In a Nutshell: Protecting Medicaid expansion in Montana

In February 2025, the Montana House of Representatives passed House Bill 245, a bipartisan effort to remove the sunset clause from Montana's Medicaid expansion program. This isn’t just another piece of legislation—it’s a promise to over 76,000 Montanans that their healthcare needs will be met without the crushing burden of unaffordable bills. Medicaid expansion makes healthcare accessible to adults with annual income less than 138% of the federal poverty level.  

At North Valley Food Bank, I see firsthand how Medicaid expansion touches the lives of our neighbors. Our customers, despite working hard every day, struggle to make ends meet. Many of them depend on Medicaid expansion—not just for healthcare, but as a lifeline that helps keep their families whole.  

Medicaid expansion means accessible healthcare for adults earning less than 138% of the federal poverty level. At North Valley Food Bank, they include working parents, students, and caregivers who, despite sometimes having multiple jobs, don’t qualify for marketplace insurance. In fact, a recent report from the State Department of Labor and Industry shows that over 70% of Medicaid expansion participants are employed. In Flathead County, 35% of local businesses employ someone who benefits from Medicaid expansion—with the highest percentage in the hospitality and food service sector. 

Medicaid expansion doesn’t just provide healthcare—it lightens the financial load so families can afford other essentials, like food. A 2023 study on Montana’s economic effects highlighted that increased health insurance coverage leads to better overall health and more financial stability. When families aren’t forced to choose between a doctor’s visit and a meal, they have a chance against food insecurity. 

Some critics argue that Medicaid expansion strains state resources, but we should consider that the federal government covers 90% of the costs, making the program a smart investment. In fact, Medicaid expansion has funneled roughly $650 million into Montana’s economy each year, supporting 6,000 jobs and generating $400 million in personal income. These numbers aren’t just statistics—they’re proof that when our neighbors are healthy, our communities thrive. 

As House Bill 245 moves through the Senate, I urge you to reach out to your state senators. Share your own stories or the stories of someone you love. Let them know that Medicaid expansion isn’t just policy—it’s a lifeline that keeps our families healthy, our children in school, and our community strong. Protecting this program means protecting your neighbors. 

Sophie Albert is the executive director of the North Valley Food Bank.