On the Issues


Affordable healthcare should be available to all Montanans–it shouldn’t depend on the size of your paycheck or where you live. We have made progress in recent years, but we still have work to do to make sure every Montanan can get coverage. To expand access to high-quality care, we must take bold action to make it more affordable, while also protecting and improving existing coverage. In the Senate, Steve will build on the successes of the Affordable Care Act (ACA), and fight tooth and nail against the politicians who want to return us to the bad old days when insurers could turn you away for having pre-existing conditions.


First things first, we need to end the attempts to roll back progress. There’s no excuse for threatening coverage for folks with pre-existing conditions, or re-imposing lifetime caps on coverage. Instead, we must build on the coverage expansions we have already secured and make more middle-class families eligible for this support. We need to simplify enrollment for Montana families, instead of making them jump through bureaucratic hoops to get coverage. And we should create a public option – that includes higher reimbursements for rural hospitals – for folks to buy health insurance, encouraging competition among insurers, driving down costs, and giving consumers more choice.


It’s no secret that prescription drug costs are out of control. No Montanan should ever have to choose between paying the bills and affording their medications. That’s why it’s high time to take on the pharmaceutical industry and negotiate drug prices and cap out of pocket drug costs in Medicare. We need to end surprise medical billing, so that folks who have insurance don’t get hit with outrageous out-of-network charges when they get home from the hospital. Consolidation in the healthcare industry is driving up costs and driving down competition, and we should bring antitrust enforcement into the 21st century to combat this damaging trend. Healthcare reform created caps on out-of-pocket costs; we must preserve this vital protection and work to lower those caps to more affordable levels.


Medicaid expansion was a lifeline to rural hospitals in Montana, and we must continue to protect and preserve them. Our rural communities should not lose access to healthcare because folks in Washington are trying to make health care a partisan issue. We need to keep the lights on in rural hospitals, but we also need to make sure there are doctors and nurses inside them. We need a public option that includes higher reimbursements for rural hospitals. We can and should do much more to train healthcare providers in rural areas and create incentives for them to stay. Our rural communities also need continued investments in the infrastructure necessary for telehealth, along with consistent insurance coverage of telehealth services.


Montanans have earned Medicare benefits through a lifetime of hard work, and we must make sure that it remains rock solid for current and future beneficiaries. By closing the prescription drug donut hole, healthcare reform took some important steps to making medications more affordable for seniors. It’s time to take the next step, and allow Medicare to negotiate and cap drug costs. In Montana, the state’s insurance plan negotiates with hospitals to lower costs for beneficiaries. Let’s make Washington take similar action to lower drug costs in Medicare. Keeping Medicare strong includes fighting fraud and making sure funds are going where they should: providing care for seniors.


No one is above the law, and drug companies should be held accountable for negligent sales of opioids and dangerous marketing tactics. We must increase investments in substance use disorder treatment, especially in the hardest-hit rural areas, and expand the “return to work” programs that help folks who have struggled with addiction return to the workforce.


Steve brought Republicans and Democrats together to pass and reauthorize Medicaid expansion in Montana, expanding healthcare to more than 90,000 Montanans. He increased access to telemedicine to expand access to care in rural communities, added autism coverage for all Medicaid-eligible children, and cracked down on big tobacco companies trying to get a new generation hooked on their products through vaping.

Steve made record investments in Montana’s mental health system, expanding crisis intervention and treatment, doubling the number of Medicaid substance use treatment providers, and investing in suicide prevention efforts for veterans, Native Americans, and youth. He pushed insurance companies to cover mental health and substance use treatment the same way they do physical health, and established Project ECHO to dramatically increase access to integrated behavioral healthcare in rural areas.

Steve fought for increases in the state’s support for Native American health services, and protected reproductive health services from being used as a political football by ending the constant battle over its funding at the state level.