MTLeg Viewpoint: Montana Democrats Working to Cut Red Tape in Health Care

There are laws all over the books in Montana that don’t match up to the way folks access health care now.

A lot of Montanans see advanced practice registered nurses for their health care, especially in rural areas where there aren’t as many doctors. In 2019, the Legislature recognized the critical role these nurses, also known as APRNs, play in Montana’s health care system and tried to make sure insurers and other health care providers recognized their ability to do things like make specialist referrals, sign student sports and bus driver physicals and sign medical exemptions for immunizations. But as APRNs tried to use this new law to serve their patients, they kept getting denials.

Turns out, there are laws all over the books in Montana that don’t match up to the way folks access health care now. Over 270 laws, rules and regulations, some dating to the mid-1990s, were creating inconsistencies that blocked APRNs from practicing to the full extent of their abilities. It was adding to health care costs, creating barriers to care and frustrating health care providers who felt they were swimming through a sea of red tape.

One example we heard was from a job applicant who needed a vaccine exemption form signed due to health reasons for a prospective employer. An APRN was this Montanan’s primary care provider, and had the authority to sign off on the form. Unfortunately, the employer denied the form, since the ARPN wasn’t a doctor. That Montanan lost the job opportunity because they couldn’t afford to visit another provider to get the same form signed by a doctor.

During this past session of the Legislature, Democratic Rep. Mary Caferro worked in consultation with the Montana Nurses Association to pass a bill with bipartisan support that starts stripping away red tape like this. That bill created a multidisciplinary group of health care experts to comb through the laws on our books and make recommendations for how to fix the inconsistencies and unnecessary barriers holding back health care. They are tasked with identifying where Montana’s health care provider laws unnecessarily duplicate federal regulations, contradict other state laws or policies, apply inconsistently across the state, increase cost, potentially waste resources or block Montanans from accessing the care they need. Our Democratic caucuses were proud to be a part of finding a solution to make health care in Montana more efficient and accessible.

The group established by this bill has had two meetings so far, and has put together a comprehensive set of suggested revisions to eliminate the unnecessary regulations blocking care provided by APRNs and physician assistants and harming the patients they care for. The work group is seeking public comment on their suggestions and are meeting again in February. They’ll report back on their work to the Legislature by September, and they have been tasked with presenting draft legislation that makes their suggestions a reality.

We look forward to seeing the final recommendations of the work group created by Rep. Caferro’s great bill. We hope it will lay the foundation for the 2023 session of the Legislature to once and for all clean up rules and regulations for Montana’s health care providers, and make life simpler and healthier for Montana patients.

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House Minority Leader Kim Abbott, D-Helena, represents House District 83.

Frontier Institute’s Mtleg Viewpoint series provides an opportunity once per month for Montana legislators to deliver an update about topics that matter to our followers. Offers to publish columns were made and remain open to both the Legislative Majority and Minority. Opinions expressed by guest authors do not necessarily represent the positions of the Frontier Institute