Montana's expanded Medicaid program is set to expire next year. People who rely on it are calling on lawmakers for an extension but opponents argued Medicaid was never meant to be a long-term option for most people.

The Montana Legislature voted during its last session to expand the state's Medicaid program to cover an additional 85,000 people.

Megan Martin, a small-business owner and mother in Helena who relies on Medicaid, said she is out of health care options if the state does not extend it.

"I have looked and have been told that I could get health care off of our federal marketplace, which I don't qualify for," Martin explained. "That's terrifying because I don't make a ton of money, being a small-business owner. So, not having any other option is scary."

Gov. Greg Gianforte has not been clear on whether he supports an expansion but has said Medicaid should be a temporary program to help people get back on their feet. Data from KFF Health News show 9% fewer Montanans are covered under Medicaid now than before the pandemic.

Montana's Medicaid expansion is largely funded under the federal Affordable Care Act but is administered by the state, which is why expansion takes a legislative vote. Martin pointed out like many Montanans, she is working multiple jobs just to keep up with her family's cost of living, let alone being able to afford health care.

"How many more jobs do I have to get? How much more hustling do I have to do? How much more money do I have to put in my pocket, in order to make sure that we're all healthy?," Martin asked. "Nobody should have to worry about that, at the end of the day."

The Legislature is scheduled to consider extending the Medicaid expansion when lawmakers convene in January.


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A recent foodborne illness outbreak linked to deli meats is putting the spotlight on how these foods are regulated.

The listeria outbreak in Boar's Head products has led to 10 deaths and at least 59 people sickened across the country.

Jovana Kovacevic, associate professor of food science and technology at Oregon State University, said it is important to know listeria is prevalent in the natural environment. Kovacevic pointed out the United States has a zero-tolerance testing system for listeria, which is different from other countries and, counterintuitively, might do more harm than good than a system testing for certain levels of the bacteria.

"It would encourage industry to sample more," Kovacevic asserted. "And once they find positives, it would help them act before the food becomes contaminated and before any contaminated foods end up in the commerce."

Kovacevic pointed out listeria is most harmful for vulnerable populations, such as pregnant people, older people and those with compromised immune systems. Members of Congress recently wrote a letter to the U.S. Department of Agriculture over its concern that the agency wasn't able to prevent the outbreak.

But Kovacevic noted there has been progress on how the USDA and the Food and Drug Administration, which also monitors food safety in some situations, prevent foodborne illnesses. Still, she argued there is room for improvement.

"Standardizing our approach to listeria probably we would benefit from it," Kovacevic contended. "Consumers would benefit and the industry would benefit in terms of having the ability to look openly for listeria as opposed to fearing if they find any positive what's going to happen."

Kovacevic added there are ways consumers can prevent outbreaks, such as storing meats at the proper temperatures and cooking them thoroughly.

"There's just certain foods that are higher risk foods," Kovacevic explained. "If you're in that vulnerable group, you want to avoid those foods. So, we really need to do better to engage consumers in these discussions."


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The Missouri Foundation for Health has released two reports that reveal significant obstacles Missourians face in accessing affordable health care. The first report from "Speak Up MO" covers Missourians' health-care experiences, while the second, "Medical Debt in Missouri," focuses on policy solutions. The findings highlight disparities in access to care and the financial burden of rising healthcare costs. Alarming statistics show one in five Missourians reported being without health insurance at some point in the past year.

Samantha Bunk, health policy strategist with the Missouri Foundation for Health, warned the high cost of health care is causing further hardships for Missourians.

"When you can't afford your health care, obviously that can affect things like if you can afford your housing, your basic needs, food, paying your bills, things like that - and then when we get into talking about medical debt, which was the other report, that can always have effect in other ways as well," she explained.

22% of Missourians report struggling to secure a car loan, and one in five face difficulties when applying for an apartment or mortgage. The foundation plans to work on resolving the challenges with evidence-based policies and by working closely with communities.

The reports reveal that about two-thirds of respondents found accessing physical health care "very" or "somewhat easy." However, the findings highlight disparities across different groups, with women, LGBTQ+ individuals and people with disabilities reporting more significant difficulties in receiving the care they need. Bunk noted that rural residents encounter the biggest obstacles in accessing affordable health care.

"There are obviously fewer health-care facilities, one issue having to travel longer distances -- and then when it comes to medical debts, we also reported higher rates of medical debt with our polling as well," she comtinued.

The foundation is set to release its next report on economic well-being and personal finances, with a follow-up on civic engagement expected later this fall.

Colorado lawmakers are digging into the health and economic impacts of the state's poor air quality from wildfire smoke and ozone pollution created by oil and gas operations and tailpipes.

Sen. Lisa Cutter, D-Lakewood, pointed to a new study showing bad air days are sending more Coloradans to the emergency room.

"Air pollutants have a really significant impact on the health of Coloradans, and we have the data to back it up," Cutter emphasized. "We also learned that our most vulnerable populations were impacted the most, and that's children under 18 and adults over 65."

In 2019, three quarters of counties affected by wildfire smoke saw an increase in emergency room visits. More people also sought emergency care during high ozone pollution days. The price tag for these ER visits: $1.4 billion.

Colorado has failed to meet Environmental Protection Agency ozone pollution standards for years and this past summer, the state violated ozone limits on 40 days, a near record. Wildfire seasons are projected to get longer in coming years and Cutter argued it is important to understand what's at stake for public health.

"We do know that there are increasing wildfires, in number and in intensity," Cutter noted. "It's largely because of climate change."

Recommendations from the Center for Improving Value in Health Care report included beefing up resources for emergency rooms in high-risk areas and making sure the state's most vulnerable residents can stay safe on bad air days. Cutter recently introduced legislation aiming to improve wildfire prevention and mitigation strategies. She stressed it is important to create policies to help build resiliency.

"Let's try to mitigate the impacts, with all the health issues and the poor air quality," Cutter urged. "But at the same time, let's prepare to deal with the things that we really know are going to keep happening."


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