Protecting Access to Care

Montana hospitals, skilled nursing facilities and other leading care providers unite in their commitment to improve the health and well-being of their neighbors. The following issues are critical to protecting access to high-quality care for all Montanans.

Medicaid Expansion

Every Montanan benefits from access to quality, safe and affordable healthcare. Providing health insurance to low-income Montanans through the expansion of Medicaid is a common-sense solution that protects access to care in our rural communities.

The Montana Hospital Association supported the Montana HELP (Health and Economic Livelihood Partnership) Act that authorized the expansion of Medicaid in Montana in 2015, and the reauthorization of expanded Medicaid via the Medicaid Expansion Reform and Integrity Act (MERIA) in 2019.

Medicaid expansion in Montana has successfully helped to reduce the rate of uninsured in Montana from approximately 15 percent in 2015 to 7.4 percent in 2016.

Access to Health Insurance

Hospitals provide care to all Montanans, regardless of their health insurance coverage or ability to pay. As a result, they incur bad debt and uncompensated care. Hospitals try to absorb as much of these unpaid costs as possible, but in order to maintain quality services a portion of this cost is shifted to private insurers.

At the same time, certain populations have become increasingly unhealthy. As their utilization of healthcare services and pharmaceuticals climbs, their insurance companies are seeking ways to maintain or turn a profit—increasing rates, reducing covered services and providers, or both.

Continuing to reduce the number of uninsured Montanans will help to ensure the viability of our rural safety-net hospitals and the ability for all Montanans to access quality care, close to home. Additionally, it’s important to ensure that there are minimum standards set to protect Montana consumers from overly restrictive health plans or stripped-down provider networks that prevent access to timely and appropriate care.

Issues and opportunities facing access to health insurance coverage include:

  • Continued authorization and funding for Medicaid expansion in Montana
  • Removing/reducing barriers to coverage
  • Promotion of the health insurance exchange
  • Ensuring appropriate oversight of health insurance plans to protect consumers and establish a standard for minimally acceptable provider networks suitable for a rural state like Montana

Access to Behavioral Health Services

A major focus for MHA toward its vision to improve the health status of Montanans is improving and expanding programs, services and resources dedicated to behavioral health. Montana needs a system of care for all Montanans struggling with mental health and substance abuse illnesses. A “no wrong door” approach to accessing care should be developed that focuses on local community needs matched with resources to build a regional and state system of care.

Issues and opportunities for behavioral health services include:

  • Creation of a statewide system of care built on regional need
  • Improved access to mental health crisis services
  • Expansion of suicide prevention programs
  • Meaningfully address the regulation of opioid use and those struggling with a substance use disorder
  • Expansion of telehealth to deliver behavioral health services

Access to Emergency Medical Services

The average Montanan will have need of an ambulance service at least twice in his or her lifetime according to the state EMS and Trauma Systems Program. For those living or traveling in rural communities, access to EMS services is difficult and may soon no longer be available. Counties and hospitals providing EMS have struggled with volunteer programs and a lack of resources to fund paid personnel.

MHA supports changes to the licensure and certification of EMS professionals to increase qualified training and licensure programs as well as the safe and appropriate expansion of clinical practice that will ensure the continued access and viability of emergency and general health services in rural communities.


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