Montana is set to become the 29th state to expand Medicaid after the state's House of Representatives passed a bill Saturday giving expansion supporters a rare red state victory.
The GOP-controlled Montana state House voted 54 to 46 Saturday to advance the measure, mainly thanks to Democrats and the support of moderate Republicans. The bill now goes to the state Senate to reconcile one amendment and then to Democratic Gov. Steve Bullock, who is expected to sign it.
Montana bucked several other red states that have denied Medicaid expansion bills this year, including Tennessee, Utah and Wyoming.
For a while, it seemed likely the bill would die in a state House committee. However, on Wednesday 11 moderate Republicans used a little-known legislative maneuver to side with Democrats and get the bill to the full House floor.
The legislation cleared a key hurdle after a heated debate on Thursday in which the coalition of Democrats and moderates voted down several amendments proposed by conservative Republicans.
Some Montana Republicans were dismayed that the bill could add red tape to the healthcare process.
"I have a hard time supporting another level of bureaucracy in our healthcare system," said state Rep. Wendy McKamey.
Others pushed back at the notion that this expansion was the same as Obamacare.
"This isn't Obamacare. This isn't Medicare," said Democratic state Rep. Geraldine Custer. "This bill is a Montana solution for people who are too rich for Medicaid but too poor for the Affordable Care Act."