DPHHS Seeks Public Comment on Proposed Community Engagement, Cost Sharing
Press release from Department of Public Health and Human Services
The Department of Public Health and Human Services (DPHHS) has opened a 60-day period within which the public may comment on its planned 1115 Medicaid Demonstration Waiver application to the Centers for Medicare and Medicaid Services (CMS).
“Implementing community engagement and cost sharing requirements for Medicaid Expansion enrollees is a top priority of Governor Gianforte’s administration,” DPHHS Director Charlie Brereton said. “DPHHS is committed to securing federal approval of our waiver as soon as possible, and I encourage all Montanans to weigh in and participate in this public process.”
DPHHS is preparing to submit an 1115 Medicaid Demonstration Waiver application for Montana’s Health and Economic Livelihood Partnership (HELP) program, also known as Medicaid Expansion.
Specifically, the waiver seeks approval from CMS to implement community engagement and cost sharing requirements as required in state and federal law. Under the waiver, certain Medicaid Expansion enrollees will be required to help pay for a portion of their health care services as well as demonstrate compliance with eligible community engagement activities, such as full or part-time work or education, as a condition of receiving Medicaid coverage. Some Medicaid recipients will be exempt from community engagement, but the list of exemptions has not yet been finalized.
Once available on July 18, Montanans can review the draft waiver application and find details about upcoming public hearings in late July and early August on the DPHHS HELP webpage, help.mt.gov. In advance of the draft waiver becoming available and while waiver design is ongoing, DPHHS welcomes public comments on potential waiver features and other considerations.
The period within which public comment may be submitted began on July 3, 2025. Comments can be submitted via email to dphhscomments@mt.gov with "HELP Demonstration Waiver" in the subject line, or by mail to: Department of Public Health and Human Services, Director’s Office, Re: HELP Waiver, P.O. Box 4210, Helena, MT 59604-4210.
DPHHS has also notified all Montana tribes and offered a formal tribal consultation, encouraging comments from tribal governments, Urban Indian Health Centers, the Indian Health Service, and other tribal stakeholders.
Montana law, amended in 2019 and 2025, directs DPHHS to implement community engagement and cost sharing requirements. DPHHS will also align and comply with recently enacted federal policy changes.