As 2025 comes to a close, the Montana Free Press team is reflecting on our coverage over the past year and what lies ahead in 2026.
This year, health care access dominated my reporting. The debates and developments were unexpected but crucial for many Montanans.
At the start of the 2025 legislative session, health policy advocates braced for a showdown over the state’s expanded Medicaid program. Funded by both state and federal dollars, this program helps about 75,000 low-income Montanans aged 18 to 65 access essential health services.
Surprisingly, House Bill 245, which renewed funding for Medicaid, passed easily, thanks to bipartisan support. Governor Greg Gianforte backed the bill, which Rep. Ed Buttrey, a Republican from Great Falls, sponsored. Interestingly, shortly after the bill passed, the Montana Hospital Association named Buttrey its next president.
Despite the legislation’s success, some conservative Republicans voiced strong opposition. They worried about the cost to taxpayers and the dangers of government-run health care. They also cited the national political climate, suggesting changes in the Medicaid framework under the Trump administration could disrupt state programs.
In mid-2025, national developments did shake Medicaid. A budget resolution from Congressional Republicans imposed strict new requirements on the program, including mandatory work hours. Although Montana crafted its own work requirements, they were not approved by the Biden administration. Analysts predict that these new rules will lead to a significant reduction in Medicaid funding, potentially impacting enrollment in various states, including Montana.
Another key issue this year was the push to renew enhanced subsidies for health insurance through the Affordable Care Act. These subsidies, first introduced during the COVID-19 pandemic, have been vital for many Montanans who don’t qualify for Medicaid. However, debates in Congress led to disagreements over funding, causing uncertainty for thousands seeking affordable coverage.
As the deadline for these changes approached, I spoke to many Montanans feeling the financial strain of rising health insurance premiums. Many expressed that the costs were forcing them to make tough decisions, often sacrificing other necessities just to keep their insurance.
Looking ahead to 2026, I’m eager to see how the implications of ongoing legislation will manifest for everyday Montanans. Understanding their experiences is crucial for making sense of these large policy changes. If you have a story to share about your health care journey, I’d love to hear it. You can reach me at [email protected].
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2025 legislature,Affordable Care Act,Congress,H.R. 1,Health Care,health insurance,Medicaid Expansion
