilities and providers of care for the elderly and long-term, have pushed to fill that gap beyond what was initially proposed by Gianforte’s budget, albeit to a different extent.

As Democrats and providers have sought to raise rates to meet the benchmarks identified in the 2022 study, some Republicans were wary of releasing a sudden surge in funding in that sector of the healthcare industry. Other party members, including Health Care Budget Subcommittee Chair Rep. Bob Keenan, R-Bigfork, supported record rate hikes, but expressed concern that the funding hikes suggested by Democrats and Service providers would put rates on the chopping block in future budget shortfalls.

Healthcare providers, many of whom have testified to lawmakers that Medicaid patients make up the majority of their caseloads, insisted that fully funding the rates identified in the study was the only way to prevent further closures of healthcare providers . At least 11 nursing homes closed statewide in 2021 and 2022, a trend also seen in local group homes and behavioral health services. In addition to inflation and pervasive pressure on direct service providers during the pandemic, providers have frequently cited inadequate Medicaid reimbursement rates as a leading cause of closures.

During the session, bipartisan support for financing rate hikes eventually brought levels down to those of the contract study. Vendors slated to receive the largest rate hikes said Wednesday that the governor’s approval signaled less financial strain for years to come.

The vendor rate increase combined with our temporary county tax levy we are receiving will allow us a little more time to continue caring for the members of our community who have built and maintained our cities and who won’t have to relocate due to a closure, said Wes Thompson, administrator of Valley View Home, a retirement home in Glasgow. Stabilizing long-term care is not achieved with this rate increase, but it is a badly needed starting point due to Montana’s growing senior population.

The approximately one-month delay between the conclusion of the sessions and the governor’s approval of the budget has created anxiety among many in the health care field. In recent weeks, Democrats have accused Gianforte’s office of holding supplier tariffs and other high-profile bills hostage, as lawmakers debated whether to override his vetoes on bipartisan reforms at Warm Springs State Psychiatric Hospital. and the childcare system. Two out of three of these override efforts were successful, lawmakers losing seven votes before enshrining child welfare reform into law.

Members of both sides approved the final tariffs approved by Gianforte.

It’s good to see that ticked off the list, Keenan said in a statement Wednesday.

Democrats also celebrated the news by taking credit for their role in the outcome.


In this session, Montana Democrats finally convinced Republicans to invest in our community’s health care providers, and Montana’s seniors and working families will finally have a better shot at getting the care they need closer to home. said Rep. Mary Caferro, D-Helena in an emailed Democratic news release.

The fiscal year begins on July 1st.


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