The states play an important role in protecting citizens against this flawed federal health care law–from challenging the health care law before the Supreme Court, to resisting efforts to establish Obamacare exchanges or expand a failing Medicaid program, to offering alternative proposals that will ensure citizens are not left abandoned when the federal law collapses.

Today, Carl Graham—President of the Montana Policy Institute—updates Foundry readers on developments in Montana.

One of the important lessons in Montana is that special interest groups will go to great lengths to get their hands on new federal money.

Much to everyone’s surprise, nearly 60 of Montana’s 90-day legislative session lapsed before Democratic Governor Steve Bullock introduced his long-awaited Medicaid expansion bill.

That bill was promptly and predictably killed in the Republican-controlled House. Regrettably, a handful of big-government Senate Republicans then teamed up with Democrats, Big Medicine, and the usual professional victim industry lobbyists to spend the session’s waning hours parading the expansion corpse around from committee to committee and chamber to chamber until the House leadership finally put a stake through its heart.

By the time it was finally over, five Republicans, along with all Democrat Senators, repurposed no fewer than three bills and flouted House and Senate rules—as well as the Montana Constitution—until eventually the entire battle came down to a 50–50 procedural House vote. During this, an apparently oblivious Democrat accidentally pushed the wrong button, voted against his caucus, and validated the maxim that sometimes it’s better to be lucky than good.

What was particularly appalling about this was that it violated both the Senate rules and Montana’s Constitution, which clearly states that a bill’s contents must reflect its original purpose. This approach by a handful of Republicans has poisoned the conservative well to the point that it may throw Montana’s next election to the progressive side.

Nevertheless, the bill passed the Senate with all Democrats and five of 29 Republicans voting aye. It then went to the House, where the Speaker promptly sent it to the Great Medicaid Expansion Dying Grounds, aka the Health and Human Services Committee. The Speaker’s action was naturally challenged on the floor, leading to the aforementioned 50–50 vote and the fat lady’s aria, at least for this session.

Governor Bullock is pondering whether to bring the legislature back for a special session dedicated to expansion. He’ll do it if he thinks he can swing enough House Republicans to join the five who favored expansion in the Senate. Failing that, the hospital pork-chasers and victim lobby will put it on the ballot as a referendum in 2014.

We still don’t know whether this expansion will turn out to be a comedy or a tragedy. But either way there’s sure to be lots of drama. This shouldn’t be a surprise, with this much money at stake, these special interest groups won’t give up.

Carl Graham is president of the Montana Policy Institute.