Pow Wows Bring Culture and Economic Bursts to Communities

American Indian pow wows are many things. They are reflections of both traditional and contemporary tribal cultures. They are spectacular displays of athleticism, craftsmanship, and a distinctive style of music and singing abilities. But they are also events that spark short-term economic growth for local and neighboring communities. This blog reports on the economic impacts of three diverse pow wows in our state: the Arlee Celebration, located on the Flathead Reservation; MSU-Bozeman’s large off-reservation pow wow; and Poplar Indian Days, located on the remote Fort Peck Reservation.

While several factors play into economic impact, pow wows are often categorized as cultural tourism for the fact that they bring in numerous out-of-towners—spectators, dancers, drummers, and oftentimes hand game contestants—all of whom leave their money in the local economy. Two key factors that play into the level of attendance (and corresponding economic impact) are location and whether or not the pow wow is a contest pow wow. Some pow wows are small social gatherings and celebrations. But many, including a majority of the larger ones, are contests, meaning they feature highly competitive dance and drumming competitions where winners are awarded cash prizes. In these cases, payout amounts and the notoriety of head staff and host drum can all affect turnout and therefore economic impact.

The Arlee Celebration is now in its 118th year and, according to Pow Wow Committee Chairman Willie Stevens, brings in approximately 5,000-6,000 spectators, 2,000-3,000 campers in about 500 camps, 500 dancers, 240 drummers, 300-600 hand game contestants, 20 food stand vendors, 20 arts and crafts venders, and 10 non-profit information booths. Stevens reports that this influx of people benefits “all local businesses from grocery stores to gas station to restaurants and any tourist shops and casinos.” This economic boost impacts not only the Flathead Reservation’s Jocko and Mission valleys, but also the greater western Montana region, including Missoula, as food vendors and many of the campers get their supplies and other items there.

The Arlee pow wow is unique in terms of its economic impact on multiple communities. While the impact of MSU-Bozeman’s pow wow is largely confined to the city of Bozeman, it is still notable. Richard White, pow wow advisor and director of American Indian/Alaska Native Student Success at MSU-Bozeman, reports that their free-admission/registration pow wow attracts between 2,500-4,000 spectators, 200-300 dancers, 200-250 drummers, 45-60 vendors, many of whom utilize local services like hotels, restaurants, gas stations. They also take advantage of local attractions and the shopping available in one of the few urban centers in Montana.

Smaller pow wows held at more remote locations like Poplar Indian Days on Fort Peck have a smaller overall impact but still work to spark economic growth. Greg and Mary Plante and Raymond “Abby” Ogle, who work to plan the pow wow, estimate that it brings into Poplar about 2,000-3,000 spectators, half of whom are reservation residents. They also estimate that it draws between 120-150 drummers, 200-350 dancers, and 12-15 vendors. They believe that these additional consumers positively impact the economic climate of the tiny town of Poplar, which usually boasts a population count of 810 residents.

pow wow pic

2015 Kyi-Yo Grand Entry. Photo courtesy of UM Kyi-Yo Native American Student Association.

While pow wows are primarily about bringing people together to celebrate tribal culture, family and friends, they also have an economic impact by creating varying degrees of economic growth across our state. Every reservation hosts one or more pow wows, as do many of our urban centers with sizeable Native populations. All pow wows are open to the general public and a majority of them do not charge admission. Pow wows run throughout the summer months and are a great way to see our state. They’re also an opportunity to support local businesses, including those that are Indian owned. To find a list of Indian owned businesses, check out the Montana Indian Business Alliance’s website.

MBPC encourages you to check out a pow wow near you. If you are new to pow wows, check out “Your Guide to Understanding and Enjoying Pow Wows.” It is a great tool to learning about pow wows in Montana.

Calendar of Montana Pow Wows

  • MSU-Bozeman American Indian Council Pow Wow: March 25-26, 2016, Bozeman
  • MSU-Billings Pow Wow: April 8, 2016, Billings
  • UM Kyi-Yo Pow Wow: April 22-23, 2016, Missoula
  • 118th Arlee Celebration: June 29-July 4, 2016, Arlee
  • Northern Cheyenne 4th of July Chiefs Pow Wow: June 30-July 4, 2016, Lame Deer
  • North American Indian Days: July 7-10, 2016, Browning
  • Standing Arrow Pow Wow: July 14-17, 2016, Elmo
  • Milk River Indian Days: July 29-31, 2016, Fort Belknap Agency
  • Annual Rocky Boy’s Celebration: August 5-7, 2016, Box Elder
  • Hays Pow Wow: August 10-15, 2016, Hays
  • Crow Fair and Rodeo: August 17-22, 2016, Crow Agency
  • Poplar Indian Days: September 2-4, 2016, Poplar
  • North American Indian Alliance Pow Wow: September 9-10, 2016, Butte
  • Last Chance Community Pow Wow: September 30-October 2, 2016, Helena

Happy Mother’s Day: 18 paid leave victories give moms the gift of time

Sunday is Mother’s Day! Truly, time is one of the best gifts for moms. Working moms want (and need) time to care for themselves and their loved ones and to be able to earn a paycheck. Unfortunately, many working Americans do not have access to paid leave, putting their and their families’ health and financial security at risk.

But momentum for paid leave is growing. This past year, we saw 18 victories throughout the country, providing families (and moms) more time through paid family leave and paid sick days.

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 Family Leave Victories

Shifting work and family patterns mean that most parents must work in order to put food on the table. In Montana, 48 percent of the workforce is made up of women, 70 percent of children have both parents in the workforce, and many women are either co-breadwinners or are fully supporting their families. Yet, women are still considered primary caregivers and often have to reduce their work schedules – or leave work entirely – to care for seriously ill loved ones. When this happens, women can lose hundreds of thousands of dollars over their lifetimes, which takes a toll on their ability to provide for their families and contribute to their local businesses and communities.

The United States lags behind every industrialized economy in providing a national paid leave program. However, over the past decade, several states – California, New Jersey, and Rhode Island – have created statewide paid family leave programs to help workers balance home and care demands. Recently, victories in New York, California, and Montana guarantee workers a better balance.

New York – In early April, New York became the fourth state to enact a statewide family leave insurance program, guaranteeing workers a portion of their weekly wages when they have a baby or need time off to care for a seriously ill family member. Workers can access benefits starting January 2018.

Californialawmakers expanded upon the state’s existing paid family leave program and now provide low-wage workers 70 percent of their weekly wages during leave. This will encourage lower-wage workers to use the program when they need it and will ensure they remain financially secure during leave.

San FranciscoBecame the first city in the country to require employers to provide fully paid parental leave. Starting in January 2017, employers with more than 50 workers located San Francisco will make up the difference between the state’s plan so that employees will receive 100 percent of their weekly earnings during parental leave.

Missoula – In March, Missoula County Board of Commissioners adopted a paid parental leave policy. Starting July 1st, county employees will have access to six weeks of paid parental leave after the birth or adoption of a new child.

Sick Days Victories

Similar to family leave, access to paid sick days allows workers the time to recover from a routine illness and care for sick children or family members while receiving their wages.

Over the past year, 2 states (Vermont and Oregon), 11 cities, and 1 county have enacted paid sick days laws, guaranteeing over 715,000 workers the right to earn a set number of sick days annually. Over the past decade, sick days victories in 32 locations have provided more than 10 million workers access to paid sick leave.

Moms work hard, whether it is in the home, the workforce, or both. They deserve access to workplace policies that provide them adequate time off to attend to their needs and their families’ needs without risking their economic security. There’s growing support for paid leave policies throughout the country. The staff at MBPC is excited to work with organizations and families across the state to find Montana solutions to better support workers and their families.

 

GUEST BLOG: A Brighter Future Because of Tribal College

Today, the Montana Budget and Policy Center will hear from one Montanan and her story what tribal college means to her.

The tribal college on my reservation has impacted my life more than any other organization, which is ironic because I never planned on attending college. I grew up in St. Ignatius, just 20 miles south of Salish Kootenai College (SKC).   During my senior year of high school I transferred to Two Eagle River School, our tribal school that literally borders SKC, and completed early. I was eager to get out on my own and experience life outside the reservation. But as many of us discover, life outside the rez isn’t all it’s cracked up to be. I worked a couple of jobs but didn’t know what I wanted to do with my life. Luckily, my older sister enrolled me at SKC and told me to come home.  

Jody Perez photo

During my first year at SKC I had the opportunity to develop several basic academic and organizational skills, but I also learned what it meant to be a part of the SKC family. I got engaged to the student body president and we got married on campus in the Michel Building. Joe McDonald, the college president, emceed our wedding. Many of our guests were staff and faculty and many others were connected to the college in some way. We even lived on campus because my husband was the site manager for student housing. I felt support and love from the SKC family, which I was now a part of.

The next year I switched degree programs twice and we welcomed our first baby. I held a part-time job at the local travel agency and took classes that interested me, quickly discovering that I enjoyed and excelled in accounting. These classes helped me obtain a full-time job in the finance department at Mission Valley Power. Shortly thereafter, I completed my associate’s degree in general studies. Little did I know that this degree would open future job opportunities that would play a big role in changing our lives.

After the birth of our second child, I decided to put work and school on pause to focus on our family, which soon grew to four children. I stayed home with them for seven years, all the while living in student housing. My husband continued to work for the college and was also the women’s basketball coach. Living on campus and attending games and other events enabled me to remain active in the SKC family. My love and appreciation for the college continued to grow.

When I was ready to return to the workforce, my associate’s degree and the work experience I acquired because of my SKC classes helped me secure the payroll manager position for our tribe. The additional income made it possible for us to purchase our first home, a dream I wasn’t sure we would ever be able to realize. We moved out of student housing but were still very involved in the SKC family. In 2012, I applied for an open seat on the SKC Board of Directors. I am honored to be serving my second term and am currently the vice chair.

I strive to ensure that students find the same support and love that I did. I am forever indebted to SKC for lifting me up, leading me down a good path, strengthening my cultural knowledge, and always believing in me.

Presently, I am working full-time for our tribal housing authority. My position has afforded me the opportunity to finish what I started fifteen years ago. I have been attending SKC full-time for the past year and will be receiving my associate’s degree in business next month. I will continue at SKC until I earn my bachelor’s in business management. I will never stop being involved in and supporting tribal colleges because I know that they enable people like me to increase our overall quality of life by enabling us to access a broad-based education that allows us to obtain better jobs, helping to end cycles of poverty and dysfunction. They allow us to develop strong support networks that cultivate self-esteem and self-efficacy. Ultimately, they are a powerful and effective way for people to create a brighter future for themselves, their families, and our communities.

 

-Jody Perez is a member of the Confederated Salish and Kootenai Tribes. She is a past and current student at SKC and also serves as the Vice Chair on the SKC Board of Directors.

Tribal Colleges: A Great Option for New High School Graduates

As we near graduation next month, many high school seniors and other non-traditional students are finalizing their fall college plans. This post highlights an often overlooked option for post-secondary study: tribal colleges, which play a critical role in educating and training workforces across our state and which provide a range of educational opportunities, from adult basic education and certificates to associate’s and bachelor’s degrees.

The tribal colleges located in the state of Montana play a critical role within the broader higher education system in the state. Out of the 32 fully accredited tribal colleges in the U.S., seven of them are located in Montana — one on each reservation, serving more than 5,000 students. Perhaps surprisingly, non-Indian students make up between 10-30 percent of the student body at tribal colleges in Montana. However, the colleges are only eligible for federal funding tied to the number of Indian students they serve. The state of Montana has recognized the critical role that tribal colleges play and provides a state investment tied to the number of non-Indian students enrolled. Although this investment provides some support to offset the expense of serving non-Indian students, it falls well below the amount the state provides per student to non-tribal community colleges and public universities.

Tribal colleges have expanded their enrollment demographic in recent years partly because they continue to be an affordable option for students and families and also because they have increased academic offerings. Tribal colleges provide job training opportunities that meet the needs of their local communities. Additionally, they have joined tribal leaders in efforts to preserve tribal language, history and culture. All the while, their modest size and structure has enabled to them to expand their degree offerings to reflect the broader job market. Many now offer degrees in information technology, business management, and entrepreneurship, as well as healthcare-related professions like nursing and psychology. They have also worked to develop coordinated agreements with colleges in the Montana University System, so that students can successfully transfer to a MUS school or access online courses to meet their academic and career needs.

Today, tribal colleges are a great option for any student looking for an affordable, close-to-home education that includes a smaller campus and a modest class size that affords them the personal attention needed for academic success.

It’s Tax Day! Let’s Invest in Montana.

We had a few extra days this year to file our taxes, so today, April 18th, is the official Tax Day! This past week, we have been posting quotes from real Montanans who are reminding us all about the importance of taxes in fulfilling our shared vision of a better Montana and stronger communities.

Our taxes enable us to invest in the building blocks of a strong economy and the quality of life that makes Montana such a great place to live.

MWV education

The Montana Department of Revenue’s biennial report is a good roadmap for learning about how tax revenue is invested back into our communities.

  • Tax dollars are used to support education in Montana more than anything else. The money helps build and support Montana public schools, community colleges, universities, and tribal colleges. These investments make it possible for Montanans to compete in today’s global economy and helps businesses access the skilled workers they need to thrive. Tax dollars sustain a high quality education through our teachers and programs. And this is an investment we can be proud of. This past year, Montana’s graduation rate reached a historic high of 86 percent. This upfront investment in our children has rippling effects across the state and into the future. This same report notes that these higher graduation rates will result in additional earnings of $90 million over students’ lifetimes, producing higher revenue for the state and greater economic activity in local communities in the future.
  • State and local spending helps build and maintain roads and bridges and supports the police and firefighters that protect our communities. Investments in infrastructure ensure that our highways and bridges are well maintained and safe to travel so we can get to and from work and explore all of the beautiful places in our state.
  • Montana also invests in protecting our natural resources and environment, including the parks, trails, and forests we all enjoy. Both state and federal tax dollars maintain and conserve 54 state parks and two national parks so we can continue to camp, fish, and hike throughout Montana.

Tax dollars support the everyday necessities we rely on like police officers, clean water, hospitals, and public schools. These funds also sustain items that enrich our lives like parks and libraries. On this Tax Day, take a moment to consider just how much taxes improve you and your family’s well-being.

Who Pays in Montana?

Tax Day is around the corner! Why are we so excited? Because taxes represent our collective investment in public services upon which we all rely, like roads, public safety, schools, and much more. Our taxes make our state a better place to live and raise families, and that is something to celebrate.

This year, Tax Day is Monday the 18th and we invite you to join The Montana Budget and Policy Center at the Blackfoot Brewery to raise a pint to investing in Montana and our organization. Until then, we thought we would help you brush up on who is paying taxes in our state.

Overall, when considering all types of state and local taxes, low-and moderate-income individuals pay a greater share of income in taxes than do higher income earners. As you can see below, families earning less than $19,000 a year pay 6.1 percent of their income in taxes, while the top one percent of earners (those earning over $435,000) pay 4.7 percent.

Lowest 20%

Why do low-income families pay a greater share? To answer this, let’s see how three types of tax (income, property, and sales) influence tax fairness.

In many states, sales tax is a significant source of revenue. This disproportionately impacts low-income families, because we all must purchase essential items like food and clothing, and all individuals pay the same percentage of tax, regardless of income. Sales tax is one example of a “regressive” tax, where lower-income individuals pay a greater proportion of their earnings in taxes. While Montana does not have a statewide sales tax, we do have excise taxes on goods like gas, cigarettes, and cellphone services. Also, some communities in Montana, like Whitefish, have a resort tax to help maintain the community’s local infrastructure, which undergoes wear-and tear during tourist season.

Additionally, Montana relies heavily on property taxes to fund public services. Like sales and excise taxes, low-wage earners often pay a higher share of their income in property taxes. Housing costs tend to be a larger proportion of low-income families’ earnings, compared to high-income earners. For example, a family making $50,000 a year may own a home worth $150,000, or three times their income. While a family making $1 million per year may own a home worth $500,000, or half of their income. Renters also pay because landlords pass along these taxes when setting rent.

While low-income families pay more than their fair share in property and excise taxes, Montana’s income tax helps balance (but not completely neutralize) our overall tax structure. In Montana, the highest-paid individuals pay 3.8 percent of their annual earnings into income taxes, while the lowest-paid individuals pay less than 1 percent. While our state income tax helps mitigate the effects that property and local taxes have on low-income families, there’s still work to be done.

While not perfect, Montana’s tax structure is ranked third most fair in terms of state and local taxes. Of course, like all states, we can improve. For example, Montana remains one of five states that continue to impose income taxes on families living in poverty. Legislators could help balance our tax system and mitigate the impact that income taxes have on these families by adopting a state earned income tax credit, which could support Montana’s low-income workers, our communities, and state economy.

Now that you’ve brushed up, help us celebrate this important day. As you file your returns, remember that taxes are critical to making our state and local communities the places we love to live in.

MBPC Announces New State-Tribal Policy Specialist

MBPC is thrilled to announce Heather Cahoon as our new State-Tribal Policy Analyst. Heather brings a wealth of experience in policy research, and we know she will be an incredible addition to our team.

Heather is a policy scholar with a PhD in research on the evolution of tribal sovereignty in the U.S. as impacted by Heather Cahoon.AIA.headshotmajor pieces of federal Indian policy and subsequent interpretations by the U.S. Supreme Court. She has worked with numerous tribal, state and non-profit organizations to address socioeconomic issues facing American Indians in Montana and, in general, seeks to further decolonization as it relates to rebuilding indigenous governments, economies and other social institutions. She holds an Interdisciplinary PhD in History, Native American Studies, and Anthropology from the University of Montana.

A member of the Confederated Salish and Kootenai Tribes, she was born and raised on her reservation but now resides in Missoula where she has taught for the University of Montana’s Native American Studies Department for the past six years. During this time, she was named UM’s first Eloise Cobell Institute Scholar, a title reserved for faculty who are continuing Cobell’s legacy of working for justice and equity for American Indians and tribal communities. She also currently serves on the board of directors for Western Native Voice.

In 2011, MBPC established the State-Tribal Policy Analyst position to promote sound fiscal and budget policy that can help reverse the history of economic injustice that has led many American Indians to unacceptable levels of poverty, unemployment, and poor health. Our work aims to inform policymakers on how tax and budget choices affect Indian Country, and to increase participation among American Indians in advocacy for sufficient investment in the state budget.

We are excited for all we can accomplish together. 

If you would like to contact Heather and welcome her to this important work, you can do so at hcahoon@montanabudget.org.

Montana can expect continued economic benefits from Medicaid expansion

States across the country that have expanded Medicaid are experiencing significant savings as well as increased revenue, and as we heard from the Montana health agency this week, we can expect similar experiences here in Montana after the passage of the HELP Act. In case you missed it, MBPC released a new report this week, highlighting the successful enrollment levels in Medicaid – already, over 38,000 Montanans have enrolled– and detailing some effective strategies the state should consider in continuing its outreach to eligible Montanans.

The Department of Public Health and Human Services also announced this week that the State of Montana has already experienced $3 million in savings to the state general fund, and over $37 million in NEW federal dollars invested in communities across the state.

Based on other states’ experiences, Montana can expect continued good news as enrollment grows. A new study out this month shows that all expansion states should expect to see state budgetary savings and additional revenue.

As we’ve talked about before, the federal government pays 100% of the cost of expansion. That match will gradually scale down, but will never drop below 90%. This compares to a federal match of about 70% for the previously eligible Medicaid population. States have been able to “transfer” a portion of that previously eligible population into the new adult group covered at the higher federal match. For the individual, insurance won’t look any different (or in some cases, may be better!), but the state will see savings on what it has to spend on Medicaid. We’ve already seen this in Montana – with the state receiving the higher match for over 8,000 individuals previously covered by Medicaid. This translates to over $3 million in savings to the state general fund.

The report also details additional savings, through lower uncompensated care costs and less pressure on state resources for mental and behavioral health programs, public health programs, and health care services for prisoners. Because many of those who access these programs are now eligible for Medicaid, they can get preventative care and other services they need at lower cost to the state. We don’t yet have data for Montana, but the research shows that savings in other states have exceeded expectations.

Additionally, those new federal dollars into Montana communities have rippling effects all over the state. Even when the federal share scales down to a 90% matching rate, this is still a good deal for states, because these federal funds generate new economic activity that wouldn’t have happened otherwise. A simple comparison is when someone living outside of Montana visits and spends money in the state. Unlike a state resident choosing to spend a dollar in one area of the state economy versus another, our state economy reaps the benefits of that new out-of-state dollar. As the article points out, for every 90 cents in federal funds to pay for one dollar of new Medicaid spending, the state should expect $1.35 to $1.80 in state economic activity, supporting jobs and increasing tax revenues for state and local governments.

Over 38,000 Montanans are getting the health care coverage they need to stay healthy and to be active members of their communities. We’ve heard from many of these folks, who have told their stories about how getting the health services they need has made a real difference. And the fact that the state will see even greater economic benefits than anticipated is “icing on the cake”.

 

Continuing Medicaid Expansion Enrollment: What can we learn from other states?

Without a doubt, the first three months of enrollment in new affordable health care coverage in Montana has been a true success. The state health agency announced yesterday that, as of March 15, over 38,000 Montanans have gained health insurance through Medicaid expansion. Our blog post earlier this week highlighted the majority of these newly enrolled individuals are living in poverty (many in deep poverty), many of whom have never been able to afford health insurance. The enrollment numbers are exceeding expectations, but it was also not surprising that the state experienced strong enrollment during the months that coincided with open enrollment for health insurance on the federal Marketplace.

It is important to note that the enrollment period for Medicaid is year-round, and the state and other partners must continue to look at ways to improve its outreach. Today, MBPC released its new report looking at some strategies that other states have utilized to expand outreach and enrollment. The report includes specific examples and lessons learned. These lessons come from a number of excellent research reports from the Kaiser Family Foundation, as well as, our direct conversations with individuals engaged in enrollment efforts in Colorado, Indiana, and Washington.

Here are some highlights:

  • Outreach materials are most effective when the information speaks specifically to the personal benefits of having insurance and can be tailored to specific regions or demographics. For example, the state of Washington provided local navigators flexibility in modifying enrollment materials for different regions of the state.
  • Continuous tracking and analysis of enrollment data by region and demographics can help the state better target outreach on an ongoing basis. For example, the Colorado Health Institute conducted a detailed analysis of uninsured levels based on zip code, allowing the state to better target outreach efforts. Colorado targeted rural areas through direct mail cards with details on who qualifies and how to apply.
  • States have also successfully utilized community locations, such as shopping malls, libraries, and schools, to educate the public about affordable health coverage and enroll individuals in Medicaid. The state of Washington set up kiosks at local malls and tied its marketing campaign to the idea of “shopping” for affordable health insurance.
  • States have found other partners that may not be directly tied to health care system to help get the word out. Colorado enrollment assisters engaged for-profit entities, including pizza delivery companies and supermarkets, to include enrollment information during delivery or checkout. Kentucky has utilized community leaders, including faith leaders, to help spread the word of health insurance opportunities.
  • Outreach efforts to inform American Indians of new coverage opportunities in Medicaid must recognize how having health insurance relates to accessing care through IHS, Tribal health clinics, Urban Indian health centers. Outreach efforts should emphasize that American Indians can continue to access care at IHS, tribal, and urban Indian clinics. Gaining access to Medicaid allows clinics to access reimbursements for services through Medicaid, which frees up IHS funds to increase and improve health services for their communities.

We encourage you to take a look at the report, and we look forward to working with our partners across the state to continue to emphasize the success of Medicaid expansion in Montana.

Medicaid Expansion: Enrollment to Date

In just the first few months of new coverage under Medicaid expansion, we are seeing significant enrollment levels and evidence that thousands of Montanans need (and are now receiving) affordable health insurance. This month, the Montana Department of Public Health and Human Services (DPHHS) released new data on the number of people who have enrolled through the Montana Health and Economic Livelihood Partnership (HELP) Act. Since enrollment began on November 2 (with coverage beginning on January 1), over 36,320 Montanans have signed up, exceeding first-year projections on all levels.

This week, we will release a new report analyzing this enrollment and the populations that the state should consider focusing future outreach efforts. The report will also detail a number of successful strategies that other states have deployed to reach eligible families and get them enrolled.

As a preview of this work, here are some of our thoughts so far on enrollment.

Income levels

It is not surprising that Montana has seen a significant portion of newly enrolled individuals at very low incomes. So far, over 60 percent (or approximately 22,000) of those enrolled are living with family incomes below 50 percent of the federal poverty line. For an individual, this represents an annual income of $5,990, or about $490 per month. These are families that, in the past, have had few or no options for affordable coverage. The state and other partner organizations did incredible work to reach these populations using existing data and let them know they would be eligible for new health care coverage options in 2016.

We know that a significant percentage of the uninsured population below 50 percent has now enrolled; future enrollment efforts may be best targeted to populations with incomes between 50 and 138 percent of FPL. This population will be enrolled in the HELP Plan and subject to premiums and copays, so it is critical that the state’s materials are clear on what these premium levels are and the importance of gaining health insurance.

American Indians

While we have seen over 4,300 American Indians enroll, this number is low compared to the estimated percentage of the entire eligible population that is American Indian. According to Census data, American Indians represent nearly 20 percent of the total eligible uninsured population. And yet, only 12 percent of newly enrollees are American Indian.

Outreach efforts focused on eligible American Indians must take into account the unique health care dynamics, including how insurance relates to accessing services through Indian Health Service (IHS), tribal health clinics, and urban Indian health clinics. The state should work closely with tribal leaders and tribal advocates to ensure enrollment is supporting this existing tribal healthcare infrastructure. These types of partnerships are happening across the state, but even more can be done to support health coverage enrollment in Indian country.

Regional differences

We are seeing regional health departments and health centers actively engaged in enrollment efforts across the state, but enrollment numbers show opportunities to expand efforts in certain areas. Over 56 percent of enrollment has occurred in the top five counties in Montana (Cascade, Flathead, Gallatin, Lewis & Clark, Missoula, and Yellowstone counties). And while all five counties are reaching significant numbers of newly eligible, Gallatin County is lagging behind the other counties when comparing enrollment as a percent of eligible uninsured population.

MBPC commends the state, those engaged in Cover Montana, and others involved in enrollment efforts. The need for the HELP Act is clear – with over 36,000 Montanans accessing coverage in just the first couple months.

But thousands more Montanans are eligible. Stay tuned for the release of our report later this week, which will detail our research on strategies that other states have undertaken to reach eligible individuals and get them the health coverage they need.