2025 Annual Report: Medicaid in Montana

This fifth annual report on Montana Medicaid assesses the performance of Medicaid expansion, focusing on its impact on the health care system, state budget, and health outcomes. The Montana Healthcare Foundation commissioned the report, which was produced by Manatt Health in partnership with the Montana Department of Public Health and Human Services.

Key findings include:

• Medicaid expansion has expanded access to services for all Montanans, particularly in rural areas. In a survey of 27 Montana critical access hospitals, 93% reported adding or expanding new specialty services since Expansion was implemented in 2016.
• State expenditures on Medicaid have remained consistent at roughly 13% of Montana’s total general fund spending 2016, despite adding coverage for more than 90,000 Montanans, as the state benefits from high federal reimbursement rates.
• Medicaid expansion improves access to preventive services, contributing to fewer - and often costly - visits to the emergency room and shifting health care costs from emergency and inpatient care to outpatient services and pharmacy.
• By providing a new source of reimbursement, Medicaid expansion helps the Indian Health Service stretch its limited budget, improving access to non-emergency health services for tribal communities at no cost to Montana.