Montana

Medicaid unwinding deals blow to Native care in Montana

Published

2 years ago

May 20, 2024

Medicaid unwinding deals blow to Native care in Montana

Jazmin Orozco Rodriguez

(KFF) About a year into the process of redetermining Medicaid eligibility after the covid-19 public health emergency, more than 20 million people have been kicked off the joint federal-state program for low-income families.

A chorus of stories recount the ways the unwinding has upended people’s lives, but Native Americans are proving particularly vulnerable to losing coverage and face greater obstacles to reenrolling in Medicaid or finding other coverage.

“From my perspective, it did not work how it should,” said Kristin Melli, a pediatric nurse practitioner in rural Kalispell, Montana, who also provides telehealth services to tribal members on the Fort Peck Reservation.

The redetermination process has compounded long-existing problems people on the reservation face when seeking care, she said. She saw several patients who were still eligible for benefits disenrolled. And a rise in uninsured tribal members undercuts their health systems, threatening the already tenuous access to care in Native communities.

One teenager, Melli recalled, lost coverage while seeking lifesaving care. Routine lab work raised flags, and in follow-ups Melli discovered the girl had a condition that could have killed her if untreated. Melli did not disclose details, to protect the patient’s privacy.

Melli said she spent weeks working with tribal nurses to coordinate lab monitoring and consultations with specialists for her patient. It wasn’t until the teen went to a specialist that Melli received a call saying she had been dropped from Medicaid coverage.

The girl’s parents told Melli they had reapplied to Medicaid a month earlier but hadn’t heard back. Melli’s patient eventually got the medication she needed with help from a pharmacist. The unwinding presented an unnecessary and burdensome obstacle to care.

Pat Flowers, Montana Democratic Senate minority leader, said during a political event in early April that 13,000 tribal members had been disenrolled in the state.

Native American and Alaska Native adults are enrolled in Medicaid at higher rates than their white counterparts, yet some tribal leaders still didn’t know exactly how many of their members had been disenrolled as of a survey conducted in February and March. The Tribal Self-Governance Advisory Committee of the Indian Health Service conducted and published the survey. Respondents included tribal leaders from Alaska, Arizona, Idaho, Montana, and New Mexico, among other states.

Tribal leaders reported many challenges related to the redetermination, including a lack of timely information provided to tribal members, patients unaware of the process or their disenrollment, long processing times, lack of staffing at the tribal level, lack of communication from their states, concerns with obtaining accurate tribal data, and in cases in which states have shared data, difficulties interpreting it.

Research and policy experts initially feared that vulnerable populations, including rural Indigenous communities and families of color, would experience greater and unique obstacles to renewing their health coverage and would be disproportionately harmed.

“They have a lot at stake and a lot to lose in this process,” said Joan Alker, executive director of the Georgetown University Center for Children and Families and a research professor at the McCourt School of Public Policy. “I fear that that prediction is coming true.”

Cammie DuPuis-Pablo, tribal health communications director for the Confederated Salish and Kootenai Tribes in Montana, said the tribes don’t have an exact number of their members disenrolled since the redetermination began, but know some who lost coverage as far back as July still haven’t been reenrolled.

The tribes hosted their first outreach event in late April as part of their effort to help members through the process. The health care resource division is meeting people at home, making calls, and planning more events.

The tribes receive a list of members’ Medicaid status each month, DuPuis-Pablo said, but a list of those no longer insured by Medicaid would be more helpful.

Because of those data deficits, it’s unclear how many tribal members have been disenrolled.

“We are at the mercy of state Medicaid agencies on what they’re willing to share,” said Yvonne Myers, consultant on the Affordable Care Act and Medicaid for Citizen Potawatomi Nation Health Services in Oklahoma.

In Alaska, tribal health leaders struck a data-sharing agreement with the state in July but didn’t begin receiving information about their members’ coverage for about a month — at which point more than 9,500 Alaskans had already been disenrolled for procedural reasons.

“We already lost those people,” said Gennifer Moreau-Johnson, senior policy adviser in the Department of Intergovernmental Affairs at the Alaska Native Tribal Health Consortium, a nonprofit organization. “That’s a real impact.”

Because federal regulations don’t require states to track or report race and ethnicity data for people they disenroll, fewer than 10 states collect such information. While the data from these states does not show a higher rate of loss of coverage by race, a KFF report states that the data is limited and that a more accurate picture would require more demographic reporting from more states.

Tribal health leaders are concerned that a high number of disenrollments among their members is financially undercutting their health systems and ability to provide care.

“Just because they’ve fallen off Medicaid doesn’t mean we stop serving them,” said Jim Roberts, senior executive liaison in the Department of Intergovernmental Affairs of the Alaska Native Tribal Health Consortium. “It means we’re more reliant on other sources of funding to provide that care that are already underresourced.”

Three in 10 Native American and Alaska Native people younger than 65 rely on Medicaid, compared with 15% of their white counterparts. The Indian Health Service is responsible for providing care to approximately 2.6 million of the 9.7 million Native Americans and Alaska Natives in the U.S., but services vary across regions, clinics, and health centers. The agency itself has been chronically underfunded and unable to meet the needs of the population. For fiscal year 2024, Congress approved $6.96 billion for IHS, far less than the $51.4 billion tribal leaders called for.

Because of that historical deficit, tribal health systems lean on Medicaid reimbursement and other third-party payers, like Medicare, the Department of Veterans Affairs, and private insurance, to help fill the gap. Medicaid accounted for two-thirds of third-party IHS revenues as of 2021.

Some tribal health systems receive more federal funding through Medicaid than from IHS, Roberts said.

Tribal health leaders fear diminishing Medicaid dollars will exacerbate the long-standing health disparities — such as lower life expectancy, higher rates of chronic disease, and inferior access to care — that plague Native Americans.

The unwinding has become “all-consuming,” said Monique Martin, vice president of intergovernmental affairs for the Alaska Native Tribal Health Consortium.

“The state’s really having that focus be right into the minutiae of administrative tasks, like: How do we send text messages to 7,000 people?” Martin said. “We would much rather be talking about: How do we address social determinants of health?”

Melli said she has stopped hearing of tribal members on the Fort Peck Reservation losing their Medicaid coverage, but she wonders if that means disenrolled people didn’t seek help.

“Those are the ones that we really worry about,” she said, “all of these silent cases. … We only know about the ones we actually see.”

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Montana

Game Day Live Blog: Louisville vs. Montana | Game 12

Published

4 hours ago

December 20, 2025

Press Room

Game Day Live Blog: Louisville vs. Montana | Game 12

LOUISVILLE, Ky. – The Louisville men’s basketball program suffered a setback in their last time out on the floor, but the time has come to bounce back, as they return to the KFC Yum! Center to host Montana.

The Cardinals made the trek down to Rocky Top for a top-20 showdown at Tennessee, but they were punched in the mouth early and couldn’t recover. UofL wound up suffering a demoralizing 83-62 loss, falling to 0-2 in true road games so far this season.

Louisville was without star point guard Mikel Brown Jr. due to a lower back injury, but even with him on the floor, it’s unlikely they would have taken down UT. They shot just 37.9 percent from the floor, with Adrian Wooley and Ryan Conwell combining for 43 of their points. In fact, the Cards had twice as many turnovers (16) as they did assists (8), and let the Vols shoot 54.7 from the floor.

As for the Grizzlies, they are coming off a 2024-25 season in which they made the NCAA Tournament by way of winning the Big Sky Conference Tournament. However, year 12 under head coach Travis DeCuire has been up-and-down.

Montana is 1-1 against KenPom top-100 teams, losing 86-81 at Texas A&M but winning 102-93 at UNLV. Additionally, in their last time out, the Griz lost 82-75 to Montana Tech – an NAIA school – at home.

Preview: Louisville Cardinals vs. Montana Grizzlies

Here is where you will get all the latest updates from today’s contest in real time. Throughout the game, we will include any notes, injury updates and analysis in the game feed at the link below.

Montana

Broadband access is expanding in Montana, but rural areas still lag behind

Published

16 hours ago

December 20, 2025

Press Room

Broadband access is expanding in Montana, but rural areas still lag behind

In the southeastern Montana town of Belfry, 65-year-old resident Mary Boyer reflects on her relationship with technology.

“I’m a green-ledger girl,” Boyer said. “I can handwrite. I don’t like calculators. I never owned a television, I have a crank Victrola for music.”

Boyer’s home is about an hour south of Billings. The Beartooth and Pryor Mountains flank Belfry, as the Clarks Fork of the Yellowstone River meanders through it.

Belfry, MT is flanked by the Beartooth and Pryor Mountains. This terrain is challenging and expensive when it comes to installing fiber optic cable, which in some parts of the state can cost up to $300,000 to reach one home or business, according to ConnectMT Director Misty Ann Giles.

She said technology has always been slow to come to their town.

“We had a heck of a time getting songs – because we have to do it over the internet – for the karaoke machine,” she said. “And all of a sudden halfway through a song there’s no words or there’s no karaoke whatsoever.”

Boyer knows connectivity goes beyond a karaoke machine.

Before this year, she said their internet service couldn’t meet the community’s needs. Her neighbors rely on it for telehealth appointments, education and commerce.

“I think it’s all about the community and keeping them in touch with the outside world,” she said.

Montana ranks among the lowest in the country when it comes to internet access. And rural places disproportionately lack access to high speed connectivity compared to urban.

Montana ranks among the lowest in the country when it comes to internet access. Broadband Now, an independent research organization, ranked Montana second to last in the nation for internet speeds and affordability. And rural places disproportionately lack access to high speed connectivity compared to urban; this is known as the digital divide.

State officials and telecommunications companies have been trying to change that. Over the last few years, just shy of a billion dollars in federal funding aimed at tackling this issue came into the state. The goal is to use it to close the digital divide for good.

In the southern end of Belfry, Jay Velez stands in front of his restaurant, the Silvertip, admiring the scenery.

“What a view, man!” he said, looking toward the Beartooth Mountains. “It doesn’t suck here.”

His restaurant serves as a local watering hole. It offers the karaoke night coveted by Boyer. And this summer, the Silvertip’s internet got better.

The Silvertip Restaurant in Belfry, MT. The restaurant’s internet speeds got an upgrade after Nemont Communications finished building fiber optic lines to the town. That work was funded through a federal program aimed at closing the digital divide.

“We just rely on it for our point of sale systems, and so far, it’s been working great,” he said.

His improved internet is due to newly installed fixed fiber optic lines. These are thick cables laid in the ground. They’re considered the “gold standard” for broadband connectivity.

But this technology is expensive to install, and it’s been slow to reach towns like Belfry.

“We’re way behind, in looking at the grander sphere of the problem,” said Misty Ann Giles, the head of the state’s broadband office ConnectMT. “We are farther behind our sister states. Montana does have a lot of challenges when it comes to thinking about internet access.”

Government-led efforts to close the digital divide have been underway for decades. The federal government established the Universal Service Fund in 1996, prescribing that “all Americans” should have access to basic connectivity. The fund subsidizes fiber installation and maintenance in remote areas.

But it wasn’t enough. So, another project emerged in 2018. The U.S. Department of Agriculture’s ReConnect program offers federal funds and loans to expand internet access.

Giles helped stand-up the program as former Chief of Staff at the agency’s Rural Development office.

“A lot of the work we did when we were at USDA when we first came into office was trying to look at the bigger Rubik’s Cube of, why are rural communities lacking some core services when it comes to education, telehealth, things like that in their communities,” Giles said. “And what it all came down to was connectivity.”

This connectivity became even more imperative during the pandemic. Business, community, health care and education all required a stable internet.

Belfry is flanked by the Beartooth and Pryor Mountains. This terrain is challenging and expensive when it comes to installing fiber optic cable, which in some parts of the state can cost up to $300,000 to reach one home or business, according to ConnectMT Director Misty Ann Giles.

According to the Federal Communications Commission, broadband expansion timelines considered reasonable pre-COVID-19 became “unworkable,” and the Commission pushed to get rural communities connected faster. So the federal government launched several new programs.

Since 2019, around $900 million from four federal programs for rural broadband expansion has flowed into the state.

Since 2019, around $900 million from four federal programs for rural broadband expansion has flowed into the state.

The main sources include funds from the ReConnect Program, which go to telecom companies through grants and loans. Those total around $144 million for Montana-focused projects. Then there’s the American Rescue Plan Act, which provided $310 million; The Broadband Equity Access and Development program, which allotted around $308 million; Lastly, there’s the FCC’s Rural Digital Opportunity Fund, which provided Montana $126 million for a 10-year period during its Phase I auction.

And it’s through these programs that Belfry’s internet just got a little better.

Back in southeastern Montana, Nemont Communications Chief Operating Officer Scott Paul drives through the 250-resident town on a sunny October afternoon.

“You probably didn’t see it, but look for an orange capped plastic pole,” he said, pointing out markers of their recent efforts. “Beneath that orange-capped plastic pole, there is gonna be a handhole. And then between those plastic poles, there’s fiber that’s buried underground.”

White poles with orange caps mark places Nemont Communications recently installed fiber optic to bring better internet speeds to Belfry, MT. The work was funded in part by the USDA’s ReConnect program, which funds broadband buildout in rural areas.

Nemont just replaced Belfry’s copper wire laid around the 1970s. Paul said copper was great for dial-up internet, but fails at providing the internet speeds we expect today. But installing fiber in Montana is expensive. It can cost up to $300,000 to reach a single home or business, according to Giles.

“If you’re trying to put all of this fiber into an area that’s all rock, then it becomes a lot more expensive because rock’s a lot harder to get through than the dirt,” he said.

For Belfry’s project, Nemont received $10 million ReConnect dollars to build fiber for around 1,000 households in 500 square miles. That’s an area the size of Los Angeles. Paul said they installed 80 miles of fiber just to reach Belfry.

Most companies rely on their customer base to cover the costs of installing internet infrastructure. But in low population states like Montana, that model does not always work. Paul said that’s why these funds are so important.

“It’s allowing us to escalate the speed of doing that,” he said. “We’re doing a little bit more now than we have done in the past, for that reason.”

Dozens of companies like Nemont have leveraged these federal programs to try and reach more residents. Sometimes the costs still exceed what they can afford, and they default.

According to the FCC, Montana’s broadband coverage increased 10 percent between 2023 and 2024. But there’s more work to be done. 70,000 homes and businesses across Montana still need better internet.

Some progress has been made. According to the FCC, Montana’s broadband coverage increased 10 percent between 2023 and 2024. But there’s more work to be done. 70,000 homes and businesses across Montana still need better internet.

And rural residents like Mary Boyer know how necessary it is to be connected.

“If we didn’t have the access to the good communications, we could be in a world of horse pucky,” she said.

State officials hope to bridge the digital divide by the end of the decade.

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Montana

Humane Society of Western Montana has many pets for adoption

Published

1 day ago

December 19, 2025

Press Room

Humane Society of Western Montana has many pets for adoption

MISSOULA, Mont. — Humane Society of Western Montana’s Director of Marketing Katie Hofschield dropped by NBC Montana Today with special guest Lady Bird.

Lady Bird is a 9-year-old mixed breed who is available for adoption. Lady Bird is house and crate trained and in general is a very laid back dog who loves cheese.

The Humane Society of Western Montana currently has many animals looking for homes, including several older pets, cats, plus two guinea pigs and a rabbit.

The Humane Society of Western Montana runs an annual pet food pantry, but this year they’re expanding into a larger-scale pet food relief project due to holiday and financial pressures on families.

Through a partnership with Greater Good Charities and the Montana Food Bank Network, they received 25 pallets (almost 20,000 pounds) of pet food, which will be stored in a former food bank facility and distributed across the state, including to tribal partners.

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