The huge cost of the governor's 'free' health clinics

In Montana, the legislature is responsible for establishing the state programs to benefit the public, while the executive is charged with administering them. That structure has worked very well for decades and is referred to as the separation of powers. When the power of the purse is taken over by the executive, that’s when we start having problems.

In 2011, then Gov. Brian Schweitzer established — without legislative authority — “free health clinics” for state employees and their dependents to use “free of charge.” These clinics were supposed to save the state government millions of dollars on the amount we spend on health care every year by “improving health outcomes of employees.” But the reality is that since the establishment of these clinics, the cost of the state’s health insurance program has grown at one of the highest rates ever, increasing 22 percent in the last four years.

When the governor’s office began the “free” health clinics, the balance in the account for the state employees health plan contained $75.9 million. Today, that number is closer to $35 million. In just a few short years, the governor’s program burned through over half of our state employee health care reserve funds, largely to pay for these “free clinics,”

This session, Gov. Steve Bullock wants to throw even more resources into this costly and failing program, and has requested that the legislature increase the amount of money sent to the fund. He proposes to do this by increasing the amount of money that the state employers (taxpayers) contribute to insurance costs every month.

That increase is estimated to cost the taxpayers $30 million a year and cost state employees about $25 million a year. And as most of the increase is due to the high cost of the state’s clinics, I think it is time to quit calling these clinics “free.”

So before we consider if it’s worth continuing to throw resources towards the governor’s health clinics, we must ask ourselves, “Who really benefits?”

All state employees and their dependents are eligible to use the governor’s health clinics. However, there are only six of these health clinics in the state — Anaconda, then 13 miles away Butte, Helena, Billings, Miles City and Missoula.

So most of our state employees are miles away from the nearest clinic and cannot practically use them as a primary care provider. In other words, taxpayers in the state pay for state employees to use these terribly expensive and deceptively named “free” health clinics, but only a portion of the state’s employees actually have practical access to them.   

Under the current structure, the governor continues to administer the state’s health insurance program, but it is the legislature and inevitably the taxpayers who are left to pay for it. This program breeds inefficiencies, lacks accountability and falls short of the state’s goal of reducing the costs of health care.

The legislature needs a stronger voice in managing the state’s health insurance program. Otherwise, the unrestrained consequences of misguided public programs like the governor’s health clinics will continue to haunt us.

It’s imperative that we not allow one branch of government go beyond its constitutional authority and then bully the other branch to go along with their scheme. That’s not how our government works, and the people of Montana deserve better.

Sen. Debby Barrett, R-Dillon, represents Senate District 36 and serves as Senate President for the 64th legislative session.