Reps. Mary Caferro, D-Helena, and Ed Buttrey, R-Great Falls, debate Medicaid expansion on the Montana Lowdown podcast with John S. Adams. Credit: MTFP file photo

HELENA — Medicaid expansion is going to be one of the most hotly debated issues the 2019 Montana Legislature will tackle this session, and Rep. Mary Caferro, D-Helena, and Rep. Ed Buttrey, R-Great Falls, will play critical roles in determining the final outcome.

In 2015 these two lawmakers worked across the aisle to craft a bipartisan bill that expanded Medicaid health care coverage to nearly 100,000 low-income Montanans.

Supporters say Medicaid expansion has been a boon to Montana’s economy. It’s cut an estimated $400 million in uncompensated care in half, supported thousands of jobs, and improved health outcomes for tens of thousands of Montanans.

But the Medicaid expansion lawmakers passed in 2015 is set to expire in July unless the Legislature votes to renew it.

Democrats say the 2015 compromise is a model for the country and should be renewed with only a few minor changes, but Republicans say the cost to the state is too high, and some sideboards need to be added to limit the number of people receiving the benefits.

That debate is going to heat up as lawmakers head into the last half of the session.

Our reporting on health care issues is funded in part by a grant from the Montana Healthcare Foundation. 


Montana Free Press was founded by veteran award-winning investigative and political reporter John S. Adams. John was formerly the Capital Bureau Chief of the Great Falls Tribune and a correspondent for USA TODAY. John is known as a dogged investigator and the host of the MT Lowdown podcast whose unbiased reporting has changed the shape of Montana politics. Contact John at, or follow him on Twitter.