Montana Editorial Roundup
Bozeman Daily Chronicle, Jan. 1, on critical issues requiring civil discussion:
Informed observers on both sides of our political divide agree on one thing: What’s going on in Washington is an embarrassment. Rhetoric is as extreme as it’s ever been. Whether it’s porn stars or an increasingly chaotic shouting match over border security, every day brings another wild distraction that prevents Congress and the administration from accomplishing what’s needed.
Montana legislators and the governor are strongly urged to not follow their example.
The Legislature convenes next week following a midterm election with the highest voter turnout in 24 years. Though for sometimes vastly different reasons, voters flocked to the polls with determination. And they expect something in return for their votes.
Now it’s time for action.
More than ever, we need a coalition of the reasonable — moderates from both parties — that will get something done. The more experienced legislators know exactly who populates this faction and citizens can figure it out too by watching how their representatives and senators vote on the Legislature’s website at https://leg.mt.gov/. And all are strongly encouraged to do so.
Among the more pressing issues legislators will have to deal with is funding for roads and bridges and other infrastructure that has fallen into disrepair. During the last two sessions historically low-interest bonding that would have paid for much of this was blocked by a handful of lawmakers.
Also to be considered is adequate funding for the University System that will allow the two-year tuition freeze proposed by Gov. Steve Bullock. It’s imperative for the future of our state that higher education remains affordable to Montana families.
And there will be lively debate over extending the Medicaid expansion passed in 2017. Nearly 100,000 Montanans have found health coverage through this expansion — many for the first time in their lives.
An expansion of the early childhood education pilot program passed last year must be considered. The program has been successful and the benefits of pre-kindergarten education on later student performance has been proven.
And there will be local-option sales tax measures that must be thoroughly and thoughtfully debated.
Those are just a few of the critical issues the Legislature will consider. And Montanans deserve and expect a fair and civil discussion on them all — and compromise wherever it can be found.
Let’s get some relief from the juvenile name-calling and tweeting coming out of Washington and have a successful and constructive 2019 Montana Legislature.
Billings Gazette, Dec. 30, on Medicaid expansion working for Montana:
Montana Medicaid expansion covers low-income adults ages 19 to 64, but its benefits extend to children and grandchildren.
Before Medicaid expansion, most low-income Montana adults weren’t eligible for Medicaid and the state’s uninsured rate was above 15 percent. Healthy Montana Kids covered the children, but the parents or grandparents raising them usually had no insurance.
What a difference Medicaid expansion has made in the past three years. The percentage of Montanans with no health coverage has dropped to 7 percent and preventive health care is now accessible to grandparents, parents and future parents.
For example, with regular health coverage and doctor visits, women can learn that they are diabetic or pre-diabetic before they become pregnant. That knowledge helps assure a healthier pregnancy, mom and baby, according to Dr. Rebecca Slingwine, a third-year family medicine resident at RiverStone Health, which saw nearly 15,600 unique patients in the first 11 1/2 months of 2018.
In an interview at the South Side clinic, she noted the importance of health care after child birth. Heavy bleeding during delivery may cause anemia, post-postpartum depression may not manifest for months. With regular, ongoing access to care, the new mom can get medication to help with depression.
One mom had a lump on her thyroid that was detected when she came to RiverStone late in pregnancy. After delivery, Slingwine referred the new mom to a specialist who accepts Medicaid. If she had no care, she would have died of thyroid cancer and her baby wouldn’t have a mother.
Before Medicaid expansion, RiverStone used federal grants to offer patients reduced service fees based on their income. However, there was no money to pay for needed specialty care outside the clinic.
Swingline recalled another Medicaid expansion patient who was struggling with substance abuse in pregnancy, but she got treatment, stayed clean and is now caring for her baby while going to college to earn a nursing degree.
“Because of the help she got, she got clean and the baby has a mom,” the doctor said.
RiverStone has mental health and addiction counselors on staff because mental illnesses and substance abuse issues often are seen in primary care patients.
“I have many patients who are raising grandkids or taking care of parents,” Slingwine said. Some grandparents in their early sixties are raising grandkids while working outside the home. They need Medicaid for their health care.
Dr. Chris Baumert, a RiverStone staff physician who is chief of family medicine for St. Vincent Healthcare, takes care of the community’s low-income workers.
“The majority of the Medicaid patients I have work,” Baumert told The Gazette. “One is a CNA at a nursing home who has diabetes. I have multiple truck drivers. I have patients who are restaurant workers. These are the working poor. Anybody who thinks these people are freeloaders hasn’t met them,” Baumert said.
Remember: Medicaid isn’t free to all eligible Montanans. Copayments and premiums are required of some expansion enrollees, although all of them have income below 138 percent of poverty level — less than $16,700 in 2018 for a single person.
Forty-six percent of RiverStone patients seen in 2018 were covered by Medicaid or Healthy Montana kids. In 2014, before the expansion program started, nearly half of all RiverStone patients were uninsured. In 2016, the first year of expansion, the uninsured rate plummeted to 30 percent, and it dropped to 21 percent in 2017. RiverStone and other community health care providers worked hard to get eligible Montanans enrolled.
In Yellowstone County, 53.3 percent of employers have at least one worker who is covered by Medicaid expansion, according to a new Montana Department of Labor and Industry study that Gov. Steve Bullock cited on a December visit with The Gazette editorial board.
“What we’re effectively doing through a state-federal health care program is taking care of workers whose employers can’t or won’t,” Bullock said.
Purchasing employee group health insurance isn’t financially feasible for many small businesses and Montana is a state of small businesses.
About 70 percent of the 96,000 Montanans in the expansion program are working. Most of the rest are sick, injured, in intensive addiction treatment or caring for children, elders or disabled family members.
We agree that people who are able should work for their benefits. The facts show that by and large Montanans covered by Medicaid expansion are working — if they can.
We caution lawmakers who want stricter work requirements to avoid making laws that will cost more to enforce than they save. As of this year, administrative costs for the expansion program are a modest 6 percent, according to Sheila Hogan, director of the Montana Department of Health and Human Services.
Montana lawmakers also must be cautious about making compliance so difficult that low-income workers will lose coverage, as thousands reportedly have in Arkansas.
Legislators, let’s not spend more state money than necessary to administer this program that is a lifeline for low-income Montanans. Let’s make sure that state money is used to leverage federal funds to provide needed, timely care to keep Montanans working or to help them become healthy enough to work.
Missoulian, Dec. 30, on New Year’s resolutions for Tester, Daines and Gianforte:
December’s end is always a good time to take stock of the recent past and resolve to do better in the New Year. Montana voters recently offered performance reviews of a sort to two of our three congressional delegates this past November, when they re-elected Jon Tester to the U.S. Senate for a third term and returned Greg Gianforte to the U.S. House.
Now facing another contentious session of Congress, along with U.S. Sen. Steve Daines, who will be up for election next in November 2020, these newly re-elected federal officials ought to recognize that even though they’ve earned Montanans’ official vote of confidence there’s still room for improvement — and Montanans are counting on them to represent us to the very best of their ability.
With that in mind, the Missoulian’s editorial board offers these New Year’s resolution suggestions for our congressional delegation:
To start, Montana’s senior Senator Tester needs to do more to help move the needle on transparency and accountability in Congress, and better align his criticism of campaign finance laws with his own role in the system.
It seemed to catch Tester by surprise, for example, that he was the No. 1 recipient of money from lobbyists during his recent re-election campaign, even though he was also a top recipient in his previous election campaign in 2012. At one point this year, he had accepted more money from lobbyists than any other member of Congress as total spending in the Montana Senate election topped $60 million, making it the most expensive in state history.
Tester has repeatedly and appropriately criticized the campaign finance system as too bloated by too much money from groups such as corporations and political action committees that often do their utmost to obscure the original source of financial contributions.
The U.S. Supreme Court ruling in the Citizens United case infamously upended Montana limits on corporate contributions, and Tester fought back by introducing a handful of bills aimed at shining a light on so-called “dark money.” Just this month, in fact, the Senate passed his bill to stop the Internal Revenue Service from allowing nonprofits to keep the names of their major donors secret.
That’s laudable, but rings a little hollow when organizations like the nonpartisan Center for Responsible Politics reports that Tester’s own campaign records show federally registered lobbyists and their families contributed nearly $500,000 to support Tester’s re-election. In his third term, Tester should resolve to show his Montana supporters that these contributions have not, in fact, bought influence — and to never again be among the top recipients of lobbyist money.
Senator Daines, of course, would do well to do the same, given that he will very likely face a similarly expensive re-election campaign in 2020. But even more importantly, he should resolve to better demonstrate his effectiveness on behalf of Montana as a member of the majority party in the Senate. Daines ought to be part of the effort to build a convincing case for critical government funding measures, for instance, instead of throwing out long-shot “nuclear options” that have little to no chance of passing.
Although he is serving his first term in the Senate, having previously served in the House, Daines has steadily earned seats on a number of important committees, including the powerful Appropriations Committee. It is therefore disappointing that Daines doesn’t have more to show for his time in Congress.
Yet many Montanans breathed a sigh of relief when his signature legislative attempt so far, to end federal protections for five wilderness study areas in Montana, failed to make any headway. Daines’ bill would have removed wilderness study designation from a total of 450,000 acres in the Blue Joint, Big Snowies, Middle Fork Judith, Sapphire and West Pioneers.
Such momentous and contentious proposals would seem to warrant a series of public hearings, especially in each of the communities nearest to these treasured public lands. Yet Daines has relied almost exclusively on “input” from county commissions and special-interest groups, and appears poised to re-introduce the legislation in the next session. In the New Year, Daines should take pains to remember that effective public service starts with actually listening to the public in person.
Congressman Gianforte, for his part, should resolve to schedule actual public meetings. While he and Daines, both former tech industry executives, have shown a marked preference for “tele-town halls,” such contrived events can never replace good old-fashioned face time with regular Montanans.
Montanans appreciate the unparalleled access to our federal representatives we have previously enjoyed, and it would be more than a shame to see that access end. It would be a missed opportunity. And public hearings would go a long way toward helping Gianforte show that all Montanans — and not a few powerful individuals — have his ear. Unfortunately, his own WSA bill echoing and expanding on Daines’ proposal burned up a lot of good will in Montana. Gianforte’s legislation would have stripped protections in a whopping 29 WSAs, representing more than 800,000 acres.
In a meeting with the Missoulian editorial board prior to his re-election, Gianforte explained that he follows three main principles in his legislative decision-making. When it comes to public lands, he looks for opportunities to: 1. Keep them in public hands. 2. Increase public access. And 3. Make sure local voices have a say.
Like Daines, Gianforte needs to do a better job of inviting a broad array of local voices to the table, showing that he hears them, and then taking their concerns to Congress. Unlike Daines, in the new year Gianforte will have an extra hurdle to overcome as a member of the minority party for the first time in his tenure. To have any hope of passing legislation, Gianforte will need to work across party lines to build consensus in an often bitterly divided House.
Let’s let 2019 be the year Montana’s entire delegation leads by example, represents our state well and makes meaningful progress in Congress.