Montana appears headed to becoming the latest state to expand Medicaid.
The state senate approved a measure Saturday that — with a signature from Democratic Gov. Steve Bullock — would make Montana the 29th state to accept the Affordable Care Act's offer of Medicaid coverage for adults earning up to 133 percent of the federal poverty level.
Enough Republicans joined all of the legislature's Democrats to approve the bill, which is expected to expand Medicaid coverage to about 45,000 Montana residents.
As with other Medicaid expansion plans that have won GOP support, this one would require some special approval from the Obama administration because it seeks to diverge from traditional Medicaid in several significant ways.
Enrollees would have to help pay a small portion of the premiums and co-payments and they'd be offered a program to help them find a job, which could provide them with employer sponsored health coverage so they could eventually leave the Medicaid program.
Bullock, who had pushed hard for Medicaid expansion, has said he'll sign the bill.
"Our state is finally poised to expand health access, support our critical access hospitals, create jobs in the health industry, and provide career training opportunities for thousands of Montanans," he said in a statement Friday. "It is a testament to what can be accomplished when folks put aside politics and focus on solutions to the issues facing our state."
Medicaid expansion is a key way President Obama's healthcare law seeks to expand health coverage to the uninsured. While many Republican-led states have opted out of it, others have sought permission to expand the program in ways more palatable to their party.
Several GOP-led states, however, have rejected Medicaid expansion attempts this year, including Tennessee, Utah, Wyoming and Idaho.