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You are here: Home / Anderson On Health Insurance / Good news in Montana

Good news in Montana

by | 48 Comments

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Some good news on the Medicaid expansion front in Montana:

The House has voted in favor of a bill to expand Medicaid.

Senate Bill 405, sponsored by Republican Senate Ed Buttrey, could bring health coverage to 45,000 people.

13 Republicans supported Democrats in support of the bill, passing it 54 to 46….The bill has a final House vote expected Friday.If it passes it goes back to the Senate to reconcile one amendment the House added.

From my extremely limited understanding of Montana politics, it was the House that was seen as the toughest chamber to get on board.  I am reading through the bill right now, and it is a fairly straight forward expansion with minor tweaks that will require waivers.  Premiums will be collected up to 2% of income , disenrollment for failure to pay will need a waiver, and Montana wants to move their entire Medicaid model to a third party administrator (which is not full privatization just outsourcing expertise and claims processing) with delivery reform based on some type of shared risk bearing between the state and providers.  The requested waiver set is well within the waiver parameters that the Department of Health and Human Services has already approved for other states, so I am assuming that should be a fast process.

The coalition to pass the bill is a combination of all Democrats and Republicans who can count to eleven with their shoes on as rural hospitals in Montana have been screaming for expansion to allow their books to balance.

Reader Interactions

48Comments

  2. 2.

    satby

    @WereBear: Not likely. I think it’s just that it’s so far between hospitals in rural Montana that they can’t afford to close any. Too easy to trace how many people would die directly from that.

  3. 3.

    mainmata

    @satby: I agree. Long ago, Republican ideology overtook common sense and cost-effectiveness. Most of their proposals oppose prevention ( of preventable health problems, economic destruction, national security, etc.) in favor of mindless Freedumb.

  4. 4.

    ThresherK

    @satby: Sometime before the internet I recall a Montana story on TV news, perhaps 60 Minutes:

    A city in Montana banned smoking in bars, and before the ban was overturned, the hospitals’ reported rate of heart attacks went down dramatically. This showed how smoking was a major trigger to people susceptible to cardiac events.

    Turns out this was a great situation in which to study this kind of thing because of the fairly stable, stationary and isolated set of people. It wasn’t the crossroads of the world. This kind of ban in a place with the through-traffic of, say, suburban Phoenix or Gwinett GA wouldn’t show anything.

  7. 7.

    raven

    @ThresherK: I went to presentation by two Georgia Gwinnett College profs yesterday and they noted that GGC is the most diverse institution in the South. The were using family histories in their courses and told some wonderful stories about their students.

  8. 8.

    Mr Stagger Lee

    I loved the fact the Montana GOP told the Kochs and their odious organ, Americans For Prosperity go f#ck themselves the people over the oligrchy.

  9. 9.

    TS

    The republicans tried so hard to explain that this is not Obamacare

    “Rep. Geraldine Custer, R-Forsyth, who sits on the board of her local hospital (an uncompensated position for a nonprofit), said the hospital (h)as a “huge and growing” loss from charity care for people unable to pay for treatment.
    She said if Montana didn’t pass the bill, the state would continue sending money to other states to cover their poor instead of Montana “waitresses, clerks” and others among the working poor.
    “The only thing this has to do with Obamacare is it’s the same pool of money,” she said. “This isn’t Obamacare.” ”

    http://www.greatfallstribune.com/story/news/local/2015/04/09/house-passes-medicaid-expansion/25548651/

  10. 10.

    JPL

    @TS: haha… There is a saying that if it walks like duck… yadda yadda yadda

    It isn’t Obamacare, it’s part of Affordable Care Act

  11. 11.

    Punchy

    I’d hold off on the hookers and blow job parties until the Montana Senate actually passes this. I’m sure after the mouthbreathers catch wind of their treasonous House, they’ll mobilize the Rascal Army to decend on the Capitol like stink on a Mizzou alum.

  12. 12.

    Richard Mayhew

    @Punchy: The mouthbreathers have already caught wind of this, and the Montana Senate already passed a very similar bill, so there are two major votes left; a Senate reconciliation, and then the House voting on the Senate reconciliation followed by a signature by a governor who really wants to expand Medicaid.

  13. 13.

    FlipYrWhig

    @TS: @JPL: That’s because all Republicans think “Obamacare” is welfare. It’s free goodies for mooching layabouts and Those People.

  15. 15.

    Randy P

    as rural hospitals in Montana have been screaming for expansion to allow their books to balance.

    Yet 46 Republicans voted against it.

    Are the red-meat state voters hearing that message?

  16. 16.

    Randy P

    I kind of miss seeing the Newsmax feed on the upper right of this page, because I could painlessly get a glimpse into the Tea Party id by just scanning what Newsmax decided to feature as headlines.

    But I must say that I enjoy the Wonkette brand of snark, in their headlines as well as their article, and the Wonkette feed has rapidly made me into a fan and regular reader. Good link yesterday from a Wonkette article on what the Confederacy means to those who like to display the symbology.

  17. 17.

    Elizabelle

    @Randy P: Yeah, I love the Wonkette headlines. Snark on steroids.

    Richard: I am glad to see this. Montana and Kentucky can be islands of sanity for other red states.

    And Montana elects Democrats from time to time. It’s not Wyoming.

  18. 18.

    Tommy

    @Elizabelle: Wonkette is close to my favorite site, if for no other reason they are mean. They say what I think but don’t write. Oh and I should say go Montana.

  19. 19.

    Mike in NC

    Short of being born there, how does anybody justify living in a place like Montana? Are there like 10,000 cattle to every human?

  20. 20.

    Roger Moore

    @Mike in NC:

    Short of being born there, how does anybody justify living in a place like Montana?

    A big chunk of the state, especially the mountainous western part, is really beautiful, with lots of nature to experience and wonderful outdoor activities. There are also a fair number of jobs in agriculture and resource extraction. Don’t knock the place until you’ve visited.

  21. 21.

    Elizabelle

    Meanwhile, Montana’s reading about its own coroner’s inquest into a police shooting. Found this off Richard’s link to the Medicaid expansion story.

    DEER LODGE – The police fatal shooting of a suicidal man in Deer Lodge back in December was ruled justifiable at a coroner’s inquest Thursday.

    “Drop the gun, drop the weapon. Do it, do it now. And he says ‘No,’” said Deer Lodge Police Officer Eric Miller.

    Miller recounted the dramatic moments before firing the fatal shots that killed Nicholas Frazier, 28, on Dec. 19. Miller and his partner Gavin Rosselles testified Thursday morning before a seven-member jury at a coroner’s inquest to determine if the shooting was justified or not.

    The officers responded to Frazier’s 4th Street home after he called 911 threatening suicide. Miller testified that Frazier held a gun to his own head and told Miller he wanted to suicide by cop.

    So: Frazier points the gun at Miller and …

    Miller believed his life was in danger at that point and testified that he had a mystical vision of his life passing before him as he saw Frazier point the gun at him.

    “I started seeing an image of everybody that I loved circling that barrel and that’s when I depressed the trigger for the first time,” he said.

    Frazier was shot twice in the chest and a third shot grazed his head and he pronounced dead at the hospital.

    Jeebus. Why can’t these cops use nonlethal force? Couldn’t they have shot his wrist, or a kneecap, to distract him and then disarm him? Merry Christmas, Frazier family. I want to hear more about this “justified” shooting.

  23. 23.

    Fake Irishman

    Thanks for picking this up and running with it Richard! Incidentally, your twitter handle is highly amusing in a way that rather perfectly matches the mental level of us in this site’s commentariat.

  24. 24.

    Amir Khalid

    @Elizabelle:
    It defeats the purpose of intervening in a suicide attempt, doesn’t it, if you wind up killing the suicidal person. The suicidal person wouldn’t have been a danger to the cop, only to himself; why was the cop fearing for his own life?

  25. 25.

    CONGRATULATIONS!

    TOTALLY OT, my apologies:

    A majority of Americans believe businesses should not be allowed to refuse services based on their religious beliefs in the wake of controversies in Indiana and Arkansas over gay rights and religious freedom, a Reuters/Ipsos poll found on Thursday. […]

    The poll found solid opposition to allowing businesses to refuse services or refuse to hire people or groups based on religious beliefs.

    Fifty-four percent said it was wrong for businesses to refuse services, while 28 percent said they should have that right. And 55 percent said businesses should not have the right to refuse to hire certain people or groups based on the employer’s religious beliefs, while 27 percent said businesses should have the right.

    THAT FUCKING NUMBER. It’s amazing. Ask anyone a question that will define them as a totally unreasonable shithead and sure enough, about 27% will answer “yes”. It just keeps popping up everywhere you look, like pi.

  26. 26.

    low-tech cyclist

    @Mike in NC:

    Short of being born there, how does anybody justify living in a place like Montana?

    How can you resist pygmy ponies and fields full of dental floss?

    More seriously, go to Glacier National Park some August, and hike the Highline Trail. Then follow it up with pizza at Truby’s in Columbia Falls.

    That’s about as perfect a day as I can imagine. I’m already planning a trip there for the summer of 2016.

  27. 27.

    low-tech cyclist

    @CONGRATULATIONS!: I remember back during the Watergate days, it was 26% that would pop up on Nixon’s side in every poll, almost right up to the end. It’s moved up a tick since, but 27% is close enough that clearly the same principle is at work: 27% of the population will support the Republican, or the conservative/GOP stance, regardless of how crazy it is.

    So when we’ve gotten to the point where only 27-28% of the population supports being able to discriminate against gays due to one’s religious beliefs, man, we’ve really gotten somewhere.

  28. 28.

    richard mayhew

    @Elizabelle: I was always taught that if I pointed a weapon at someone, I must mean to kill the person, any other result is either happy happenstance or blind luck. It is only movies and blind luck where a perfectly placed shot will hit a knee or a wrist Cops are taught to shoot for center mass because most cops can’t shoot straight to save their lives (that is why they want large magazines as getting twelve or fifteen chances for a hit is better than getting five or six chances).

    The problem is not that the cops shot to kill, it was that they had their weapons drawn at that point. Drawing weapons means they are ready to use lethal force.

  29. 29.

    CONGRATULATIONS!

    Jeebus. Why can’t these cops use nonlethal force? Couldn’t they have shot his wrist, or a kneecap, to distract him and then disarm him?

    @Elizabelle: I know I keep hammering on this, but the reason I do so is that this idea that you can shoot someone in an extremity with any degree of certitude or safety is a really dangerous one.

    Not particularly for the cop (although it is, because what happens when you inflict a non-disabling wound on someone is not that they give up, but they get pissed off) but for anyone else in that room or behind the guy getting shot, because what’s going to happen is that the cop is going to miss and that bullet is either going to ricochet, possibly hitting someone else in the room, or go through every single wall of the structure, exit, and keep going for quite a distance.

    I am not, by the way, saying the cop needed to kill him.

    If everyone just left the room, evacuated the building, and just let the guy sit there for a while with no food or water, he’d either shoot himself (same end result) or get bored and leave.

    I have been shooting for 41 years and I would not bet a dollar that I could accurately shoot a guy in the hand or knee with a pistol from a distance of greater than 10 feet, even if the guy wasn’t moving, I wasn’t scared, and had all the time in the world to aim.

  31. 31.

    scav

    @Amir Khalid: I think we may have discovered some sort of magic elixir right up there with White Women Tears: Policeman Fears. Justifies all killings.

    Which rather makes me wonder who would win if a policeman felt his life was threatened by an unborn fetus, could he shoot the little scary thing and get away with it?

  32. 32.

    WaterGirl

    @richard mayhew:

    The problem is not that the cops shot to kill, it was that they had their weapons drawn at that point. Drawing weapons means they are ready to use lethal force.

    THIS.

  33. 33.

    Elizabelle

    @richard mayhew:
    @CONGRATULATIONS!:

    Good points, both of you. I’ll stop forming opinions based on what I see in movies!

    But it’s still ridiculous the deceased announced he was interested in suicide by cop, and the cop pretty much complied. There’s no indication Mr. Frazier posed a danger to anyone else; he was not on a bridge or city street, he’s at home; this story does not indicate anyone else is in the house.

    And maybe adequate and accessible mental health care might have saved Mr. Frazier. Maybe not.

  34. 34.

    Elizabelle

    Looking for earlier stories on the Nicholas Frazier shooting. Deer Lodge is about a 3,100 person town.

    The shooting happened at about 11:55 p.m. Friday at 113 Fourth St. When officers arrived, Frazier was holding a handgun to his head, Howard said.

    The 911 dispatcher and the two officer tried to reason with Frazier, he added.

    “There was a good seven to eight minutes of the officers trying to talk him down,” [Powell County Sheriff] Howard said.

    This is the first officer-involved shooting in Deer Lodge in at least 29 years, he said.

  35. 35.

    Frankensteinbeck

    @CONGRATULATIONS!: and @low-tech cyclist:
    There’s a thing I think is usually missed about the 27% theory. It’s not that 27% of the population is crazy and will believe anything. It’s that for each crazy thing, 27% of the population will believe/support it. They’re not the same 27%. The birthers, the truthers, the anti-vaxers, the flying saucerists, they’re different groups with only some overlap. Probably everyone here believes some damn fool thing against all evidence.

    This does not change that the GOP has been deliberately scooping up the craziest and stupidest parts of the population.

  38. 38.

    Elizabelle

    Interesting. Although: the guy had 3 times the legal limit of alcohol in his body, plus drugs, and Officer Miller had dealt with him at least 9 times previously. I still don’t understand why lethal force was used.

    DEER LODGE — A coroner’s jury took 10 minutes to deliberate Thursday afternoon before deciding the shooting death of a Deer Lodge man by a police officer was justifiable homicide.

    After hearing six hours of testimony and reviewing numerous photographs and other evidence preserved during the investigation, the five-man, two-woman jury also determined that the victim, Nicholas Frazier, 29, died at the Deer Lodge Medical Center of a gunshot wound to the heart, fired by officer Erik Miller without criminal intent.

    Anthony Popler, criminal investigator with the Montana Department of Justice, said this is the first case in Montana of an officer-involved shooting in which an officer was wearing a body camera. He said the video was one of the most vital pieces of evidence pertinent to the investigation. Even though officer Roselles’ position behind and slightly to the side of Miller was not an especially good spot for taping, the video recorded all conversation and sounds.

    … Miller has extensive training in hostage and crisis negotiations, and had dealt with Frazier a number of times during the past nine years. He began talking to Frazier, but did not enter the house.

    After the shooting

    Both officers immediately administered first aid, doing CPR for 15 minutes until the ambulance arrived. They assisted in getting the patient into the ambulance and Miller drove to the hospital where Frazier died shortly after midnight.

    …. According to the post mortem report, at the time of his death, Frazier had a .250 blood alcohol level (.08 is the legal limit) as well a number of drugs in his system. Frazier had a long history of drug abuse, and a review of his cell phone indicated he was having a difficult time with depression and suicidal thoughts, among other things.

    This one is so sad. I still don’t understand why the guy ended up shot by the cop, though.

  39. 39.

    guachi

    Looking at the Republicans who voted yes –
    District 7 in the heart of Kalispell, so as close to an urban district as you’ll get.
    District 17 in empty North Central Montana
    District 18 which consists of a few small towns in North Central MT on the border with Canada
    District 20 in suburban Great Falls, the second largest city.
    District 27 – heavily rural county NE of Great Falls and east of (and bordering) Districts 17 and 18. Almost all of Great Falls and environs voted ‘yes’. I’m sure that’s not a coincidence.
    District 32 – East of District 27. Heavily rural and majority Native American. Northern border is the Milk River.
    District 39 – NE of Billings, the largest city. Largely consists of all the small towns on the Yellowstone river between Billings and Miles City.
    District 40 – All the small towns north of Billings.
    District 56 – suburbs east of Billings.
    District 71 & 72 – Rural areas in SW Montana bordering Idaho.
    District 93 & 94 – suburban areas north of Missoula.

  40. 40.

    Roger Moore

    @richard mayhew:

    The problem is not that the cops shot to kill, it was that they had their weapons drawn at that point

    The real problem is that the police were called to deal with a mental health problem. If the guy is suicidal and wants to have the cops shoot him, you want anyone else around him except the police.

  41. 41.

    CONGRATULATIONS!

    But it’s still ridiculous the deceased announced he was interested in suicide by cop, and the cop pretty much complied. There’s no indication Mr. Frazier posed a danger to anyone else; he was not on a bridge or city street, he’s at home; this story does not indicate anyone else is in the house.

    @Elizabelle: He did pose a very immediate danger to the cops standing in front of him. A fair number of “suicide by cop” folks decide to make sure it’ll happen by shooting at least one of the police they are facing. Were I in their position, I’d have a drawn gun as well.

    But the better alternative is to simply leave and let him either shoot himself or calm the fuck down. There may be a reason that wasn’t feasible, but I’m not seeing it.

  42. 42.

    japa21

    @Elizabelle: The main reason I can see for justification in the shooting revolves around an active attempt to talk Frazier into removing the gun from his head. Then the fact that apparently Frazier pointed the gun at the officer. Considering the victims statement he wanted to commit suicide by cop, and that there were two officers there, it is reasonable for the officer to believe that Frazier would go ahead and use the gun on him if for no other reason than to get the other officer present to shoot him.

    This is not obviously a case of a trigger happy cop looking for an excuse to kill someone.

    Could it have been handled differently? Probably. But that is Monday morning quaterbacking. This is definitely not the same as, say, the Scott or Brown shootings. Or what other killings have occured recently.

  43. 43.

    japa21

    @CONGRATULATIONS!: It appears that this officer had dealt with Frazier in the past successfully and probably would have believed he would still be able to until the gun was pointed at him. I didn’t read the story, so I don’t know if anyone else was around that might also have been endangered by Frazier, although that could also play a role in why he wasn’t just left alone.

  44. 44.

    scav

    Sudden thought. Linquistic reuse. Nigerians nicknamed their mobile police (MOPOL) Kill-and-Go. Like it best with the usual accent. Kill-n-go.

  45. 45.

    J R in WV

    @Amir Khalid:

    He was afraid of the other guy because that fear allowed him to shoot the guy.

    SATSQ

    /snark

    Realistically, he was facing a guy with a gun who was obviously off his rocker to a large extent. It’s hard to tell what someone like that is going to do in any case, and once he’s told you that he wants to commit suicide by cop, you the cop knows that he might shoot at you to make you shoot at him.

    I have some sympathy for the cop under those circumstances especially if you are one of those police officers who badly wants to never use his weapon, this is a terrible situation.

  46. 46.

    Elizabelle

    Given this was the first police shooting in this community in 29 years, I would bet the officers involved, and the whole department, is shocked and sad and probably thinking on how the death by cop could have been prevented. And maybe it could not have.

    Have not yet found a story that says whether the gun was loaded or not, but it’s not like the cop will know that on responding.

  48. 48.

    low-tech cyclist

    @Frankensteinbeck: I see plenty of things where the percentage that believes in them drops well below 27%. I bet well under 27% believe in the Loch Ness Monster anymore, for instance. But the GOP hardcore – that’s 27%.

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