BY MATT VOLZ KAISER HEALTH NEWS
HELENA – Incoming Montana Gov. Greg Gianforte signaled he won’t continue a statewide mask mandate in place since July, though he said he plans to wear a mask himself and get vaccinated against COVID-19.
If Gianforte, a Republican, reverses outgoing Democratic Gov. Steve Bullock’s mask order, Montana will be just the second state after Mississippi to lift its mandate. Thirty-eight states now have statewide mandates.
“I trust Montanans with their health and the health of their loved ones,” Gianforte said in a recent interview with Kaiser Health News. “The state has a role in clearly communicating the risks of who is most vulnerable, what the potential consequences are, but then I do trust Montanans to make the right decisions for themselves and their family.”
The Centers for Disease Control and Prevention says masks help prevent transmission of COVID-19. At least one study has found that states with mask requirements have had slower COVID growth rates compared with those without mandates.
“We’re going to encourage people to wear masks,” Gianforte said. “I’m personally going to lead by example, wearing a mask in the Capitol.”
Montana is the only state where control of the governor’s office is changing parties as a result of November’s election. Also, among the 11 governors being sworn in this January, Gianforte will be the only one new to managing his state’s response to the pandemic.
Nine of the others are incumbents starting second terms. The 10th, Spencer Cox, is Utah’s lieutenant governor in the current administration and has played a central role in his state’s COVID response.
Montana alone will have wholly new leadership next year as states try to keep hospitals from overflowing amid the surging virus, while adjusting to a new presidential administration and executing vaccine distribution plans.
Gianforte doesn’t plan to scrap everything the outgoing administration has done to fight the pandemic. For example, he said he and Bullock are “on the same page” when it comes to prioritizing distribution of the vaccine to health care workers and vulnerable residents.
Gianforte also said he plans to take the vaccine when it’s his turn.
“When my name comes up on the list, I will raise my hand and I am going to get vaccinated,” Gianforte said. “It’s very important that I lead by example because I think this vaccine is a critical part of us getting back to normal.”
Gianforte, a businessman who sold his software company, RightNow Technologies, to Oracle for $1.8 billion in 2011, has long coveted Montana’s governor’s office, spending nearly $12 million of his personal fortune over four years and two campaigns to win the seat.
He ran against Bullock and lost in 2016, then won Montana’s congressional seat in a 2017 special election infamous for Gianforte’s misdemeanor assault against a reporter trying to ask him questions.
Gianforte won a second term in Congress in 2018 and defeated Bullock’s lieutenant governor, Mike Cooney, by more than 12 percentage points in November’s election.
Gianforte will be the first Republican in the governor’s office in 16 years. Republican lawmakers, who control the Montana Legislature, cheered Gianforte’s election and have high expectations for the session that begins the day of his inauguration.
Republican lawmakers will likely seek budget cuts after unsuccessfully asking Bullock to preemptively cut state spending during the pandemic. Bullock has said the state is in good financial shape and that any decision to cut spending would be made for ideological reasons, not out of necessity.
Gianforte has declined to indicate whether he plans to support spending cuts, saying his incoming team is still reviewing Bullock’s proposed two-year budget. That budget proposal includes spending increases to Medicaid, support for children and families, senior and long-term care and treatment for addiction and mental disorders.
John Doran, vice president of external affairs for Blue Cross and Blue Shield of Montana, said he hopes lawmakers spare health services used by at-risk residents if they plan to reduce spending to balance the budget.
“These are critical services and the need for them has only increased since the start of the pandemic,” Doran said.
The structure of Montana’s Medicaid expansion program could emerge as one of the more contentious health issues this session. The federal and state health insurance program for people with low incomes or disabilities extended eligibility to Montana adults who make 138% of the federal poverty level in 2015, and it now enrolls more than 90,000 low-income adults.
At least a half-dozen bill requests have been made by Republican lawmakers ahead of the session to revise the Medicaid expansion program, alarming some health care industry officials. Rich Rasmussen, president and CEO of the Montana Hospital Association, said Medicaid expansion has helped small, rural hospitals maintain financial stability, particularly during the COVID crisis.
“We will adamantly oppose any effort to dismantle the program,” Rasmussen said. “We will share with lawmakers how devastating it will be to employers.”
Gianforte said he supports continuing Medicaid expansion but would be willing to revise the program to increase safeguards against fraud. There hasn’t been evidence of widespread fraud in the state’s Medicaid expansion program.
“If we let people sign up for it who are not qualified, the benefits may not be there for the people who really need it,” he said. “So I am open to additional accountability components.”
Gianforte also is expected to be drawn into a legislative debate about changing or limiting the powers of county public health officials. Local conservative leaders and business owners complain that many health officials have overstepped their authority during the pandemic, while at least seven local health leaders have left their positions amid complaints about a lack of support by some county leaders and law enforcement officials in enforcing directives.
Republican Rep. David Bedey is proposing a measure that would require county commissioners to ratify any decisions made by a local public health officer or panel. He said his proposal isn’t meant to take power away from public health officials, but rather to shift the accountability of such decisions to elected officials.
“I do not wish to punish public health officials,” Bedey said. I think they need political cover to do their jobs.”
Bedey’s proposal is one of a handful of bill requests seeking changes in the powers of local health officials. Some health industry officials and lobbyists worry about any infringement on the ability to respond to a public health emergency.
“Local governments are best equipped to make decisions about the health of their communities,” said Amanda Cahill, the Montana government relations director for the American Heart Association and American Stroke Association. “Public health safeguards are more important than ever, and we hope that the ability of local decision-makers to take protective action remains intact.”
KHN (Kaiser Health News) is a nonprofit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation), which is not affiliated with Kaiser Permanente.