BILLINGS — As the federal government shutdown enters its second day, Montana health care providers and patients are already feeling the pain, especially those who rely on Medicare and telehealth services.
Watch how the government shutdown would impact healthcare access in Montana:
Dr. Eric Arzubi is the CEO of Frontier Psychiatry in Billings, a practice that serves over 5,700 patients solely online, spanning Montana, Idaho, and Alaska. Telehealth is a service he has seen spike after the COVID-19 pandemic.
"Before telehealth, patients often had to drive three, four, or five hours for a half-hour visit," said Arzubi. "Patients can be seen now virtually, and that saves a ton of money and time for patients and the health system overall."
The government shutdown is putting that at risk, as Congress could not come to an agreement on a bill to fund the government. As of Oct. 1, telehealth services will no longer be covered by Medicare as the flexibilities granted in 2021 to allow at-home online care, as well as the "Hospital at Home" care program for seniors, expired.
“Situations like this just make it a lot more difficult for us to give people access to high-quality care, and it's difficult enough on a regular day,” said Arzubi. “The longer Medicare doesn't pay for these things, the more vulnerable these services become in general.”
Arzubi explained that the loss could mean fewer patients getting access to the care they need, especially those in rural communities. Providers would also not get reimbursed for their services until Congress agrees on a spending bill.
Federal subsidies will expire at the end of the year without congressional action. If those provisions from the Affordable Care Act expire, health insurance premiums could skyrocket. Blue Cross Blue Shield of Montana, the state’s largest private insurance provider, has already proposed an over 24% increase in rates for 2026. Other insurers are seeking rate hikes ranging from 11% to 25%.
Patients may be priced out and could opt out of coverage if prices become too high, according to Arzubi.
“What we're seeing is the cost at a family level for health insurance is going up, up and up, and at the same time, what we're seeing is financial support for nonprofit hospitals, critical access hospitals in rural communities is going down,” said Arzubi. "Health insurance is expensive as it is, so a doubling of health insurance premiums can be pretty catastrophic for a lot of folks."
Rural hospitals in Montana would likely have to absorb the cost of uninsured care, and many are already financially strained.
"A lot of these rural hospitals in particular take more Medicare and Medicaid patients than urban hospitals, and so without these extra payments from CMS, the financial health and viability of some of these rural, critical access hospitals are under threat," explained Arzubi. "We all end up paying for that in one way or another."
While insurance exchanges such as Medicaid and Medicare, along with other provisions within the Affordable Care Act, remain in place, the loss of funding could affect treatment options and long-term survival for many rural facilities.
Still, Arzubi said he and his practice will continue to see patients as normal. He stressed that the politicization of health care continues to put communities at risk, but he remains hopeful that lawmakers will reach a resolution.
"This is not a Republican issue or a Democrat issue," said Arzubi. "For politicians to continue to play political football with our health care, I think, is troubling at best."
