2026 Medicaid in Montana: How Medicaid Impacts Montana's State Budget, Economy and Health

The  provides a comprehensive overview of Montana’s Medicaid program. It describes:  

• Who Medicaid covers in Montana, including background on the state’s Medicaid Expansion program; 
• How Medicaid is financed and how Montana’s Medicaid budget compares to peer states; and  
• How Medicaid is structured and the state maintains program integrity.  

The  is the sixth annual report documenting the impact of Medicaid on the health and wellbeing of Montanans, as well as on the state budget and economy. Key findings from this year’s report include: 

• Emergency and inpatient costs fall the longer individuals are enrolled in Medicaid expansion. Emergency costs decreased by 28%, and inpatient costs fell by 16% among members enrolled for at least three years. 
• Uncompensated care rose amid declining Medicaid enrollment. Following Medicaid redeterminations in 2023–2024 and amid changes in the ACA marketplace, Montana Medicaid saw declining enrollment and a 40 percent increase in uncompensated care at critical access hospitals ($15M to $21M). 

This year’s reports are particularly important in establishing a baseline as Montana, like all states, prepares to implement new, Medicaid requirements that will impact enrollment, spending and health outcomes. Both reports are a product of a unique three-way data sharing relationship between the Montana Health Care Foundation, the Montana Department of Health and Human Services, and Manatt. 

Click to view the impact report.

Click to view the background report.