Montana should not opt-out of health care option

At a recent Montana community forum, farmers and ranchers gathered to discuss the ongoing health care debate. Questions about the Senate's recently unveiled bill filled the room, including: "Would Montana opt out of the public option if given the choice?"

The question was referring to the Community Health Insurance Option — the Senate bill's proposed public plan — that would be offered through state-run exchanges and be open to individuals, small businesses and people who are uninsured. States would be given an option, too — whether or not to offer the public insurance option at all.

Montanans typically have fewer health insurance options, making it that much more important to have a public health insurance option that ensures competition and access to affordable care. It is nearly as important for that option to exist in a national exchange, as written in the health care bill passed in the House.

With two health insurance companies governing the majority of Montana's plans, for example, the difference in choices offered through a state-run exchange versus a national exchange is huge (think shopping for plans across state lines).

The question above brings to light another important point — states will have a vital role in shaping programs after this landmark legislation is passed. These decisions could include whether to have a public option, how to expand Medicaid benefits, and how to enforce regulations on insurance companies. In a way, health care reform has just begun.

Kristina Hubbard is a health care organizer for the Center for Rural Affairs in Missoula.