Local leaders and community members discuss health care

Protect Our Care Montana held a discussion in Havre Wednesday about the importance of health care under the Affordable Care Act and Medicaid.

State Rep. Jacob Bachmeier, D-Havre, Paul Tuss, Democratic candidate for the state Senate, Bullhook Community Health Center CEO Brian Hadlock and two local residents spoke to Aly Russell, who organized the Protect Our Care Montana event, in the Jon Tester Conference Room at Bullhook.   

Paying for pre-existing conditions

Tricia Ferry of Havre said she was at the event because her son, Sam, has a pre-existing condition, and the Affordable Care Act and Medicaid are vital in sustaining his care.

Ferry's son was diagnosed two days after he was born in 2005 with pulmonary valve stenosis, she said, a potentially fatal heart condition in which the outflow of blood from the right ventricle is obstructed at the level of the pulmonic valve, resulting in the reduction of blood flow to the lungs.

When her son was 4 months old, Ferry said, she had to take him to Salt Lake City to undergo a procedure to correct the valve.

Sam is now 13 years old and the valve is as close to normal as it will ever be, she added, although when he gets older he will need to have the valve replaced.

"With the ACA and with Medicaid, currently, I have some security in knowing that when that comes we'll be able to do it," she said.

But he has to have annual checkups, each of which last about three hours and costs about $3,000.

"It's not the kind of thing that you can wait until he can't catch his breath," Ferry said, adding that she is using benefits from Medicaid and ACA to pay for them.

"It has been a godsend for me because I don't know how I would be able to afford those check-ups," she said.

She said the thought of losing coverage for pre-existing conditions terrifies her.

"It's not my son's fault that he was born with a bad heart valve," Ferry said, "and he has everything to offer this world like everybody else's child does."

"When you're a mom you want to fix it all," she added. "But I can't fix his heart and I need everything that is currently in place for that to happen."

Paying for cancer treatments

Brett Moen of Havre also spoke about his own experience with the benefits of Medicaid and the Affordable Care Act.

He said that, last December, after having undiagnosed symptoms for some time, his brother was diagnosed with cancer..

Moen said his brotherdid not have health insurance as he had been mainly farming for many years, and had to get Medicaid to see a doctor about his condition.

He said his brother went to Bullhook clinic to be diagnosed. A few days later he had to go to Northern Montana Hospital for a colonoscopy because the severity of his symptoms, and a few days after that he had a CT scan because doctors found polyps in his colon.

His brother had to go into surgery a few days later because they had found a tumor around where his appendix is. His brother started chemotherapy in January of this year, he said, and will once again have surgery in August in Kalispell.

"Every bit of his care depends upon his ability to receive coverage through Medicaid right now," Moen said. "If Medicaid is disturbed ... he stands to lose all of his coverage."

He added that if his family sold the farm and all their possessions they still would not have the money to afford the care needed and that without care, his brother's survival rate would be close to zero.

"I'm very thankful that we got this diagnosed in the area we have, where Medicaid has expanded, so we got a chance to have health care for my brother," Moen said. "Fighting for that coverage is very important."

He added that health care should not be a political issue but a humanitarian issue.

"I'm hoping as time goes on we can find better solutions for health care but right now, simply eliminating these programs en masse, with a stroke of a pen for an ideology that isn't really founded in humanitarian goals, is not our answer and we need to have social services actually be provided as social services in this country," Moen said.

Bachmeier, Tuss and Hadlock

Bachmeier said that as the youngest member of the Legislature he is often asked to share his opinion about the younger generation, adding that health care is a concern for many youths in Montana.

Bachmeier, who faces libertarian Conor Burns and independent Robert Sivertsen, both of Havre, in his bid for re-election this year, said one of the most popular provisions of the Affordable Care Act was that young adults were able to stay on their parents health care until age 26.

As a young adult himself, he said, knowing he has access to health insurance while he attends college and figures out his career gives him peace of mind.

Tuss said the Affordable Care Act allowed states to expand Medicaid in efforts to "make sure more people have access to health care," adding that in Montana, Medicaid has been a huge success.

Tuss, who is challenging state Sen. Russ Tempel, R-Chester, said the Montana Healthcare Foundation recently teamed up with Manatt Health to study the impacts of Montana's Medicaid. He said the study found it to have an extremely positive impact on the state's budget and health care economy.

Around 96,000 adults in Montana now have access to health care, with 70 percent of them working, Tuss said, and the state has saved $36 million in its budget because of federal funding.

He added that 65,000 adults have received preventative health care services, including 195,000 screenings, vaccinations, wellness visits and dental exams.

The state has also gained 5,000 new jobs in the health care field, he said, with $280 million in new personal income and about $47 million in new tax revenue.

  "More Montanans have insurance than ever before, uncompensated care costs for rural hospitals and clinics decreased by $103 million, 44.9 percent, in 2016 alone," Tuss said, "and hospitals became more profitable."

Hadlock said Bullhook handles nearly 9,600 patient visits each year from more than 3,202 people who have a place where they receive the care and services that they need. He said that provides many services for people, from regular check-ups to behavioral health care and dental services.

He said he is standing up for his patients, many of whom have pre-existing conditions.

Before the Affordable Care Act, Bullhook worked with many low-income patients on a sliding-pay scale but at cost to Bullhook, he said. With Medicaid and the Affordable Care Act, more patients have health coverage now and that has improved things financially, he said.

Hadlock said if the protections from the Affordable Care Act are lost, he is worried about how they would be able to continue service for their patients with pre-existing conditions and people on Medicaid.

"The patients we serve are your friends and neighbors, and they deserve access to health care," Hadlock said. "We cannot go back."

Affordable health care is at risk, Bachmeier said. In February of this year, the Texas attorney general filed a lawsuit arguing that the Affordable Care Act is unconstitutional now that the individual mandate has been repealed. The mandate, he added, required most people to have health care coverage or to pay a fine and was crucial for the act to work.

"While legal experts agree this argument is without merit, the concern is that the federal Department of Justice normally defends federal laws in court," Bachmeier said. "But the Department of Justice has refused to defend the constitutionality of the ACA and they specifically attacked the ACA's most popular reform: provisions protecting people with pre-existing conditions."

Ferry said cases like this used to not make it to the U.S. Supreme Court but there have already been three cases within the past couple of years.

That is why it is important to look at the President Donald Trump's nomination of Judge Brett Kavanaugh to the Supreme Court, she added. Kavanaugh has criticized Chief Justice John Roberts for defending the Affordable Care Act, she said, adding that Kavanaugh has also argued that the president could declare a law unconstitutional and refuse to enforce it.

Ferry said that never before has the balance of power been so upset and abused so that one branch of government is given all the power.