Montanans cannot afford Gov. Gianforte’s cuts to care | Celeste Thompson

Every day, caregivers like me help Montanans live with dignity in their own homes. We help people get out of bed, bathe, eat, take medications, and stay connected to their communities. For seniors and people with disabilities, this work can be the difference between staying safely at home and being forced into a hospital, nursing home, or other more expensive setting.

That is why the news that Gov. Greg Gianforte approved a plan to withhold Medicaid provider rate increases should concern every Montana family.

According to a recent story in this newspaper, the increase at issue is $10 million passed by a bipartisan majority of the 2025 Legislature. The 3% bump was set to take effect next week and would have helped behavioral health, home care, and other community-based services for Medicaid patients. Instead, the administration chose to axe it while blaming a budget shortfall.

For people outside the Capitol, “provider rates” can sound like budget jargon. For caregivers and the people we serve, this is a cut: fewer resources for care, more instability for providers, and workers pushed backward again.

Home care is one of the best investments Montana can make. It lets people remain at home, close to family and community. It is also far less expensive than emergency rooms, hospitals, or institutional care. When these services are weakened, people do not stop needing care. They get it later, in more costly ways.

The people I care for cannot make up the difference out of pocket. Many live on fixed incomes and are already stretching every dollar. When the state cuts funding for home care, clients cannot just pay more.

Caregivers cannot afford it either. Before the 2023 Legislature acted, many union caregivers in Montana were making around $13.75 an hour. After years of advocacy, we finally made progress toward wages closer to $20 an hour. That helped caregivers stay in the field and pay their own bills.

Withholding this rate increase is dangerous. Montana already has a care workforce crisis. Low wages and uncertainty make it harder to recruit and retain caregivers. When workers leave, clients lose services. Families scramble. Providers shrink or close.

Lawmakers and providers have told the administration there were other choices. A bipartisan group on the Legislative Finance Committee urged the governor not to sign off and identified other funding sources. This was a choice. Gov. Gianforte should choose Montana families.

This is an affordability issue. Clients cannot afford to pay more out of pocket. Caregivers cannot afford to lose income. Taxpayers cannot afford the higher costs that come when people lose access to home care and end up in emergency rooms or more expensive care settings.

Caregivers know what happens when home care is strong. People remain independent. Families breathe easier. A few hours of care can prevent a crisis.

Everyday workers should not carry the burden for balancing the state budget. Gov. Gianforte and lawmakers should protect care, keep their promises to workers, and ask the wealthiest to pay their fair share. Caregivers have kept our promises to the people we serve. Now Montana’s leaders need to keep theirs.