Legislative candidates reflect on key health-care issues

September 28, 2018

Medicaid expansion, Montana’s aging demographics and the role of state funding guided discussion in a wide-ranging candidate forum last week, as eight Flathead residents running for state office fielded health-care questions at Flathead Valley Community College.

The forum, sponsored by AARP Montana, the Montana Primary Care Association and the Montana chapter of the American Cancer Society, offered candidates a non-partisan setting in which to address the public on several pertinent health-care topics, such as elderly care, suicide and addiction prevention, paid family leave and taxes on tobacco. Participating candidates included Senate District 4 Democratic candidate Diane Taylor-Mahnke; JoBeth Blair, Democrat for House District 11; Sid Daoud, Libertarian for House District 8; House District 7 Republican incumbent Frank Garner and Democratic challenger James Cossitt; Mary Custer, Democrat for House District 6; and House District 3 Democratic incumbent Zac Perry and Republican challenger Jerry O’Neil.

Each candidate had 90 seconds to answer pre-supplied questions on a range of health-care issues. Several questions related to the Flathead’s aging population, which will necessitate more elder care, at-home care, and treatment and support for those with Alzheimer’s disease.

On the topic of in-home health care, Custer said the Legislature should work to “allow people to stay in their homes as long as possible.” She said she supports the work of the Flathead County Agency on Aging, and advocated for paying family members who take care of elderly relatives.

Cossitt also said he supports in-home care, but tied the issue to a larger concern with health-care competition.

“Competition in the health-care market is important...lack of competition has a tendency to spike prices,” Cossitt said, calling for the need to “arrest the astonishing rate of inflation in health care.”

The care of elderly residents is something “we [needed] to start planning 20 years ago,” said Garner, adding that it’s important to set priorities at the state level. “We need to diversify our revenues,” he said.

A number of the questions returned to the issue of Medicaid expansion, the federal health-care program that has provided health care to 96,000 previously uninsured Montanans. Montana’s Medicaid program, expanded in 2015 under the federal Affordable Care Act, brought in federal dollars to insure eligible enrollees. The federal government initially contributed 100 percent of funds, but that number will decrease to 90 percent in 2020, with the state contributing the other 10 percent. The program will sunset in 2019 unless renewed by the Legislature or funded by state Initiative 185, which raises taxes on tobacco and nicotine products to cover the costs.

When asked about the program, all but two candidates - Daoud and O’Neil - said they are in favor of removing the sunset, thus allowing the program to continue.

Medicaid expansion is “ethically and morally in line” with her principles, Blair said, adding, “I absolutely believe that if you need to see the doctor, you should see the doctor, no matter how much money you have.”

Perry added “there’s been a lot of positive that we’ve seen coming out of Medicaid expansion, and I think we should build off those successes.”

Garner, who helped craft the expansion bill in 2015, said he still supports the program but thinks it “needs some tough love.”

“I support it, but I think it needs some changes that will improve it,” noting that the program was initially designed to cover 76,000 Montanans but is projected to cover significantly more, “soon to be 105,000.”

Daoud, who said he represents Libertarians, agreed the program needs to be redesigned, but thinks it should sunset in the meantime. When moderator Steven Durand pointed to a study published by the Bureau of Business and Economic Research at the University of Montana in April that says Medicaid expansion would, through a combination of increased revenues and health-care cost savings, pay for itself, Daoud said he would “like to see a closer look at the study.”

O’Neil, a Republican who also described himself as a Libertarian, called for the government to stay out of health care entirely.

Reporter Adrian Horton can be reached at 758-4439 or at ahorton@dailyinterlake.com

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