This is the second story in a three-part series examining where Montana’s federal office candidates stand on key voter issues. Montana Free Press also covered candidates’ affordability plans, ranked by Montanans as the top voting issue in November.
Around 60% of Montanans consider healthcare a critical factor in their voting decision, according to a Montana Free Press-Eagleton poll of registered voters from late August to early September.
Democrats prioritize healthcare the most; approximately 90% regard it as very important, compared to 37% of Republicans. Another 47% of Republicans find it somewhat important.
Healthcare cost remains a significant hurdle, with two-thirds of registered voters in a recent poll by MTFP reporting difficulty affording healthcare and medical expenses, consistent with earlier polls.
As the 2026 midterms approach and absentee ballots are mailed on Oct. 9, MTFP queried Montana’s federal office candidates on addressing healthcare concerns.
Nine candidates are competing for two U.S. House seats and one Senate seat. They were asked:
- Identify actions to enhance healthcare affordability, access, and quality. Specify laws or programs to change or repeal, funding methods, and evidence of success.
To ensure fairness, candidates were limited to 300-word responses, which remain unedited.
U.S. SENATE
KURT ALME, REPUBLICAN

Having lived across Montana, including eastern Montana, ensuring access to affordable, high-quality healthcare, and especially rural healthcare, is near and dear to me. I’ve seen first-hand how challenging it is for families to pay for and access health care.
Obamacare promised to make health care affordable, but it’s failed to deliver. Insurance premiums on Montana’s exchange have increased almost 175%. More tax dollars have not made healthcare more affordable, instead they have just subsidized big insurance companies and big pharma. We need to hold them accountable.
We also need to make healthcare more affordable by increasing transparency, competition, and putting patients first. That includes making prices and costs transparent, providing healthcare dollars to patients to shop for policies instead of subsidizing insurance companies, ensuring
Americans don’t pay more for drugs than people in other countries, and going after healthcare fraud, like I did as a prosecutor.
As we work to lower costs, I will always fight to protect access to high-quality care, especially in our rural communities. And now, we have a fantastic opportunity to improve our rural healthcare.
In the Working Families Tax Cuts Act, which both my liberal opponents opposed, Republicans invested 50 billion dollars in rural healthcare. This delivered $233 million to Montana’s healthcare system this year alone. We can use those funds to increase the number of healthcare workers through new training programs, like local apprenticeships and internships, and expand telehealth opportunities so patients can get more help in their own communities. This is critical, because in Montana, it can be a long way from the farmhouse to Billings or Great Falls.
As Senator, I will fight to protect and increase access to high-quality care, especially in our rural communities, and I will work to make healthcare more affordable.
KYLE AUSTIN, LIBERTARIAN

As the only candidate in this race with 18 years of healthcare experience, I have the only plan in this country that will finally revolutionize healthcare for our future. My Healthcare 2.0 agenda will consolidate federal healthcare programs under a congressionally chartered nonprofit, the United States Healthcare Corporation. Medicare, Medicaid, CHIP, Affordable Care Act subsidies, VA, Tricare, federal employee coverage, and other federal health benefits would retain appropriate eligibility and benefit protections while moving toward one administrative framework, one set of enrollment rules, interoperable records, and standardized claims processing using modern technology replacing outdated costly paper processes.
The plan would be funded initially by redirecting existing federal healthcare appropriations, not creating an entirely new spending stream. Additional funding would come from administrative savings, competitive prescription drug purchasing, and modern fraud detection systems. Since this will be a non-profit organization, major corporations can elect to donate to our nation’s healthcare plans. Any savings should first finance the transition and then reduce premiums, eliminate deductibles, and lower taxpayer costs. The plan also calls for creating competition in the private industry by offering a standard plan to those who cannot afford the private industry plan or do not qualify for full public assistance. This plan will lead the industry standards for overhauling corrupt insurance plans and driving the way for true affordability.
Success would be measured publicly through lower per-person spending growth, fewer uninsured people, reduced premiums and out-of-pocket costs, shorter appointment wait times, fewer preventable hospitalizations, improved health outcomes, lower improper-payment rates, and audited administrative savings. We will see a striving and healthy healthcare community allowing practitioners to once again open doors in rural communities and compete with big monopolies. Congress should require annual independent reporting and automatic corrective action when benchmarks are missing.
ALANI BANKHEAD, DEMOCRAT

I’d start by finishing what the Affordable Care Act started.
First, restore the enhanced premium tax credits that expired January 1. Premiums roughly doubled overnight for many families on the marketplace. Congress’s own scorekeeper puts restoring them at about $35 billion a year, under one percent of what we already spend on healthcare.
Second, add the public option that was cut from the original ACA: public dollars, private doctors, the same model TRICARE uses for military families. It’s a choice, not a switch anyone flips for you. When the CBO has scored public plans before, they reduced the deficit.
Third, break up the drug middlemen. Three pharmacy benefit managers handle about eight in ten prescriptions, and each is owned by a company that also owns an insurer and a pharmacy chain. A bipartisan bill would end that self-dealing. I’d also ban pharmacy “clawbacks” and require the pharmacy to tell you the lowest price every time.
Fourth, keep rural hospitals open. Sixteen Montana hospitals are at risk of closing. That means Medicare and Medicaid payments that reflect what rural care actually costs, and paying off medical-school debt for doctors, nurses and dentists who serve rural Montana.
How we pay for it: we spend $5.3 trillion a year on healthcare, and roughly one dollar in four, $760 to $935 billion, is waste, mostly billing paperwork and denials. We cut that first. New revenue should come from the largest corporations and the wealthiest, not working families.
How we’ll know it’s working: what Montana families pay in premiums and out-of-pocket costs goes down, the uninsured rate falls, and rural hospitals stop closing. Every step gets scored by independent analysts before it starts, and the next step moves only after the last one proves it lowered what families pay.
SETH BODNAR, INDEPENDENT

Health care is an absolute crisis. Everywhere I go, I hear from Montanans who are struggling to access or afford even the basic health care they need to keep their families healthy. Meanwhile, politicians in Washington are in the pocket of insurance and big pharmaceutical companies that profit off sick Americans, and they refuse to work together to fix the system.
We don’t have to submit to gridlock and inaction caused by partisan theater and an insurance industry that spends more on lobbyists every year than most Montana towns will ever see. I will work with anyone, Republican, Democrat, or Independent, who will do the actual work of making care more affordable and accessible. And I will stand up to both parties when they work against the interests of our state.
I believe every Montanan deserves access to an affordable coverage option, without losing individual choice or reducing competition. But while we work to overhaul our health care system into one that incentivizes keeping people healthy, not just pays for them after they get sick, we need to take immediate action.
As Montana’s Independent senator, my first focus will be on restoring the ACA tax credits that were allowed to expire and have caused premiums to go up nearly 30%. I will fight every day to protect Medicaid expansion and stop the Medicaid eligibility verification rules that will cause 30,000 Montanans to lose access to health care in the next 12 months. I’ll work to expand Medicare’s power to negotiate drug prices and to increase price transparency requirements for hospitals and drug-pricing middlemen to rein in costs system-wide.
Montana families shouldn’t have to choose between seeing a doctor and paying rent. Washington is making that choice harder, not easier, and I’m going to change that.
U.S. HOUSE, WESTERN CONGRESSIONAL DISTRICT
AARON FLINT, REPUBLICAN

Montanans are working harder than ever but are still falling behind, and healthcare costs are a big part of that. I have spent years calling out Obamacare’s rising costs and pushing for lower insurance premiums. We need healthcare that is affordable and effective. Here is how we accomplish that.
First and foremost, we need to kick every illegal alien off Medicare and Medicaid. Those programs are paid for by Americans for Americans.
The Republican-passed Rural Health Transformation Program provides $50 billion for rural care, including more than $233 million for Montana. One of the first things I would do if elected would be putting those resources to work protecting rural hospitals, expanding telehealth, and bringing more healthcare workers to Montana.
We also need price transparency and lower prescription drug costs. Patients should know what care costs before the bill arrives. I would strengthen hospital and insurance transparency requirements and stop drug companies from charging Americans more while selling the same medicines cheaper overseas.
We must also protect Medicare and Medicaid for the people who qualify by eliminating fraud. My opponent is attacking me for saying that, but paying people who do not qualify or providers billing for care they never delivered only weakens these programs. A program filled with fraud cannot be sustained.
My opponent wants Washington to take over even more of our healthcare system, replacing private, employer-sponsored, and union health plans with government-run coverage. That means trillions in new spending and higher taxes while taking choices away from patients. He wants to put everyone on Medicaid and Medicare. I want accountability for the tax dollars Washington already spends and to protect benefits for those who need and deserve them.
That is the kind of healthcare system I want for my family and every family in Montana.
SAM FORSTAG, DEMOCRAT

Our healthcare system is broken. Montanans are stuck paying more every year for coverage that gets worse, while 20,000+ Montanans have already lost coverage. Meanwhile, the CEOs of the top 10 health insurance companies made over $200 million last year alone. This constant state of crisis response leaves my opponent’s corporate donors getting richer while the rest of us pay more for less.
Here’s how we fix it: first, we stop electing politicians like my opponent who take corporate money, because that dirty money is precisely what’s preventing common sense solutions. My opponent is backed by over $3 million from corporate PACs and SuperPACs who are supporting Aaron because they know he’ll serve their interests, not ours.
Second, let’s reverse the $1 trillion in Medicaid & ACA cuts that Aaron cheered on from his recording studio. Those cuts left insurance premiums skyrocketing, 10 million+ more Americans losing health coverage, and a new set of paperwork requirements that will require Montana to hire 59 new staff just to boot another 30-38,000 Montanans off their healthcare.
Lastly, let’s bring real choice to our healthcare system by giving every American the choice to join Medicare, increasing reimbursement rates so our rural hospitals can stay in business, and making that coverage comprehensive. If insurance companies want to compete, let ’em, but their monopoly on coverage clearly isn’t working for most Americans.
We can pay for all of this without going deeper into debt by repealing the $3 trillion of BBB tax cuts that only went to corporations and the richest Americans, keeping provisions like no tax on overtime & Social Security that help working class Montanans, and passing laws to make sure nobody making over $1 million/year is paying a lower effective income tax than someone making $70,000.
NICK SHEEDY, LIBERTARIAN

Sheedy did not respond to MTFP’s question. He did respond to a pre-primary candidate questionnaire about rural healthcare providers — “Many of Montana’s rural hospitals and clinics are facing financial stress because of low patient volume and tight budget margins. What, if anything, should Congress be doing to support Montana’s health care providers?” — as recorded in MTFP’s Election Guide:
While federal laws and policies should not hinder healthcare services to rural areas, I am not sure the federal government has or should have a significant role to play when it comes to local hospitals and clinics — except for federally-operated resources like VA hospitals and clinics that serve our veterans. I believe that the best way for Congress to improve access to healthcare generally would be to lower the regulatory burden, which artificially restricts the supply of healthcare providers.
U.S. HOUSE, EASTERN CONGRESSIONAL DISTRICT
TROY DOWNING, REPUBLICAN

Downing did not respond to MTFP’s question. He did respond to a pre-primary candidate questionnaire about rural healthcare providers — “Many of Montana’s rural hospitals and clinics are facing financial stress because of low patient volume and tight budget margins. What, if anything, should Congress be doing to support Montana’s health care providers?” — as recorded in MTFP’s Election Guide:
Rural healthcare and critical access facilities are essential to Montana. I make it a priority to visit these communities and understand the realities facing this vital part of rural infrastructure. Workforce development is one of the most pressing challenges. Many facilities struggle to recruit and retain the providers and caregivers they need to serve their communities effectively. Facilities must also be right-sized to meet the needs of their regions, ensuring they have the capacity not only for emergency services, but also for routine care and, in many cases, long-term care. Funding remains critical. With aging populations across rural Montana, Medicare and Medicaid account for a significant portion of facility revenue. Reforms to Medicaid will help ensure more resources go directly to patient care while reducing waste and fraud. I also strongly supported the $50 billion in Rural Healthcare Transformation funding appropriated last year, with Montana receiving a significant share of these much-needed investments. Finally, we must improve CMS accountability. Delays in hospital reimbursements and Medicaid redeterminations are unreasonable and place unnecessary strain on providers, especially in rural areas with limited resources.
MICHAEL EISENHAUER, INDEPENDENT

As an Independent Congressman, I will focus on reforms that lower costs, expand access and improve quality of care, but are also measurable.
1. Lower prescription drug costs. Dramatically expand Medicare drug-price negotiation under the Inflation Reduction Act of 2022, accelerate generic and biosimilar competition, and increase transparency and accountability for pharmacy benefit managers (PBMs). Fund this through Medicare savings generated by lower drug prices and reduced improper payments. Measured Success: lower out-of-pocket prescription costs and Medicare drug spending.
2. Strengthen rural healthcare. Expand the National Health Service Corps, Medicare-funded residency training, loan repayment and other incentives for physicians, nurses, PAs, NPs, pharmacists, and behavioral-health professionals serving shortage areas. Closely monitor and strengthen the Rural Health Transformation Program and protect critical-access hospitals. Fund these efforts by redirecting existing federal healthcare workforce and rural-health dollars toward communities with documented shortages. Measured Success: more providers, shorter travel distances and wait times, fewer rural hospital closures, and improved clinical outcomes.
3. Reform prior authorization. Regulate the use of AI in prior authorizations and scrutinize Medicare Advantage programs. Promote rapid decisions, stronger appeals, and “gold-card” exemptions for clinicians with consistently high approval rates. Fund implementation through administrative savings. Measured Success: fewer unnecessary denials, faster treatment, and fewer clinician hours spent on paperwork.
4. Pay for outcomes, not volume. Expand Medicare value-based payment models and pursue appropriate site-neutral payments for clinically equivalent services. Savings from overutilization can be reinvested in quality and access. Measured Success: lower costs, fewer preventable hospitalizations and readmissions, and better patient outcomes.
5. Strengthen hospital price-transparency requirements and require usable estimates of expected out-of-pocket costs before scheduled care. Fund enforcement through existing regulatory resources and penalties for persistent noncompliance (which is common). Measured Success: greater price competition and smaller gaps between estimated and actual bills.
PATRICK McCRACKEN, LIBERTARIAN

Healthcare in America is how you know your government either hates you or wants your vote. Depends on your age bracket.
My healthy family of four pays $24,000 a year for coverage we rarely use, with a $12,000 deductible on top. That’s more than a mortgage. Insurers keep a fixed cut of what gets spent, so the more healthcare costs, the more they make. The middle manager isn’t worried about costs because your sickness is their profit.
It really doesn’t have to be this complicated. Pay your doctor cash for everyday care, off a transparent menu of pricing for service. Buy cheap catastrophic insurance for the big stuff. That’s insurance doing what insurance is supposed to do.
As your Representative, I will:
- Require hospitals and clinics to post real cash prices.
- Open catastrophic plans to every American. Today they’re mostly limited to people under 30.
- Let every American open and fund a health savings account. Doesn’t matter what coverage you have. It’s yours and portable, just like an IRA.
- Let workers take their employer’s health money tax-free and buy their own coverage. This would ensure portability instead of job tied insurance.
- Let workers under 50 keep their share of Medicare taxes in accounts they own, keeping every promise to those 50 and over.
Funding: This removes barriers instead of adding programs. Ending the $76 billion Medicare overpays private insurers this year helps cover the transition.
Evidence: Posted cash prices falling, catastrophic premiums Montana families can afford, more doctors offering cash and direct primary care, and family premiums dropping from the $27,000 average.
Pay the doctor for the checkup. Insure against the catastrophe. Get Washington and the middlemen out of the equation.
BRIAN MILLER, DEMOCRAT

We need to reverse the trillion-dollar cuts to Medicaid that Troy Downing voted for, as well as the repeal of the Affordable Care Act subsidies, which caused health insurance to be out of reach for tens of millions of Americans. We fund those by clawing back the trillion-dollar tax cuts that Troy Downing voted to give to the top 1%, and then tax wealthy corporations at an equitable level. Wealthy corporations are paying almost no income tax anymore, while raking in record profits. So, that is where we’re going to go to fund the restoration of these subsidies.
I support the goal of universal healthcare for all Americans. I believe that it should be the goal of every civilized nation in the 21st century to provide healthcare for all of its citizens. We need to end our grotesque experiment with for-profit healthcare.
There are many different proposals out there: single payer, public option, Medicaid for all. And also there is a solution which is lesser known, which is the German multi-payer system. We have to be careful about imposing a federal solution on the states. And also, we must preserve patient choice.
Bottom line is that we must end the practice of allowing corporations and the wealthy to profit off other people’s suffering. We must design a healthcare system that is run to cost along the model of a co-op. We must ban pharmaceutical companies from running ads for their products. We must limit the salaries of CEOs. We must penalize private insurers for denying claims and provide incentives when more claims are covered.
Also, we must do a medical debt forgiveness program for middle class families across the United States and have that paid for out of the salaries of wealthy CEOs and bloated health insurance companies.
Montana begins mailing absentee ballots for the 2026 general election on Oct. 9. The voting method has become dramatically more popular over the past two decades: About 22% of ballots were cast absentee in 2004, compared with roughly 70% cast through absentee ballots in 2024.
A union representing employees at Columbus Metallurgical Complex and Stillwater Mine, which are both owned by a South African company called Sibanye-Stillwater, have ended a month-long strike. United Steelworkers Union 11-0001, which represents about 420 employees across both facilities in south-central Montana, approved a three-year contract Tuesday.
Flathead National Forest officials rejected a 2022 version of the plan in a preliminary review before any public process got underway. The 2026 proposal varies little from the earlier one, according to Pursuit Chief Operating Officer Gary Rodgers, except to operate year-round instead of seasonally. It would still feature a base facility in Hungry Horse and a café about 3,000 vertical feet above.
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