Governor Gianforte, DPHHS Announce Montana Submitted Application to Strengthen Medicaid Expansion Program

Governor Gianforte, DPHHS Announce Montana Submitted Application to Strengthen Medicaid Expansion Program

State submits HELP Demonstration waiver application

• September 02 2025

HELENA, Mont. - Governor Greg Gianforte and Department of Public Health and Human Services (DPHHS) Director Charlie Brereton today announced Montana submitted a proposed 1115 Medicaid Demonstration waiver application to the Centers for Medicare and Medicaid Services (CMS) to strengthen the state's Medicaid expansion program.

The waiver, named the Health and Economic Livelihood Partnership (HELP) Demonstration, seeks to require community engagement and enhanced cost-sharing for working-age, able-bodied adults enrolled in the program.

"The safety net of Medicaid should be there for those who truly need it, but if everyone is allowed to climb upon the net, it will collapse," Governor Gianforte said. "By requiring healthy adults to engage in work-related activities and cost sharing, we can help preserve the long-term sustainability of the Medicaid program and ensure that this critical health coverage remains available for those who need it most."

The HELP Demonstration waiver requires eligible individuals to actively participate in their health care by paying premiums and contributing to their communities through work, job training, education, or community service activities that enhance their employability.

Director Brereton said the waiver aims to reduce government dependency and encourage self-sufficiency and upward economic mobility for low-income adults, which has long been a priority for Montanans.

"Montanans who can find employment and improve or gain new skills while maintaining access to essential health care services are best positioned to support themselves and their families," Dir. Brereton said. "We are committed to promptly implementing work requirements and premiums for individuals enrolled in Medicaid expansion, as we firmly believe these program elements will foster self-sufficiency and lead to independent, healthier futures for enrollees."

In a letter to Secretary Robert F. Kennedy of the U.S. Department of Health and Human Services, the governor outlines previous amendments to Montana law to implement community engagement requirements and premiums for the Medicaid Expansion population that were challenged by the Biden administration.

The governor wrote, "After the Biden administration's refusal to allow Montana to implement these requirements, my administration committed to swiftly achieving this goal as quickly as possible in partnership with the Trump administration."

"As reflected by our early and proactive waiver application submission, I believe that work requirements and cost sharing for able-bodied Medicaid recipients are long overdue," the governor concluded.

In July, DPHHS released its proposed 1115 Medicaid Demonstration waiver application for public review and comment and held a tribal consultation and two public meetings to collect feedback.

Montana is seeking a five-year approval of the HELP Demonstration waiver and plans to implement it upon securing federal approval.

The waiver application can be viewed here and is posted to the DPHHS HELP webpage at help.mt.gov.

Gov. Gianforte's letter to Secretary Kennedy can be viewed here.

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