Neumann, nurses call for protecting health-care subsidies

Montanans can’t afford the exploding costs of health insurance coming their way if Republicans in the U.S. Senate won’t work with Democrats to protect Affordable Care Act tax credits — that was the message Wednesday from a video call hosted by U.S. Sen. Patty Murray.

Murray, a Democrat from Washington, hosted the call with three Montanans, state Sen. Cora Neumann of Bozeman; Vicky Byrd, CEO of the Montana Nurses Association; and Rob Gregoire, a retired business owner from Bozeman who relies on ACA tax credits for health care.

Wednesday was the 15th day of a federal government shutdown. Republicans and Democrats are at an impasse in Washington, D.C., and health care subsidies are a key issue in the fight.

Murray said she held the call because families in red states such as Montana are being affected, Republicans in the U.S. Senate are dodging the issue, and Republican lawmakers need to negotiate.

Montana has an all Republican federal delegation, including U.S. Sens. Steve Daines and Tim Sheehy, both of Bozeman.

“This issue is not going to magically disappear,” said Murray, vice chairperson of the Senate Appropriations Committee and a senior member and former chair of the Senate Health, Education, Labor and Pensions (HELP) Committee.

The U.S. Senate has failed to pass resolutions for a short term fix, and neither Republicans nor Democrats appear ready to make concessions, States Newsroom’s Washington, D.C., Bureau reports.

Democrats argue health care tax credits set to expire at the end of the year need to be extended, but Republican leaders say Democrats first need to fund a stopgap measure.

Byrd said without the tax credits, families and local economies will suffer. More than 67,000 Montanans use the ACA tax credits to afford insurance, according to KFF, a health policy research organization.

Byrd said farmers, ranchers and small business owners that use the ACA marketplace for insurance bring critical revenue that allows rural hospitals to stay afloat.

Those hospitals pay the nurses and providers who care for people in small communities. Citing KFF, she said more than 80% of marketplace enrollees in rural areas rely on the subsidies.

“The stakes couldn’t be higher,” Byrd said.

She said 7,000 Montanans could lose coverage entirely.

Montanans with the tax credits pay an average monthly premium of $145, compared to $635 without the credit, according to Murray’s office.

Nearly 70% of the hospitals in Montana are rural, among the highest in the nation, and those facilities are crucial, Byrd said.

Neumann, a Bozeman Democrat, said Montana has been a success story for rural access to health care, and she said the 2025 Montana Legislature passed Medicaid expansion with bipartisan support.

“We know in a state as large as ours just how vital it is to be able to access rural health care,” said Neumann, who works in the field.

Around the country, as many as 100 rural hospitals have closed, but she said Montana has not lost one.

Neumann said that’s because Montana has cut its uninsured rate in half, reduced the burden of uncompensated care on hospitals by 50%, and in just one year, brought in $475 million in new personal income because of Medicaid expansion.

“Let’s continue this winning streak,” Neumann said.

She said Montana’s own Republican state auditor James Brown signed onto a letter with other auditors across the country calling on Congress to continue the enhanced tax credits that started during the pandemic.

“Auditors know intimately how dangerous these cuts are,” Neumann said.

But Neumann said the federal delegation is not listening to Montanans.

She also said the delegation “has phenomenal health care coverage,” and their intransigence on the matter for others confused her.

“For them to sit pretty in Washington and accept some of the best health care coverage in the country while Montanans lose their coverage just reminds me of how out of touch they are with Montana,” Neumann said.

Spokespeople from the offices of Daines and Sheehy did not respond to emails from the Daily Montanan late Wednesday afternoon about the comments they are hearing from Montanans on health subsidies. Both have blamed Democrats for the shutdown.

Some Republicans believe the subsidies, enhanced during the COVID-19 pandemic, went too far, and they can be discussed after the federal government reopens.

But the leaders on the call Wednesday said the matter is urgent.

Neumann said when people lose coverage, they stop seeking care, end up in the emergency room, and the hospital covers the costs — and the vicious cycle puts hospitals on the ropes, and with them, communities.

She said 56% of Montana’s small businesses rely on the marketplace and Medicaid for coverage, and small businesses could collapse without the support.

Byrd said she only receives form letters back from members of the delegation when she has reached out to them, and Neumann said she has not heard a response to a message she sent when the shutdown started (it wasn’t immediately clear which members of the delegation Neumann, of Bozeman, had sent messages to).

Murray said Republicans “moved heaven and earth” this summer to pass a “tax extender” — temporary tax cuts — for billionaires in just a few short weeks, and Democrats repeatedly asked them to do the same for ACA tax credits, “and they refused.”

People in Idaho started seeing increases Wednesday to their insurance costs, and Montanans will on Nov. 1, she said.

“I”m hearing a lot of stress, apprehension, fear, people who are saying that they’re farmers or ranchers, and they’re on the ACA in Montana, and I know that they are counting on us to do the right thing,” Murray said.