A poll by the non-partisan health research organization KFF released March 7, 2025, found 82% of those surveyed said Congress should keep spending on Medicaid about the same or increase it. (Photo by Ariel Skelley/Getty Images)
One of the most egregious actions taken by our state legislators in the past few years was dropping Medicaid coverage for thousands of Montanans, a process called “disenrollment.” It’s a fact we’ve heard over and over again, but the impact of actions like this sometimes don’t register unless we hear the actual stories of people affected.
A few weeks ago, Medellee Antonioli, the owner of two businesses in Montana, entered the offices of Montana Public Services. Medellee, who is the single mother of two young children since her husband died by suicide a few years ago, had been informed by her dentist that she was no longer covered by Medicaid. This was the second time her dentist had informed her about this, with the first time being when Montana unceremoniously dropped more than 100,000 people. Neither time was Medellee informed by the state that she had been disenrolled. The dentist informed her that this has become standard practice in Montana. They don’t inform anyone.
Medellee is in a unique position when it comes to dealing with issues like this because she has long been interested in data collection, and she took several classes about data entry, including a government documents class, while she was in graduate school. So when she found out the first time that she had been disenrolled, she assumed it would just be a simple matter of filling out the proper paperwork. She researched what she needed to do and submitted her form.
She found out later that she was one of many Montanans who were pointed in the wrong direction in order to become reinstated. Instead of having these people fill out a reinstatement form, the Medicaid offices led them to the form for people who were enrolling for the first time, which meant that everyone who filled out that form was rejected. And it wasn’t as if their information was automatically transferred to a reinstatement application. Instead they were asked to fill out the new form. In Medellee’s case, by the time all of this was accomplished, she and her children had gone several months without health care. As she is quick to point out, she was among the lucky ones because nothing tragic happened to anyone in her family during that time. But if something had, they would not have been covered.
The other confusing thing to Medellee on her most recent visit was that she had just submitted a form to renew her eligibility in December, before the Dec. 15 deadline. So this visit was her effort to find out what happened to that application.
While she was waiting to speak to an official, the lights went out. In a space where dozens of people were sitting at tables trying to fill out paperwork, and she watched a young man get up to open the front door, which turned the lights back on. After this happened a couple more times, the young man approached the front desk and asked whether they could just turn the lights on permanently, and he was told no, which is when Medellee realized that the lights in the office were on a timer so that they automatically shut down every few minutes, despite the fact that people were trying to fill out paperwork.
In the half hour that Medellee waited in line, she heard several stories that left her gutted. She and her mother cried when they left the office later.
One of them was from a woman who had been fired from her job at a government agency in the great government cutback a few weeks ago. Her husband also worked for the same agency, and although he had not lost his job, his hours had been cut to a third of what they were before. The woman wanted to apply for Medicaid, but was told that she would have to provide pay stubs to show when her job had ended. But she had been shut out of her work computer so she no longer had access to that information. So they told her they would need a letter from her boss telling them when her employment had been terminated, but of course all of her bosses had also been fired, so she is not allowed to contact anyone at the office where she once worked. She was told that there was nothing they could do unless they had this paperwork.
The next woman in line had lost her job, and had tried several times to upload her application online, but it wouldn’t work. So the woman had come in to submit her application personally, and while she was in the process of submitting that, the official told her that they now had a program to opt in for reproductive health care. So they asked if she wanted that, and when she said yes, they told her she needed to answer some questions first. The first question was whether she was able to have children.
The woman told them she was very uncomfortable answering that question, and thought it might even violate the rules of HIPPA, to which the employee said that she realized it was a violation, but that she couldn’t fill in the form without an answer to that question. So the woman told them that she didn’t want children, which led the employee to check the “NO” box for being capable of having children, which meant she would not be eligible for reproductive health care.
Months before, when Medellee was there for her previous efforts to get her paperwork straightened out, she stood behind a woman who fell into the category of having filled out the newly enrolled member rather than being reinstated. She was told that they were working overtime to manually transfer the data from the newly enrolled forms to the reinstated forms, but that it would be a four-month wait before her data would be transferred.
“But you don’t understand. I am undergoing treatment for thyroid cancer,” the woman told them.
She had already been waiting for several months. Their reply was that there was nothing they could do for her. She would have to wait like everyone else.
By this time, Medellee found herself feeling some empathy for the woman behind the counter, who was in the unenviable position of giving person after person some form of bad news.
When it was finally Medellee’s turn, she explained that she had filled out the paperwork before the Dec. 15 deadline, so the woman looked her up in the computer and said that yes, she could see that her paperwork had been submitted on time. She went on to explain that they were required to process this paperwork within 45 days of receiving it, but that they had been so overwhelmed by these requests that this wasn’t happening. So she told Medellee that the best way to deal with the issue was to come to the office every day until she was sure that she had been approved. In the meantime, the woman processed the form, which Medellee said took about two minutes. So she was understandably confused about why it hadn’t been completed within the 45-day window. She was also told that, in order to confirm that she’s in the tax bracket she claims to be in, she would need to provide her tax returns for 2024 even though it’s only March, and those forms aren’t due till April 15.
“And I kept thinking, they have my tax returns in the system! Why can’t they just access them there?” she said.
So if Medellee observed this amount of bureaucracy in just two visits to the office, it’s impossible to imagine how many other people, people who are not as well versed in this world, and don’t have time to leave work or their kids and visit the office every day, must be getting lost in the shuffle of paperwork.
Medellee pointed out that we have a governor who made millions creating a company that specializes in data entry, so if they wanted to put the manpower into upgrading the system to make it more efficient, and create a situation where less people would be left out in the cold, they could easily do that. The amount of hours that these employees spend trying to correct the mistakes and misdirected forms is overwhelming.
It gives the impression that this system has been deliberately muddled in order to discourage people from doing what they need to do to get the coverage they deserve. Which is….what’s the word? Oh yes, evil!
The worst part of this is that it’s just one more example of an issue that could have been addressed with the vast surplus of federal funds that Montana acquired from COVID relief. Instead, they decided to drop one-in-every-10 Montana citizens from their Medicaid coverage. Do they consider this trimming the fat, because I don’t think they’re considering the amount of money it’s going to cost the taxpayers when these people who aren’t covered need medical coverage anyway? We all end up paying for it in the long run.
But even worse than that, rather than trimming fat, it feels much more like a deliberate strategy to reach into the chests of Montana residents and extract their hearts.