While Congress gets ready to vote on the American Healthcare Act, Montana State Auditor Matt Rosendale is asking them to consider changes to the requirements of Medicaid expansion. Rosendale says he would like to see the funds come to Montana via a block grant.

"The Montana Legislature should be able to develop a way to distribute those funds," Rosendale said. "Right now, the federal government has extremely strict criteria on how everybody has to do it across the nation, they've got some waivers you can apply for, but it's pretty vanilla, right now, you're going to have pretty much the same thing across the nation."

Rosendale would like to see the Montana legislature create a system for health savings accounts that he believes will bring down the price of healthcare.

"If we start taking the dollars for Medicaid expansion and start putting them in Health Savings Accounts, where people can direct where the dollars are spent, exclusively for healthcare purposes, now the people of Montana again are starting to identify where they find value and can start bending the curve of health care costs down," Rosendale said.

One of Rosendale’s biggest concerns is what will happen in 2020. He points out that right now the state receives $280 million in Medicaid funds, an amount which is expected to grow over the next few years. However, in 2020, the amount of funds Montana receives will be rolled back to just 80 percent of the total and Montana will have to engineer some way to pay for the difference.