This is the final story in a two-part series on how the candidates in Montana’s congressional races differ on health care.
HELENA – On the issue of health care, Democratic U.S. Sen. Jon Tester and his Republican challenger, Matt Rosendale, couldn’t be much farther apart.
Tester voted for the Affordable Care Act (“Obamacare”) nine years ago and says the act, while it needs improvement, has done plenty of good, helping many Montanans afford health coverage.
He also blasts Republicans in Congress for refusing to work on fixing problems with the law – fixes he says could help increase competition in the private health-insurance market.
“It still needs work,” Tester says of the ACA. “But to just say we’re going to repeal and just take (health) insurance away and add more instability to the system is not the direction to go, and that’s what we’ve been doing for the last five years.”
Rosendale, the state’s insurance commissioner, is a vocal critic of the ACA and says it should be repealed, because its over-regulation of health care and insurance has made both less affordable.
Its promises of reducing costs and allowing people to keep the health insurance they liked turned out to be false, he says.
Rosendale applauds moves by the Trump administration and the GOP-controlled Congress to remove some of those regulations, allowing more types of insurance products to be offered.
“I think the best thing that we can do is to continue to offer all of these options,” Rosendale told MTN News in a recent interview. “Folks are finding out now that they can accommodate their health-care needs at a fraction of the cost of what they were told that they had to purchase.”
As insurance commissioner, Rosendale has approved options such as primary-care plans, which allows patients to contract for care directly with groups of physicians, and health-care sharing ministries, a voluntary coverage plan for groups affiliated by religion.
He also supports so-called short-term insurance plans, which can offer pared-down, less expensive coverage for up to 364 days.
Tester dismisses these plans as “junk insurance,” which had been greatly restricted by the ACA. The Trump administration has expanded them.
“Yeah, they don’t cost much money, but they don’t cover anything,” he told MTN News this week. “People have insurance in case they need it. And these junk plans, when you need insurance, it’s not going to be there.”
He also says if the ACA is repealed, as Rosendale wants, people with pre-existing health conditions would no longer be protected from sky-high premiums or denial of coverage.
Rosendale, however, says he would protect people with pre-existing conditions by setting up a “reinsurance” plan, which would backstop policies that cover high-risk people and keep their premiums affordable.
He proposed bills last year to develop the plan and they passed the 2017 Legislature, twice, but Democratic Gov. Steve Bullock vetoed them. Now, Bullock and others have embarked on a similar plan.
“From the discussions we’re having with the insurance industry, it looks like it could drop the insurance rates for everyone else from 10 percent up to as much as 30 percent,” Rosendale says.
When asked if he supports getting rid of the ACA’s Medicaid expansion, which is providing health coverage to nearly 100,000 low-income adults in Montana, Rosendale doesn’t really answer, saying the Montana Legislature “has complete control over (it).”
Tester says he supports Medicaid expansion, as part of the ACA.
On the price of prescription drugs, Rosendale points to action he’s taken as insurance commissioner, to expose the contracts of pharmacy benefit managers, which he says are blocking consumers’ access to the lowest-priced products.
“I think this is another really good example of how state-based regulation works the best,” he told MTN News.
Tester agrees that pharmacy-benefit managers need to be reined in, but says Congress needs to take action to “put more transparency on prescription drugs,” to reduce their high price.
“Health care costs are too high,” he says bluntly. “It’s up to the federal government to take pro-active steps to drive down the cost of health-care down.”
Libertarian Rick Breckenridge also is in the race.