Big Sky Connection


Eric Tegethoff

July 5, 2018

HELENA, Mont. - Supporters of an initiative to extend Medicaid expansion through a tax on tobacco products will learn this month if it qualifies for the November ballot.

Backers turned in more than 40,000 signatures, well over the approximately 25,000 needed. Initiative 185 would increase the cigarette tax by $2 to fund the state's expansion of Medicaid past its expiration date in 2019. Medicaid expansion now covers nearly one in 10 Montanans.

Amanda Cahill, director of government relations for the Montana chapter of the American Heart Association, which is backing the measure, said Medicaid has been a lifeline for lower-income folks.

"We've seen stories of people who chose not to go to the doctor. They were living in severe pain, but it was either go to the doctor and not be able to pay the heat, the energy bill," she said. "And so, people were having to make some really hard choices."

Although the initiative hasn't yet qualified for the ballot, state lawmakers are considering a special session to introduce a referendum that would compete with I-185. It would place work requirements on Medicaid recipients. Lawmakers have until July 15 to decide if they'll hold a session.

According to the Healthy Montana campaign, the initiative would generate nearly $75 million a year in revenue by 2023.

I-185 also would fund other programs for veterans, smoking prevention, and to help seniors stay in their homes. For supporters, an equally important part of the measure is the tobacco tax, which they believe can cut down on smoking Cahill said increasing the cost of the habit does stop people from smoking.

"It's the only tax that you never have to pay, right? You never have to pay this tax if you choose not to use tobacco products," she said.

The initiative has the backing of Gov. Steve Bullock, the state's hospitals, and an array of groups including AARP Montana and the American Cancer Society Cancer Action Network.

Cahill noted that Medicaid expansion funds also are integral to the budgets of rural hospitals.

Details of I-185 are online at