Montana policy on how Medicaid recipients qualify for treatment for hepatitis C defies logic. There are so many hurdles to overcome, many who are infected don’t qualify and remain untreated with the potential to spread the disease to others.

Some basics: hepatitis-C is a disease of the liver transmitted by bodily fluids — such as through sex, blood transfusions or shared drug needles. There is a prevalence of the disease among baby boomers. An estimated 1 in 30 are infected. The disease can lay dormant for decades in a victim with no symptoms. But when it manifests itself it can lead to cirrhosis of the liver and death.

According to a report by National Viral Hepatitis Roundtable, about 15,000 Montanans are infected with the virus — with an estimated 1,000 new cases diagnosed each year. And many of those depend on Medicaid for health care. The organization awarded Montana an F for its policies on this disease — one of just five failing grades awarded throughout the nation.

Hepatitis C can be cured. But, when it comes to this disease, Montana Medicaid beneficiaries are denied that care unless 1) they can show they have already severe liver damage, 2) they can document they have been drug-free for six months and 3) have a referral from a specialist — something that can be very difficult to get, especially in a rural state like Montana.

The upshot? There are many people who have been diagnosed with the disease but can’t get treatment through Medicaid.

Among justifications for the policy, state health officials blame the high cost of prescription drugs needed to treat the disease. And one can empathize with the sentiment that those who can’t document they are drug free and not at risk of reinfection shouldn’t get coverage. But that means there are many people with this treatable disease who are circulating on the population at risk of infecting others and ballooning this problem into something even bigger.

State health officials and lawmakers need to address this illogical — and deadly — situation. Those who qualify for Medicaid and have been diagnosed with this disease deserve treatment, for the sake of all of us.


Editorial Board

  • Mark Dobie, publisher
  • Nick Ehli, managing editor
  • Bill Wilke, opinion page editor
  • Don Beeman, community member
  • Richard Broome, community member
  • Renee Gavin, community member
  • Sarabeth Rees, community member
  • David Swingle, community member

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