A recent report on Medicaid expansion in Montana shows a continued decrease in state enrollment.
Bozeman-based philanthropic organization the Montana Healthcare Foundation released its Medicaid in Montana report this week. The analysis breaks down annual data to provide a snapshot of healthcare access across the state.
It shows in 2025 Medicaid covered nearly 218,000 Montanans, the lowest level since before Medicaid expansion in 2016.
Montana Healthcare Foundation CEO Aaron Wernham said enrollment declined steeply after eligibility redetermination in 2023, primarily because of human error, and they’re not sure why enrollment dropped again in 2025.
“But we suspect that it’s continued challenges of getting re-enrolled in the program or they have fairly limited assistance lines open and it also may be that there are more people who are employed and getting assistance in other ways" Wernham said.
Montana spends a low proportion of its state general fund on Medicaid compared to the national average and peer states. During SFY 2025, Montana had the 11th lowest rate of state general fund spending on Medicaid nationally and a lower rate of spending than all peer states, including those that have not expanded Medicaid to cover adults with low income.
According to the report, nearly three quarters of enrolled adults work or attend school and more than half of members live in a rural area.
