Greg Gianforte

U.S. Rep. Greg Gianforte meets with residents Monday at the Bozeman Senior Center to discuss health care.

Katheryn Houghton/Chronicle

It’s hard to get treatment when you’re 65 or older and rely on a program that pays health providers less than the price of care. And surprising medical bills is a whole other issue.

That’s what a small group of locals told Montana’s U.S. Rep. Greg Gianforte at the Bozeman Senior Center on Monday during a roundtable over how federal health coverage plays out for seniors.

Esther Fishbaugh held up several medical titanium bolts that once acted as spinal hardware in her back.

“These cost $46,000,” she said, adding that doesn’t make any sense to her. “You’ve got to have price transparency. And you got a dynamic going on where insurance companies stand between the patient and the doctor.”

Tamera Hall said she’s been trying to jump through the hoops of health care for years, an effort that became more difficult after her multiple sclerosis diagnosis. She said year-to-year, people face changes in what’s covered through their plans and how much care costs, from surgeries to prescriptions.

“We’re smart people, but they change this constantly and they downgrade it and they play games and you can’t keep up,” Hall said.

The complaints aren’t new but highlight the starting point of lawmakers’ ongoing debate around how to fix the nation’s health care delivery system.

Echoing a bipartisan frustration, Republican Gianforte said health care is one of the only areas in life that people make major decisions without knowing what it’s going to cost.

“I think as we look to reform health care, it’s got to include increased transparency, understandable bills and removing barriers between their doctors and patients,” he said.

Gianforte said the Affordable Care Act, known as Obamacare, hasn’t done that and is often too expensive. A critic of the nation’s existing health system, Gianforte said he’s covered through Obamacare, though he said he couldn’t remember what plan he’s on.

The event, hosted by the Coalition for Medicare Choices, placed Gianforte at a table with a handful of people who have relied on Medicare Advantage, a branch of the federal program that offers coverage through private health plans.

More than 19 million seniors and people with disabilities are covered through the plan. That includes 44,000 Montanans.

The meeting took place the same month Centers for Medicare and Medicaid released proposed changes for Medicare Advantage in 2019.

“We wanted the congressman to get an idea of the real-world impact that Medicare Advantage has in Montana,” said Chuck Denowh, representing the Coalition for Medicare Choices.

This month, the federal agency proposed a 1.84 percent average payment rate increase for next year’s advantage plans along with other tweaks that officials said will strengthen the program. That number could change before the Centers for Medicare & Medicaid Services finalize the bump in April.

During Monday’s discussion, the Bozeman roundtable of seniors said as it stands, Medicare reimbursements to health providers aren’t high enough to secure their treatment.

Fishbaugh said she realized that as a caretaker for her dad years ago when she had to “beat down the doors” to get him connected to care.

“Nobody from the medical community was taking new Medicare patients because the payments for the doctor’s time in the office was so abysmally low, they could only take two or three medical patients at a time,” she said.

Gianforte took notes and occasionally jumped in the group’s lists of issues asking for solutions.

He said Monday’s meeting was a chance to hear what is and isn’t working for senior health care. After the discussion, Gianforte said he has some more investigating to do.

Katheryn Houghton can be reached at khoughton@dailychronicle.com or at 406-582-2628. Follow her on Twitter @K_Hought.

Katheryn Houghton is the city government reporter for the Bozeman Daily Chronicle.

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