Montana's special election for lone House seat highlights divide over healthcare reform

Montana's one and only seat in the House of Representatives is up for grabs, and in the final weekend before Thursday's special election, the underdog Democrat was hammering the Republican health care bill in TV ads.

The ads open with Democrat Rob Quist asking, "Did you know half of all Montanans have a preexisting condition?" He then attacks Republican challenger Greg Gianforte for supporting the House-passed American Health Care Act, which would allow states to drop preexisting conditions protections.

The latest polls put the race within a single-digit margin, surprising in a mostly red state where the previous two Democrats running for the seat lost by 15 points or more. Republicans have held Montana's statewide seat in the House since the 1996 election. It became vacant in March when Rep. Ryan Zinke resigned it to become secretary of Interior.

Quist, a political neophyte, is a Montana-famous folk singer, who has written and performed Western-themed songs across the state for four decades.

[Also: Analysts debate key elements of GOP healthcare bill on pre-existing conditions]

Republican Gianforte is a software entrepreneur whose only political experience is failing to unseat Montana's Democratic governor in November, getting the fewest votes of any Republican statewide candidate in 2016. Donald Trump won Montana by 20 points.

A last-minute TV ad for Gianforte, funded by $2.5 million that the national Republican Congressional Leadership Fund has poured into the race, pairs a photo of Quist with Nancy Pelosi and says Quist supports her agenda, including "government-run health care."

Montana resident Jim Lynch plans to vote for Gianforte. Lynch is a member of the Glacier Country Pachyderm Club. Members get together once a month in Kalispell, Mont., to talk about advancing Republican values.

[Also: GOP senators, governors, rethinking American Health Care Act]

Lynch says health care is a top issue for him. He hates the Affordable Care Act. He's 63 and says his job provided good health insurance coverage throughout the Obama administration and continues to do so. But, he said, "there's a lot of people in my shoes who aren't that lucky. I do know, personally, that they've seen huge increases in health care costs, to the point that they don't even have it anymore."

Indeed, people who are 55 to 64 can be charged as much as three times what a younger person can be charged for ACA health insurance. Subsidies are available based on income, but older people may earn more than young people just starting their careers.

Under the GOP bill passed by the House, however, older people can be charged five times as much as younger people, and the subsidies are decreasing in aggregate.

Lynch said he doesn't think the House health care bill is perfect, but he's confident that, as President Trump shepherds it through Congress, it will be modified into something much better than the Affordable Care Act.

[Also: Senate rules could put GOP healthcare bill, goal of defunding Planned Parenthood at odds]

About a hundred miles south in Missoula, Mont., restaurant owner Molly Galusha dreads the idea of Obamacare being repealed. She said the current health care law's subsidies have made it possible for her employees to afford health coverage on the wages she can afford to pay them.

Galusha is 62 and gets her health coverage through her husband's job. She says she doesn't know what they'd do if their insurance went away.

"We're old and broken," she said with a laugh.

The Affordable Care Act's protections for people with preexisting conditions are also likely to affect older people, because the likelihood of having a preexisting condition increases with age.

"We are uninsurable as a couple, so we're very grateful," Galusha said.

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Republican candidate Gianforte said he won't vote for a health care bill that doesn't work for Montana.

"I need to know that, in fact, it'll bring premiums down, preserve rural access and protect people with preexisting conditions," he said.

He also said he would have voted against the House health care bill if he'd already been in Congress, because there wasn't enough time to read the bill and understand it before the House voted.

Democrats, however, accused Gianforte of being disingenuous. They point to a recording of a phone call he had with lobbyists on the day the House bill passed, which was leaked to The New York Times. On the tape he said, "Sounds like we just passed a health care thing, which I'm thankful for, that we're starting to repeal and replace."

Quist pounced on those words. Quist needs Republican votes to win, so he's trying to convince Republicans that their candidate will sell out the state's interests on health care.

"Montanans want a congressman who'll shoot straight, not a dishonest politician who says one thing to Montanans and another to the millionaires behind closed doors," he said. Quist said he wants to build on the ACA and thinks the country should eventually move to a single-payer health insurance system.

This story is part of a partnership that includes Montana Public Radio, NPR and Kaiser Health News.

Twitter: @HC_Finance