Native Issues
Health Policy
Aug 5, 2025

Tribal representatives cite “more questions than answers” as Montana pushes Medicaid work rule plan


August 5, 2025

Tribal health representatives are urging Montana officials to slow the state’s move toward Medicaid work requirements and premiums for the low-income health coverage plan, according to Montana Free Press. They warn the state may be acting too far ahead of the federal timeline laid out in the Trump administration’s domestic policy bill and have expressed concerns about potential administrative hurdles. At a July 29 consultation, stakeholders — including Urban Indian Organizations — said the state’s draft proposal risks disenrolling tribal members.

Although Native Americans are exempt from many new rules, state health officials, including Medicaid Director Rebecca de Camara, told tribal counterparts that the plan’s details don’t yet exist. Joel Rosette, CEO of the Rocky Boy Health Center, described the process as “a year ahead” with “more questions than answers.” He and other tribal leaders pressed the state to simplify applications and avoid replicating administrative failures from previous Medicaid redetermination efforts.

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