It was at a small meeting in Superior where I learned about the petition. Folks there are worried about their Mineral Community Hospital. Already facing a tough economic future, an end to Montana’s Medicaid expansion could be the town’s death knell. Other small, rural Montana hospitals are in the same boat.
If Superior’s hospital closed, the closest one would be 60 miles to the east, in Missoula. When a rural hospital closes in Eastern Montana, the nearest might be hundreds of miles away.
Mineral Community Hospital is also the second largest employer in Mineral County, after the Idaho Forest Products mill. Hospitals closing in any rural community can have a crippling economic impact.
Rural hospitals aren’t alone. Urban hospitals are already feeling the effects of the legislature’s budget cuts to health and human services, and ending Medicaid expansion will just exacerbate the situation. Sunday’s Missoulian was awash with stories from hospitals around Montana laying off employees and/or cutting services. Missoula’s Community Medical Center pink-slipped 16 of its staff:
“Our focus on women’s and children’s care, adult rehabilitative care, brain injury patients and the severely disabled, makes our facility more reliant on state Medicaid,” (CEO Dr. Dean French) wrote. “As we look to the future, the state Medicaid Expansion Act or HELP is slated to end in June of 2019, further challenging hospitals across Montana.”
Bozeman’s hospital is looking at a $2.6 million drop in revenue and Kalispell’s hospital is laying off staff. Details here.
The Montana Legislature narrowly passed expanded Medicaid in 2015, which granted 94,000 lower-income Montana adults health care coverage. The federal government picks up 95% of the tab until 2020, when it falls to 90%. The state’s contribution will sunset in 2019, as dictated by the legislature, which is what prompted I-185. The ballot measure would contribute an estimated $50 million a year from a higher tax on tobacco products.
I rarely disagree with Flathead Memo’s James Conner and on some points in a recent post on I-185, I couldn’t agree more. But whereas Conner is not enthralled by the initiative, I most certainly am. Let’s take a look at his arguments:
Taxing the poor is a filthy, evil, morally reprehensible, policy. Tobacco taxes fall most heavily on the poorest and least well educated among us. Efforts to help people kick their smoking habit should be funded by the progressive income tax.
All true but at this point, it looks like the only avenue available. And maybe a hefty tax on tobacco will encourage these folks to kick the habit. You can be sure that the Montana legislature in its current makeup isn’t going to pass a progressive income tax to fund tobacco cessation programs. Conner continues:
Expanded Medicaid in Montana is a bastardized program that levies a tax on the incomes of poor people, employes private health insurance, the worst possible form of health insurance and the greatest evil in America’s health care system. It is something to lament, not celebrate. Yes, it’s better than nothing — but “it’s better than nothing” is the argument made by people who’ve resigned themselves to defeat and a permanent minority political status.
“It’s better than nothing” is the operative phrase here because until we get single-payer, these stopgap measures are all we have. Conner is right, though, that it’s a “bastardized program (and) employs private health insurance, the worst possible form of health insurance…”
Conner suggests that the way to fix America’s health care disaster is to elect progressive candidates to office who will move our country toward a single-payer system. Again, I couldn’t agree more but until that day arrives, bandaids must be applied.
I’ll be out with a clipboard at Missoula’s Farmers Market and First Friday. The initiative needs 25,468 signatures before June 22 to get on the ballot.