Montana has always been a place where neighbors look out for one another. We take pride in our strong communities, where families, businesses, and organizations work together to ensure that everyone – from our youngest children to our eldest citizens –has the care and support they need. But today, we face a looming crisis that threatens the very foundation of our state’s healthcare system: the potential reduction or elimination of federal Medicaid funding.
As the President and CEO of Immanuel Living, a nonprofit dedicated to providing quality care and services to older adults, I see firsthand how vital Medicaid is to our seniors, families, and rural communities. Any significant cuts to Medicaid would be catastrophic. Even if federal funding remains intact, Montana is already failing its seniors by underfunding Medicaid at the state level.
Montana’s population is aging. Nearly a quarter of our residents are over the age of 60, and many rely on Medicaid to access essential healthcare and long-term care services. At Immanuel Living and other senior living communities across the state, Medicaid helps provide care for thousands of older adults who have exhausted their savings after a lifetime of hard work. Without Medicaid, these seniors would have nowhere to turn.
But here’s the stark reality: Montana’s Medicaid reimbursement rate for nursing home care is one of the lowest in the western U.S. At just $283 per day, it falls far short of the actual cost of providing care. At Immanuel Living, for example, it costs $445 per day to care for one nursing home resident. This gap is financially unsustainable, forcing nursing homes to operate at a loss, cut services, or close entirely.
Since 2021, at least 13 nursing homes in Montana have closed. A significant contributing factor is the inadequate Medicaid reimbursement rates. When these facilities shut down, seniors are often forced to move far from their communities and loved ones.
In addition, Montana’s rural hospitals and healthcare facilities are already operating on razor-thin margins. Medicaid funding plays a critical role in keeping these institutions open. Cuts at the federal level would result in hospital closures, fewer healthcare providers in rural areas, and reduced access to critical services like emergency care and mental health treatment. In a state where some residents must drive hours to reach a hospital, this is a matter of life and death.
Healthcare and senior services are among Montana’s largest industries. Medicaid helps fund jobs for thousands of healthcare workers – nurses, aides, therapists, and others who dedicate their lives to caring for those in need. Without Medicaid, staffing shortages would worsen, wages could stagnate, and the quality of care would inevitably decline. We need to invest in, not dismantle, programs that support healthcare workers and their patients.
While we must fight to preserve federal Medicaid funding, we also need our state legislators to take immediate action to protect Montana seniors by raising the Medicaid reimbursement rate for nursing homes. If we do not, more facilities will close, and our elderly population will suffer.
I urge Montana’s legislators to pass a bill this session to bring Medicaid reimbursement rates in line with actual care costs. Without this action, Montana will continue to have the lowest reimbursement rate in the West, worsening the financial strain on nursing homes.
If you are concerned about the future of healthcare in Montana, now is the time to act. Contact your elected officials and tell them to support higher Medicaid reimbursement rates for nursing homes. Medicaid is more than just a budget line item – it is a lifeline for thousands of Montanans.
We have a choice: We can invest in a future where all Montanans – young and old – have the healthcare and dignity they deserve, or we can turn our backs on those who need us most. The decision should be clear.
Jason R. Cronk is the president and CEO of Immanuel Living in Kalispell.