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Montana politics, elections and legislative news

Survey Reveals Surprising Opinions On Healthcare In Montana

Support for Montana's Medicaid expansion according to a new survey from the Rural West Initiative
Support for Montana's Medicaid expansion according to a new survey from the Rural West Initiative

A new survey done by the University of Montana and Stanford University reveals some surprising opinions on health care in Montana. The statewide representative sample poll was done over landlines and cell phones in February in advance of a conference last week at UM.

UM Political Science Professor Christopher Muste helped put the survey together. He said the healthcare questions started with asking Montanans if they had health insurance.

CHRISTOPHER MUSTE: We found that almost 90 percent of Montanans had some form of insurance, or some kind of coverage for care. What we did find though, is that 17 percent did not see a doctor in the past year due to cost, and another quarter of Montanans delayed health care for a reason not related to cost, for example, distance, or having to wait too long to get into a clinic. A lot of people who have insurance did mention cost as a specific problem in getting access. And people in urban areas had harder problems getting appointments in a narrow area of time.

ERIC WHITNEY: Sounds like a lot of Montanans have health insurance coverage, but being able to use that coverage to get access to actual health care itself … that still sounds like an issue.

CM: It does, and if we drill down into that I think we would probably find that a lot of that has to do with the fact that there are high deductibles, and then again, just how much health care availability is there. Distance really does matter in the rural west, and especially in Montana.

EW: You asked people specifically their opinions about the Affordable Care Act, or what a lot of people call the Obamacare Act, right?

CM: Yeah. It was not very popular in the state of Montana, by about 2 to 1; 64 to 31 percent of people thought it was not a success, that included a big urban-rural split. About 72 percent of rural residents thought Obamacare, or the ACA, was not working well. Only 55 percent of urban residents thought it wasn’t working well. There’s a really strong partisan component to how people view the ACA. The Republicans are extremely opposed, and the Democrats are much more positively disposed toward the Affordable Care Act.

EW: Did they have a chance to tell you why they did or did not like it?

Percentage of Montana respondents who say the ACA helped or hurt them, according to a new survey from the Rural West Initiative.
Percentage of Montana respondents who say the ACA helped or hurt them, according to a new survey from the Rural West Initiative.

CM: Yes, we specifically asked them if they were helped or hurt by Obamacare, and the main reason they gave was that their costs had gone up. Now, health care costs have gone up, pretty much, since time immemorial in the United States, so it’s unclear if they felt like the cost had accelerated due to Obamacare, but very few people said they specifically lost insurance. And in terms of the people who were favorably disposed toward Obamacare, or the ACA I should say, they were primarily saying that they had access they didn’t have before, or some family member of theirs was able to keep insurance that they would’ve otherwise lost, or that they’d be able to have coverage for a condition, a pre-existing condition that had been preventing them from getting health insurance before. There was very little mention of cost going down, but there was a lot of people saying that their cost had stabilized, and we had a fairly small number, but a significant number, of people saying that their deductibles had gone down from previously. And interestingly enough in Montana, it’s difficult to separate out people’s responses to the Affordable Care Act from their responses to the Medicaid Expansion, because Medicaid expansion is partially taking place because of provisions for the Affordable Care Act. So when people think of Obamacare they may be thinking of some of the negative aspects of it, and not some of the other follow up aspects like making Medicaid expansion possible in Montana.

EW: So the Medicaid expansion, which was passed by legislation last year, and has just started to be rolled out Jan. 1 of this year, you say that a majority of Montanans view that favorably?

CM: It was interesting, we asked the question with three possible responses, we asked if they were favorably disposed or opposed to the Medicaid expansion, and then we asked if they would favor expanding to cover all Montanans, and 36 percent of Montanans favored the expansion, 27 percent favored expanding the expansion to cover all Montanans. So almost two-thirds of Montanans either like the expansion, or they want it to go even further and include all Montanans. And roughly 35-36 percent Montanans are opposed to the expansion.

EW: So remind me again, the rough number of people who are opposed to the Affordable Care Act, was how much?

CM: 64 percent of Montanans said they were unfavorable to the Affordable Care Act.

EW: But it sounds like roughly the same amount say that they’re in favor of the Medicaid Expansion, or expanding the expansion even further, and the Medicaid expansion itself is part of the Affordable Care Act.

CM: Absolutely. 63 percent of Montanans either favorably viewed the the Medicaid expansion, or want the expansion to be expanded to cover all Montanans, not just the people who were additionally covered under the 2015 expansion.

EW: Christopher Muste, thanks for joining us at Montana Public Radio.

CM: Eric, I really appreciate it, thank you.

Christopher Muste is a political science professor at the University of Montana. He helped field the survey we just discussed for the annual Rural West conference held in Missoula last week. The survey results aren’t published yet, but a summary of the survey results is available here.

Interviews were conducted by the Social and Economic Science Research Center at the University of Washington.  Questionnaire design was by Christopher Muste in consultation with UM and WSU faculty.  Survey funding was provided by the Bill Lane Center for the American West at Stanford University, and by the University of Montana’s President’s Office, Provost’s Office, Vice-President for Research and Creative Scholarship, Institute on Ecosystems, Alexander Blewett III School of Law, Rural West Center for Inclusive Communities, Maureen and Mike Mansfield Center, Research and Training Center on Disability in Rural Communities, and a UM Faculty Research Grant.

Rural West Conference Montana Survey Preliminary Report Crosstabs

EDITOR'S NOTE: This web post initially offered a link to preliminary results of the survey discussed here. Since then, revised results have been made available. See the revised survey results here.

Eric Whitney is NPR's Mountain West/Great Plains Bureau Chief, and was the former news director for Montana Public Radio.
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