HELENA — Republican Rick Hill and Democrat Steve Bullock offered some details Monday on their health care plans if elected governor.
Both candidates spoke to the Montana HealthCare Forum, which includes groups like Blue Cross and Blue Shield, the Montana Chamber of Commerce, AARP and others. The organization advocates for improving the health care system.
Bullock, the state's attorney general, and Hill, a former congressman, are locked in a close election battle to replace term-limited Gov. Brian Schweitzer.
Some policy agreements became apparent in a forum where each answered questions, separately, for an hour. For instance, Hill and Bullock said they would support increased funding to expand the number of medical school slots available in other states for Montana students.
There was some disagreement, too.
Bullock was generally more receptive to changes coming under the federal health care law. Hill, meanwhile, said Republicans in D.C. could overturn it. But if it stands, Hill made it clear he is willing to work within the law as governor.
Under the federal health care program, Medicaid rolls are expanded as one of the ways to reduce the number of uninsured. Eventually, states will have to pick up more of the cost.
Hill said it would be better for the state to get as many uninsured as possible to use the tax and other subsidies to buy private insurance on the upcoming federal health care exchange. The Republican, who used to sit on the BCBS board of directors, said that would be cheaper for the state than if the uninsured instead choose to enroll in Medicaid expansion.
The Republican also left the door open to Montana taking over the health insurance exchange, a place where those without insurance will be able to buy private insurance with the help of federal tax credits. That stance would put him at odds with Republican legislators, who last session blocked the state from establishing an exchange. Montana will instead get one designed by federal regulators in 2014.
"I am not convinced we don't need a Montana exchange," Hill said. "If there is some reason that having a Montana exchange would be better, I am open to that."
Bullock, the attorney general, said he wants to make sure stakeholders are involved as key changes are made under the federal health care law.
"Those that are in the trenches every day will certainly help shape the policy," Bullock said.
Bullock said more could be done to bolster local prevention and wellness programs that can save money. He also said more primary care physicians will be needed in Montana to serve expanded number of people with insurance.
Bullock said he was not yet sure how he would react as governor now that the U.S. Supreme Court has ruled that Medicaid expansion is optional for states under the health care law. He said more study on the issue is needed.