Montana Healthy Kids Plan, I-155 (2008)

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The Montana Healthy Kids Plan Act, also known as I-155, was on the November 4, 2008 ballot in Montana as an initiated state statute, where it was approved. The measure established a children's health insurance coverage plan for all uninsured children in the state of Montana to be in effect by December 31, 2009.[1][2]

Election results

Montana I-155 (2008)
Approveda Yes 329,289 69.91%

Election results via: Montana Secretary of State

Text of measure

The text of the measure can be read here.

Specific provisions

The proposal expanded coverage by expanding the Montana Medicaid program, the Children's Health Insurance Program (SCHIP) and a privately insured purchasing pool with premium assistance for families based on income.

The initiative also enacted the following provisions:

  1. Raise the income ceiling for calculating which families are eligible for CHIP to 250% of the federal poverty level, or $53,000 for a family of four. The income ceiling in the current program is 175% of the federal poverty level.
  2. Remove the Medicaid asset test
  3. Create a new pool that connects families above 200% FPL with insurance plans and provides premium assistance based on income
  4. Enfold all the programs under the "Healthy Montana Kids Plan"
  5. Establish an automatic enrollment mechanism and require parents to register their children if uninsured
  6. Provide for sliding scale premium assistance for families who income falls between 200% and 350% of the federal poverty level
  7. Establish a board of directors for the purchasing pool plan.
  8. Require the state to launch an aggressive, coordinated campaign to sign up eligible children for coverage, using schools, hospitals, public agencies, youth sports programs and others.


The author of the initiative was Jonathan Motl, and state Auditor John Morrison was the chief proponent of the plan. C. Everett Koop, the former surgeon general of the United States (1981-1989) supported the measure.[3]

Kristina Wilfore of the Ballot Initiative Strategy Center, a national organization that advocates for liberal ballot measures, has written that "progressives should feel good" about I-155.[4]

Academy Award winning actress Olympia Dukakis showed her support for the initiative at a fundraiser in Whitefish, Montana and said that she was happy to be supporting I-155 because she considers the health and welfare of kids to be an issue of great importance.[5]

Arguments in favor of I-155

Some of the arguments for the plan by its supporters:[6]

  • According to CHIP data it costs $1,734 annually to cover a child as opposed to $3,468 to cover an adult
  • It would reduce cost shifting
  • 16 percent or 37,000 children in Montana are currently uninsured.
  • It would enable preventative care.
  • The children of farmers and ranchers are generally uninsured and therefore these families spend a disproportionate percentage of their total income on medical costs.[7]
  • Supporters cite studies saying that children with health insurance as a group perform better in school.[8]


The official argument against I-155 prepared for the Montana Voter Information Pamphlet was written by State Senator John Esp, State Representative John Sinrud, and State Senator Sam Shockley.

Arguments against I-155

Arguments made by the opponents were:

  • In the current economic climate, a large increase in the CHIP program would be fiscally irresponsible.
  • The initiative will increase the number of Montanans eligible for the program from 90,000 to 127,000, with family earning as much as $60,000 per year still being eligible.
  • Opponents say that "a parent could be a millionaire and his or her child could still receive the benefit if the parent's wages were low enough at the time of application."
  • While children are defined in law as people 19 years of age or younger, a waiver can allow people up to 25 years of age to qualify for the initiative's benefits.[9]

Taxpayer's perspective

According to the National Taxpayers Union, "Initiative No. 155 would offer government-provided health coverage to uninsured children by expanding eligibility for Medicaid and the Children’s Health Insurance Program. Funding for I-155 will come from a share of the insurance premium tax and federal matching funds, with an estimated cost to the state of $22 million.[10]

Fiscal impact

Gov. Brian Schweitzer is troubled by the cost of the program and says he won't support a tax increase. Schweitzer has not taken an official position for or against the measure.

Morrison believes the proposal could cost about $20 million annually. Gov. Schweitzer's budget office produced its own fiscal evaluation, estimating the cost at $38.5 million for the next two years and another $45.5 million for the two years after that.

"The initiative increases health insurance for children without providing for additional state taxes," according to the budget office. "Therefore, a significant reduction in general tax revenues for other state services would start December 2008."

But Morrison expects a surplus sufficient to cover the costs, denying that other programs will suffer. "There are no existing programs and no existing funding that will be impaired for the foreseeable future by this initiative," he said.[11]

David Ewer, the governor's budget director, said "My worry is, how do I get it to fit with all of the other things we have to pay for? I don't have a good sense of what the (future) revenue picture is going to be."[12]


See also Polls, 2008 ballot measures.
Month of Poll Pollster Yes No Undecided Reference
Sept 2008 MSU Billings 73 percent - - [13]

See also

Suggest a link

External links


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