Bullock, Daines fight to the finish line over pre-existing conditions

Both candidates, Republican incumbent Sen. Steve Daines and Democratic challenger Gov. Steve Bullock, vow they'll preserve those protections. But Bullock points out votes Daines has taken to repeal the Affordable Care Act as evidence he says show the senator's actions speak louder than words. The ACA is where those protections are codified. Daines responded in a television ad that Bullock is misrepresenting his votes to "fix the Obamacare mess to lie to you about pre-existing conditions."

Bullock also cites Daines' support of a lawsuit the U.S. Supreme Court will hear the week after the election that could strike down the law.

"The absurdity (that) Daines' line now is that 'Oh, well this won't overturn the ACA;' the whole purpose of this lawsuit is to overturn it," Bullock said in an interview recently. "(This is) a guy who's literally now voted five times to get rid of the ACA."

Bullock also pointed to a vote in October where five other Senate Republicans up for re-election, and another who isn't this year, voted with Democrats in an attempt to defund the lawsuit, a bill Politico called "largely symbolic." "He's still all in on it," Bullock said.

Daines in a debate earlier this month said he does not think the court will end the law, citing a mock trial outcome. In an interview this week, he said he believes the court would leave a "long runway" if it does strike down the ACA, meaning he thinks there will be time for Congress to respond with a plan.

Earlier this year Daines' office said the senator "supports whatever mechanism will protect Montanans from this failed law, lower health care costs, protect those with preexisting conditions and expand access to health care for Montanans."

Daines argues the ACA has been harmful to Montanans. 

"Health care insurance rates more than doubled and over 20,000 Montanans lost their health care insurance, even though President Obama said if you like your health care plan you can keep it. That turned out to be not the case," Daines said in an interview.

A 2017 report from the federal Department of Health and Human Services found that premiums for individual plans on the marketplace created by the ACA rose from $2,784 in 2013 to $5,712. About 43,800 Montanans had coverage purchased on the exchange in 2020. The study found rates increased in Montana by 133%. However, most people covered on the exchange qualify for subsidies that offset the costs.

The Montanans who lost their coverage, as Daines said, were unable to stay on their existing plans and had to get coverage elsewhere because their plans did not meet minimum requirements laid out in the ACA.

Daines said that protecting those with pre-existing conditions is important, and personal, to him.

"My sister, who was born and raised in Bozeman, had four children, she never left Bozeman, she was in her early 40s when she died of an autoimmune disease, a very rare disease that cost her her life," Daines said. "She battled this disease for many, many years. And had she lost her health care insurance, their family would have been bankrupt. They had over a million dollars of health care costs. She had to have access to (health insurance), or the family have been financially ruined, not to mention that she wouldn't have been able to get health care while she battled it."

Daines said he supports a bill from Sen. Thom Tillis, a Republican from North Carolina, called the Protect Act, which would provide protections for those with pre-existing conditions.

That bill does not go as far as the ACA, however. Kaiser Health News reports that act has "loopholes that would allow insurance companies to drop coverage of certain expensive disease from all their policies."

Daines said the Senate Finance committee, which he serves on, has also passed a bill aimed at lowering prescription drug costs. It was originally sponsored by Sens. Chuck Grassley, an Iowa Republican, and Ron Wyden, a Democrat form Oregon. Wyden over the summer dropped his co-sponsorship over a complicated election-year dispute.

Grassley in an opinion piece in the Wall Street Journal blamed election-year politics while Wyden later said in a statement to the New York Times and other news outlets there was not support for the bill from across the aisle.

Daines said he believes "there's a proper role for the federal government to be a backstop for those who are higher-risk," and pointed to a bill from Republican Sens. Lamar Alexander, of Tennessee, and Susan Collins, of Maine, that proposes a high-risk pool.

Daines also said he backs legislation to speed up the process of getting generic drugs to market by having major prescription drug companies work with generic manufactures to ramp up capacity in advance of patents expiring.

"The bottom line is we've got to come together on this, and there's room to come together on it, to address the issue of pre-existing conditions and then lower the cost of prescription drugs. That needs to be added to the package," Daines said. "There's a lot of good policy, we just need to get both sides agreeing on it, and that's how we ultimately solve these problems."

As he has done through the election on several issues, Daines tries to paint Bullock as too liberal when it comes to health care, mostly by saying Bullock's support of a public option is really a ruse to move toward a government-run system.

The public option is allowing some people to buy into Medicare or Medicaid instead of private insurance.

Bullock rejects Daines' characterization of what the public option means, and added that such an option should include higher reimbursements for Montana's rural hospitals.

"I think the senator has tried to say 'Bullock wants to rip away all employer-sponsored health care.' What I want to do is make it affordable and accessible," Bullock said. "I do think there is a bipartisan interest in doing that."

Reducing the price of prescription drugs is also a priority for Bullock, who said he wants to see the federal government be able to negotiate the price it pays for medications.

"It is insane to me that Costco can negotiate prescription drug prices, but it is illegal for the largest purchaser in the nation of prescription drugs, the federal government, to negotiate prices," Bullock said.

The governor points to his experience working with a Republican-majority Legislature to expand Medicaid in 2015 and reauthorize the program in 2019. The program covers roughly 85,000 Montanans and studies have shown brings nearly $600 million to the state annually and created between 5,900-7,500 jobs.

Another statistic Bullock often points to is the number of rural hospitals that have closed in states that did not expand Medicaid, while Montana has not seen any shuttered. He said that while he doesn't believe the ACA is perfect, it allowed for that program and should be improved upon, not ended.

"The experiences I've had in Montana and also the experiences I've had as governor ... where we could come together as Democrats and Republicans and say 'For us this isn't just talking points, we're on the ground and here's where we can find consensus' can be a real helpful model for Washington, D.C."