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Michael Butz


In a March guest opinion, I encouraged Montanans to: “act your conscience and contact your legislators.” I urged action after consideration of how many of our fellow Montanans would lose health insurance if the Affordable Care Act were repealed without certain considerations. We are talking numbers that parallel whole cities — not towns. Would the loss be as large as Helena, Missoula, or as large as Billings?

The threat I spoke of then is very much alive today, with the hurried American Health Care Act passed by the House that would leave 23 million uninsured, according to the Congressional Budget Office. Thirteen Senators have drafted a comparable bill in secret, again working to hurriedly pass the bill. It is not, therefore, rhetorical to ask which city in Montana will account for its share of the 23 million uninsured?

Medicaid has been a cornerstone of our country’s mental health system, accounting for 25 percent of all financing for mental health services and 21 percent of substance abuse services. Capping Medicaid payments to states risks coverage for the 16 percent of Montanans covered by Medicaid/Children's Health Insurance Program, three in five Montanans in nursing homes, two in five children, two in five who have disabilities, and two in five who have low incomes.

Before the ACA’s essential benefits were enacted, 33 percent of insurance policies sold on the individual market did not provide coverage for substance abuse treatments, and nearly 20 percent of policies failed to cover mental health. Ending the Affordable Care Act’s Medicaid expansion would remove coverage for 46,700 Montanans — the population of Bozeman plus a good chunk of Livingston.

My national organization, the American Psychological Association, has asserted that no health care reform legislation should be passed by Congress unless it would cover at least as many people, with decent, reliable health insurance — including behavioral health care services, such as mental health and substance use, treatment. This continues to be my position as well.

I am asking each of you to ensure you know the impact of what is before you, not only on yourself, but your loved ones, neighbors, and other Montanans. Then, act your conscience and contact your legislators to ask them to take action on your part.

Michael R. Bütz, Ph.D., of Billings, is federal advocacy coordinator for Montana Psychological Association.