Senator Jason Priest (R) held an open forum on Wednesday, May 29, at old Roosevelt School in Red Lodge to update the community about the past legislative session. He said he was “frustrated” with the inability to get more accomplished this session. He said the model was the 2011 session: “We cut 6 percent, we spent less, the economy grew. We did not get there.” Priest talked about the Medicaid expansion bill, highway funding projects and other topics. About 16 people attended the event held in the gym. Medicaid expansion was a hotly contested issue. Priest praised the senators who voted with him against it. Former Senator Kim Gillan was present and commented, “We have an aging population. I believe that about 40 percent of Medicaid dollars actually goes to people who have to go into retirement homes.” Priest did not support enormous government assistance to hospitals.
Gillan commented, “I understand the big hospitals but I am really concerned about small, rural hospitals…if Scobey goes under.” “I think there’s something to that argument,” said Priest. As an example he said that Sidney’s hospital has a different reimbursement rate than big ones. But, he continued, if you talk to Benifice Hospital (Great Falls), it has to live under Medicare rates. “I think there’s good management out there…They can do it in Sidney; they can do it in other places.” Later, Gillan said, “The reality of rural hospitals is that they’re struggling to keep their doors open. Without these hospitals, many people would have to drive hundreds of miles for healthcare. They have to provide a certain level of coverage and Medicare only reimburses 50 cents on a dollar. If you have healthy citizens, you have a health economy, you have a healthy community.” The Medicaid expansion bills in the last session died.
However, Gillan asked Priest, “If the governor calls a session (to discuss Medicaid expansion) what are your thoughts?” Priest said he believed House Bill (HB) 623, a health care reform bill alternative, would be a good model to start with. He said he would prefer to have a task force study the way other states have negotiated with the federal government. HB 623’s last form defines participating parties: “(4) The department shall propose that participation in the program be limited to adults who are: a) currently employed or actively seeking employment; (b) primary caregivers for a family member; or (c) the spouses of adults who are employed or actively seeking employment.
The bill further states: “ (5) The department may propose that the program exempts from purchase of a qualified health plan any eligible individuals for whom obtaining a qualified health plan is determined to be impractical, overly complex, or contrary to continuity or effectiveness of health care…” and lists subcategories that deal with exceptional health care needs, living in a geographical area lacking health care providers in a qualified plan. It also requires the department to negotiate to the greatest extent possible with the USDHHS to limit eligible individuals who are able bodied and not actively seeking employment.
CCN questioned the financial analysis for HB 623, stating that by followingthe proposal to pay eligible individuals’ premiums it appeared to generate a cost to the state of at least $400 million (using COBRA minimum rates and the state’s estimated number of 70,000 uninsured). Priest replied, “Yes, we had to rethink that,” and said they would be using a different formula. He disagreed with the 70,000 figure as the number of those uninsured in Montana, saying it was too high. He also disagreed with the $400 million estimate, saying if they had kept to the bill’s original formula the state costwas more likely $30 million. Other topics touched upon included pension reform, the positive effects of the Bakaan boom and new leadership in the house and senate. One member of the audience commented that Priest’s appearance provided people of diverse views a rare opportunity for give and take discussion amongst those who might not have otherwise shared their views. A local resident wished there were more such opportunities for constructive exchange.