Health Care

Certificate of Need (CON) is the regulatory process through which medical providers must get approval from the government to open or expand certain medical services.

Supporters say CON laws are important because without them, hospitals would over-build capacity and purchase unnecessary equipment, resulting in higher health care prices as they pass those costs on to patients. CON protects smaller, rural hospitals from predatory competition. Opponents say CON laws are top-down regulations that place artificial limits on health care services and facilities. CON limits health care access and higher prices since these regulations tend to protect existing medical providers from competition which drives up prices and creates regional monopolies. The government is incapable of knowing how many healthcare providers there should be, the market process discovers through entrepreneurship what is needed to meet human needs.

Campus Free Speech

Gov. Steve Bullock vetoed a bill in 2019 which would have provided important free speech protections for students and faculty at Montana’s public colleges and universities. The bill passed with bipartisan support, as well as with support from a diverse group of organizations including Americans for Prosperity, the ACLU of Montana and the Foundation for Individual Rights in Education. The bill would have banned “Free Speech Zones” on Montana public campuses, guaranteed free speech rights for students and the public, required universities to inform students of their free speech rights and university policies and created accountability mechanisms for public universities to the legislature for free speech violations.

Opponents claim that Campus Free Speech is a solution looking for a problem and that the First Amendment of the United States Constitution and Article II, section 7 of the Montana Constitution are absolute and inviolate protections of the rights of free assembly and free expression. Additionally, opponents claim that campus free speech bill is driven by news headlines and that university leaders have assured the Governor that their policies are compliant with federal and state laws and values of free speech.

Direct Primary Care (DPC)

DPC is a practice were primary care physicians and nurses create a direct commercial relationship with their patients without the intermediary of insurance. Like Netflix or a gym membership, the entire medical cost for primary care is a subscription service often giving family discounts and giving unlimited access to the primary care provider. It was unavailable in Montana until 2017 when the state auditor ruled that his office would not regulate DPC clinics with insurance company rules. It has since grown into a significant industry in Montana. A statutory change to enable DPC will make this executive branch decision permanent.

Supporters say DPC increases both patient satisfaction and doctor fulfillment because it maximizes the doctor-patient relationship and minimizes paperwork. It is more affordable than insurance, especially for people who go to the doctor a lot and is often paired with catastrophic insurance coverage for worst case scenarios and specialists. Opponents say it is unneeded because standard insurance, Medicaid and other products are already serving these people.

Telehealth refers to remote delivery of certain health care appointments and monitoring though the internet. The Governor suspended restrictions to telemedicine access in response to the COVID-19 pandemic, which expanded the service greatly.

Supporters of expanding telemedicine say it will improve patient access for those who are privately insured as well as those enrolled in Medicaid. Telehealth drives down costs and provides care that is otherwise out of reach especially to rural patients who need to talk to a specialist. Opponents argue expanding telehealth compromises quality of care. It is important for physicians to see patients in person most of the time and strict regulations are needed to maintain high quality of care.

Criminal Justice System

In recent years, there has been a change in the way many people view criminal justice. Nobody wants to be seen as soft on crime, but many people now view the criminal justice system as broken and overly burdensome on taxpayers.

Incarceration even for low-level non-violent offenses is the norm, with few diversion opportunities and minimal access to get treatment for drug abuse problems or mental health issues. As such, recidivism in Montana is high and the long-term budget impacts are significant.

There is very little transparency on the effects of our current justice system on individuals. The Department of Corrections reports are about what they do, not the results of incarceration. To make better criminal justice policy we need objective, individualized information that is anonymized to protect privacy but tracks individuals through the justice system.

The issuing of bail is often based on ability to pay rather than threat to public safety. Hence why 62% of the people in Montana’s overcrowded jails have not yet been found guilty of any crime or danger to public safety.

Supporters of criminal justice reforms say the criminal justice system is a very expensive revolving door where nobody wins, public safety is undermined and taxpayers bear the burden of an ineffective system.

Opponents believe criminal justice reform is a euphemism for not supporting public safety, our police, judges, and courts.

Policing Reform

As a subsection of criminal justice reform, there has been increasing scrutiny on policing practices.

Supporters of policing reform point to qualified immunity, which, expressly predetermined by court or legislature, a police officer is not liable for his actions on the job - even if those actions violate a person's civil or constitutional rights.

Supporters of policing reform focus on community policing to integrate police with their communities to ensure there is greater trust and confidence in the police. Opponents in our state say the police in Montana don’t have the problems that those in big cities and that the concerns are not relevant here.

COVID-19 Recovery: In response to the COVID-19 pandemic, some feel that the Governor had too much authority and no legislative oversight about how stimulus funds would be spent.

Some feel that City and County Health Directors also have too much authority during emergencies, including the ability to issue misdemeanors to those who disregard directives - or even fire an elected sheriff for not carrying out their new rules.

Spending: COVID-19 has put a significant strain on our state and local budgets. Montana reserves hold just 4.6 percent of expenditures; however, the current budget was estimated to boast a $360 million surplus that could be used to fund COVID-19 response expenditures.

Education Reform: With the repeal of Montana’s Blaine Amendment by the Supreme Court of the United States, Montana now has an opportunity to expand the educational opportunities for every child in Montana including:

• Tax Credit Scholarships: This program is currently not able to grow due to current government constraints regardless of scholarship demand. Montana should expand this program to allow more families the ability to attend a school that fits their individual needs. Do you agree or disagree and why?
• Individual Tax Credits for children who attend private school: Some believe parents who send their children to private schools are currently “double-paying” for education. To alleviate some of that burden and allow parents to more easily access educational options that fit their children’s needs, this tax credit will take some of the sting off state property taxes for parents whose child is attending an educational alternative.
• Educational Savings Accounts (ESA) for special needs children: In 2017 the legislature passed an ESA program for children with special needs. The ESA would provide these families funds for certain educational expenses including therapies, school alternatives, and home school programming. The program was vetoed, citing Montana’s Blaine Amendment. Now that the Supreme Court has struck down Montana’s Blaine Amendment, should the Montana legislature re-introduce and pass an Education Savings Account for Special needs students?

Occupational Licensing: Occupations requiring government licenses have increased from 5% in 1950 to more than 20% today. Is the current level of licensing not enough, about right, or too much?