Medicaid Expansion has made a great difference in Montana

As a nurse practitioner in Missoula, prior to the Affordable Care Act (ACA), I was initially surprised that so many patients came from rural areas — especially Lake County. Some had very little money and could be late because they had hitchhiked or waited on a ride from a friend. Ours was a specialty practice, but much of the work could have been done nearer people’s homes if there had been a program in place. Then as now, rural hospitals, and some rural practices, were struggling — and rural people were struggling.

The ACA, which, for Montana, included Medicaid Expansion, has made a great difference. Research has shown that this program, covering care that would have otherwise been charity care, improves finances of all hospitals — but especially rural hospitals. This does not mean that these hospitals are getting rich, but they are surviving. 

Without these programs, St. Joseph’s Hospital in Polson, and St. Luke’s in Ronan, might not make it. That would mean decreased services, delayed care and very expensive transport to Missoula.

What is more, the ACA has reduced health care costs, nationally and statewide. We could do more, but what we have done already has made the system more reasonable and efficient — and provided money-saving preventative care.

We look to our Montana Legislature and Congress to continue these essential programs. This session, the state Legislature will decide whether to continue Medicaid Expansion. The Congress will decide whether to continue to fund the ACA and Medicaid Expansion.

Sen. Jon Tester has strongly supported the ACA, and he has been active in using this act to meet the specific needs of Montanans. In fact, he has received the 2024 Rural Health Champion Award from the National Rural Health Association.  

He responded, “As a third-generation farmer that lives 12 miles off the main strip of a town of about 600 people, I see firsthand the consequences of policies being made in Washington that don’t take rural America into account.” 

Jon Tester has also worked to lower drug prices through the Inflation Reduction Act;  incentivizing young physicians to build careers in rural hospitals; and by securing funding to make this happen.

Tester’s opponent, Tim Sheehy, is lacking in governmental experience — leading him to advocate an entirely private health care system.  He has been recorded saying,  “Our hospitals have been built around federal health care subsidies. So in my opinion, we need to return health care to pure privatization.” 

Sheehy claimed that the system worked before health insurance, when people simply paid for medical care out of pocket. Most of us know that, since the early 20th Century, people have struggled to pay for increasingly complex and effective healthcare.  

Tim Sheehy seems unaware of what losing the ACA and Medicaid Expansion would mean for Montanans. Health care costs would skyrocket; we would likely lose protections for pre-existing conditions, and vital rural medical facilities would lose federal funding and possibly be shut down — hospitals like St. Joseph’s in Polson, and St. Luke’s in Ronan.

Losing health care is a serious concern for individuals and communities — but this is the reality of what Tim Sheehy has called for with “pure privatization.”

When we vote this November, the fate of health care funding and rural hospitals will be on the line.  We should support Tester and local legislators who understand the importance of rural health care.

Gail Trenfield lives in St. Ignatius.