Hospital CEO calls for expanding Medicaid in Montana

One of the most important issues facing the 2015 Montana Legislature is how our state can work together to come up with a solution to provide affordable healthcare coverage for citizens in our communities.

The debate has been whether to take advantage of the opportunity to expand health insurance coverage to low income Montanans who fall in the gap between those eligible for Medicaid and those who typically can afford private insurance. The administration and board of directors of North Valley Hospital support such an expansion for a variety of reasons.

The Affordable Care Act (ACA) envisioned that low-income people would receive coverage through Medicaid and therefore does not provide financial assistance to people below the poverty line. Thousands of Montanans are in the coverage gap and do not qualify for any assistance because they are not eligible for Medicaid and their incomes are too low to be eligible for tax credits.

The coverage gap is “alive and well” here in the Flathead County. Last fiscal year, North Valley Hospital provided $2.6 million in charity care health care services in our community. This was an increase of 7 percent over last year, building upon the 26 percent increase we saw in the year prior to that.

Every day, we care for patients in our emergency room who don’t have insurance and have waited until their situation is dire before seeking care. When patients seek treatment in the emergency room, we care for them and those currently with health insurance pay for that care. Expanding coverage to more individuals would bring them into the health care system earlier, creating an opportunity to provide them with wellness and preventive services in a more cost efficient environment.

Our state has been debating the feasibility of the Affordable Care Act for some time. Many have stated that the act should be repealed because it isn’t workable; however, few have offered solutions. Gov. Steve Bullock has offered the Healthy Montana Plan to help meet the needs of our state.

What many people don’t realize is that Montana is already paying for health care for the uninsured. Health care funding doesn’t grow on trees. It’s being paid for through higher medical costs, higher insurance premiums and higher out-of-pocket expenses for those who are already insured or paying out of pocket. Our legislators may expect “able bodied” people to be capable and willing to purchase health insurance, but that does not always happen in reality.

Some of the resistance in Montana to accepting federal money may come from our independent spirit and strong belief in local governance. Now an out-of-state conservative group, Americans for Prosperity-Montana (AFP-Montana), is attempting to influence Montanans and pressure our elected legislators to make decisions regardless of our local community’s input.

Earlier this month, the Facebook page for AFP-Montana posted “change starts on the local level.” Indeed it does. And that is what Frank Garner, a state legislator from Kalispell, is trying to do by listening to his constituents and representing their values, not those from out-of-state factions.

The positive economic impact to our state would be enormous. Recently, Kentucky announced that a year after Medicaid was expanded, they have added 12,000 new jobs and have seen the uninsured rate drop below 12 percent, down from 20 percent. Yes, this has happened by accepting federal funding, like we do on dozens of programs and projects today.

If we are going to be taxed for implementation of the ACA as individuals and employers, we should expect our legislators to bring back our share of the dollars from Washington that we are sending there. Paying federal taxes for the ACA and not receiving the benefits should be disturbing to our communities. To pay the “hidden tax” through health insurance and to pay federal taxes through provisions of the ACA means we are getting hit twice and still have no resolution to the uninsured while states like Kentucky enjoy our generosity.

Let’s change our current situation where thousands of our neighbors are unable to obtain the resources needed to be healthy to one that supports those less fortunate.

Jason Spring is the CEO of North Valley Hospital.