Montana Astroturf Strategy Backfires on Koch Brothers

This was a bad week for the Koch Brothers in Montana.

Their astroturf “group,” Americans for Prosperity, is fighting Medicaid Expansion.  That’s right–the Koch Brothers, who are worth $50 Billion – each,  are trying to ensure that someone who makes $15,000 is not able to afford health insurance or medical care.

Zach Lahn, a young GOP operative who was once a Steve Daines campaign aide, is now the head of AFP’s Montana chapter.   Lahn has thus been targeting pro-Medicaid Republican legislators, sending mailers comparing them to Obama, demanding that they sign anti-Medicaid “pledges,” and showing up in a suit holding astroturf “town meetings” in their districts designed to intimidate them.

None of it is working, and the town hall meetings have blown up altogether.  In Dillon this weekend, the legislator being targeted, Rep. Jeff Wellborn (R-Dillon, actually showed up like an adult at the AFP meeting and naturally wanted to speak.  Lahn would not allow him to.  Wellborn walked out, as did a number of attendees.  You can see a video of this on the Great Falls Tribune website here-– the crowd was not pleased with AFP’s action.

Rep. Frank Garner (R-Kalispell), the former police chief and now a pro-Medicaid Republican legislator from Kalispell, drove eight hours to be at the town hall meeting in his district this weekend and muscled his way to the podium.   That meeting, too, blew up in Lahn’s face.   A Flathead Beacon reporter covered the event:  You can also see some of the Flathead Beacon’s video coverage on the Great Falls Tribune site.

Garner’s mere presence had a chilling effect on the AFP presentation, which was frequently derailed by laughter, booing and shouting from audience members who overwhelmingly expressed support for Garner.

Following a hasty exchange with AFP State Director Zach Lahn minutes before Thursday’s meeting commenced, Garner took the podium to defend his record before the crowd of mostly supporters, who cheered the lawmaker on.

“I promised the people here when I ran that I would listen to you and not out-of-town special interests,” Garner said to raucous applause. “If every time they want me to sign a pledge card and I don’t do it they are going to rent a room and have a meeting, then this is going to get real expensive. Cause I’m not signing the pledge card.”

This is an example of a Tea Party event gone terribly wrong.  And it indicates to me that the Medicaid expansion battle will likely be won.  The moderates will break away and support some version of the Governor’s proposal.

This debacle in Kalispell (which played out in several other districts as well) is part of a larger emerging trend in the country in which classic Tea Party hooligan tactics are not working out like they used to.  A few years back, Tea Party town hall meetings were places where a moderate Republican would overwhelmed by a Tea Party mob.  Now the opposite is happening. This means that the Tea Party is in retreat. Even AFP’s own employees know how terrible their reputation is.


Perhaps the person who has best summed this all up is GOP Sen. Llew Jones, who penned an op-ed in the Fairfield Sun Times today:

Irrespective of your stance on this, or any issue, these intruders need to get out of Montana politics.   I know that I now consider any issue or individual that AFP advocates for or against as highly suspect.   To me these folks are on the same level as the predator who called my 89 year old mother last week, pretending to be her Grandson, supposedly trapped in a “bad situation” in New York, desperately needing her help, which was defined as $900.00 on her credit card.  “Please Grandma, don’t tell anyone…..!!”   How despicable.. It took my son calling, and me talking to her, to finally calm her down, but she is still very upset and confused.

Predators: get out of Montana, we do not want you here.  We can take care of our own.

The problem AFP is running into is that these districts have rural hospitals that need the medicaid expansion because they currently provide health services to poor people who can’t pay the bills.  Plus Medicaid expansion helps all Montanans – without it, we are all are subsidizing the cost of the uninsured through our insurance bills.  So while Lahn and his pals are making angry speeches at these Munich Beer Hall-type gatherings, Governor Bullock and Lt. Governor McClean are touring the hospital down the street, meeting with workers and even the Republican legislators being targeted, and getting the majority of the community behind them, such as chambers of commerce, as well as local media such as editorial boards. The major newspapers have all turned against AFP and are supporting Medicaid expansion, as has the Montana Chamber of Commerce.

It might seem natural for Steve Bullock to be supporting this but keep in mind that he has taken on a herculean task.  Bullock stands alone as the only Democratic Governor in America who both presides over a Red state and is actively pushing Medicaid expansion.



20 Comments on "Montana Astroturf Strategy Backfires on Koch Brothers"

  1. In the old days, he might have been given the rail along with a few oil well product feathers stuck to him to keep him from freezing. Welcome to the United States of Koch!

  2. Speaking of backfires, Tea Party bill – HB274 – telling Sheriffs not to uphold federals laws FAILED 39-61, with 20 SANE GOP legislators voting with Dems on the Ballance bill endorsed by Field Marshal Marbut! Maybe there’s hope, and another INSANE bill coming tomorrow is SB154, from Scott Sales, another Tea Fool, who insists adults don’t need to WEAR ORANGE vests for hunting, that’s really smart! Landowners, farmers, ranchers, hunters and the public need to say HELL NO, this bill is another -anti-Gummint bill ‘solution’ searching for a problem.

    • Damn glad to hear it. Thanks.

    • Hey, I like that bill! Now I can sneak into the elk herd wearing an elk hide, and the elk won’t know who I am! And we all know elk hunters are safe, cautious, smart and all-knowing, and would never drink a clammy bud light before 10 in the morning, so I would have no worries.

  3. I hope they kick their ASStroturf back to wherever they came from. I’m so sick of AFP stirring up good people by lying and fearmongering in our state. Good for these guys calling them out. OUR STATE NEEDS MEDICAID EXPANSION.

  4. Yellowstone Newspapers is silent on Medicaid expansion. Its publisher, John C. Sullivan, is the largest recipient of federal farm subsidies in Park County through Schnitzler Corporation at $1.6M. What say you Mr. Sullivan?

  5. These guys are quite the amateurs compared to the seasoned Montana Dems who work with Hilltop Public Solutions and their astroturf groups. Just ask Dirk Adams. This is going on at the Dem national level as well.

    As to medicaid expansion, what happens when the doctors say, ‘No!’ Making doctors the financial shock absorber has its limits before the whole system go over the cliff.

    • Craig – no matter what your opinion of the travails our physicians have to deal with, the fact is that without Medicaid expansion a lot of these rural hospitals will have to close. How would you feel if you lived in Choteau and had a heart attack – the ambulance would have to come from Helena or Great Falls to take you to an ER to hopefully save your life. This is the least we can do for our fellow Montanans. Not everyone lives in a city with easily accessible medical care.

      Be more compassionate – really, it won’t hurt.

      • Rural hospitals are in trouble… and expanded medicaid won’t save them.

        The Affordable Care Act was designed to improve access to health care for all Americans and will give them another chance at getting health insurance during open enrollment starting this Saturday. But critics say the ACA is also accelerating the demise of rural outposts that cater to many of society’s most vulnerable. These hospitals treat some of the sickest and poorest patients — those least aware of how to stay healthy. Hospital officials contend that the law’s penalties for having to re-admit patients soon after they’re released are impossible to avoid and create a crushing burden.

        “The stand-alone, community hospital is going the way of the dinosaur,” says Angela Mattie, chairwoman of the health care management and organizational leadership department at Connecticut’s Quinnipiac University, known for its public opinion surveys on issues including public health.

        The closings threaten to decimate a network of rural hospitals the federal government first established beginning in the late 1940s to ensure that no one would be without health care. It was a theme that resonated during the push for the new health law. But rural hospital officials and others say that federal regulators — along with state governments — are now starving the hospitals they created with policies and reimbursement rates that make it nearly impossible for them to stay afloat.

        Low Medicare and Medicaid reimbursements hurt these hospitals more than others because it’s how most of their patients are insured, if they are at all. Here in Stewart County, it’s a problem that expanding Medicaid to all of the poorest patients -– which the ACA intended but 23 states including Georgia have not done, according to the federal government — would help, but wouldn’t solve.

        “They set the whole rural system up for failure,” says Jimmy Lewis, CEO of Hometown Health, an association representing rural hospitals in Georgia and Alabama, believed to be the next state facing mass closures. “Through entitlements and a mandate to provide service without regard to condition, they got us to (the highest reimbursements), and now they’re pulling the rug out from under us.”

        For many rural hospitals, partnering with big health systems is the only hope for survival. Some have resorted to begging large hospitals for mergers or at least money to help them pay their bills. But Douglas Leonard, president of the Indiana Hospital Association, said these days, “I’m not sure they can get anyone to answer the phone when they call.”

        Compassion is a very poor medicine for a sick program design. The sequence and priorities are all wrong. Quality cannot be inspected into a product or service, it has to be built in at the start. The doctor suicide rate screams out that their lives matter too.

        • The sky is not falling Chicken Little. In rural Park County, Montana, Livingston HealthCare is building a new state-of-the-art $43.5M hospital and clinic facility, scheduled for completion in late 2015.

          • As you may or may not know LHC is lashed up with the Billings Clinic which provides management services to LHC. They struck a new deal whcih recreates LHC as a critical access hospital (CAH) which brings substantial federal funding and much higher Medicaid and Medicare reimbursement rates. LHC has not been a standalone community hospital since it began its Billings Clinic relationship. Under the new relationship the Billings Clinic will have 25% of LHC’s board positions.

        • Craig, I realize that it is almost custom around here to lay into your nay-saying with assumption, outrage and derision. Frankly, I haven’t the energy for such gamesmanship anymore, so I’ll simply ask: What is the point that you are trying to make? What is your goal?

          Your first relevant to topic link shows that physicians are committing suicide at a rate of about 300 per year. In context, that’s almost twice the average of the rest of the general population, except dentists, veterans and strangely marine engineers. It is significant to note that those suicides are generic to ‘doctors’, and I can find no breakdown of demographic information (age, location, practice …) Still, the argument is made that doctors are miserable, and regrettably, your first link fails to examine why other than to posit that the career choice is not living up to their expectations. They wanted to be healers and they are spending too much time on insurance paperwork, a problem exacerbated by the ACA.

          Accepting those assumptions as rote, the argument would be that we must save our doctors by repealing the ACA. However, your second relevant link shows that medicaid/medicare expansion actually can help the disbursement of moneys in a broken business model, and ease pressure on rural physicians. It is hard to disagree with that. Your final link discusses the ‘tyranny of perfection’, that doctors are failing under unreal professional and personal expectations. Strangely, that point undercuts your previous links, that it is the system that is flawed, instead of the profession. A scant 3 years ago, active military and veteran suicides outstripped physician suicides by far. In each of the years following, those suicides have decreased, based on active effort of both military administration and veteran’s support. In short, the profession saw it’s flaw and did something about it.

          From reviewing your links, several points can be made. 1) The medical profession has insisted on being self-policing as regards misconduct and the law. I don’t think it inappropriate to point out similarities to the Priesthood. If the profession has a flaw, it needs to deal with it, beyond telling young aspiring doctors to leave. 2) Rural health facilities have a problem, but it is not a problem of physician suicide or dissatisfaction. It’s a flawed business model on the part of the industry. That much is clear from your second link, as well as the fact that increasing governmental financial support for health care is a boon, not a flaw. 3) It is state governments and people like Tom Burnett and Art Wittich who are exacerbating the problem by emphasizing personal pocket book over health care. They are the one’s destroying the great physician’s dream of rich personal and financial reward, not the number of people in need of actual health care. A simple truth, unspoken in any of your links, is that everyone needs health care. Every single one of us. Those two jackwads, and people like them, are the ones setting up the opposition that leads to the failure of rural facilities and physician v. patient burnout. 4) Appeals to sympathy for doctors ring hollow when there is a false opposition set up. Is one to to choose the happiness and mental well-being of the folks who want to make bank and retire earlier by proscribing meds? It would be easy to do that; we simply need to choose their well being over that of the ill, infirm and needy, too indigent to pay for privileged health care. It’s no joke or mystery which side most folks come down on. They will choose the rancher, the grandma, the accident prone son over the stress relieving needs of the doctor any time. It’s not a mystery that people expect physicians do their job for the benefit of those they love, and they will worry about who pays the damned bill later.

          I ask again, what is your goal? If it is a state denial of medicaid expansion, then your own links show how that is exactly part of the problem. If you want us to think of the poor doctors before ourselves, than i suggest you are barking up the wrong tree. If you are urging for a better system of health care based on medicaid for all, which would be called single payer, then you and I have nothing to disagree about. However, moving in that direction, just as all change is, will be painful, and for a while doctors will be the shock absorber of financing the change. If their expectation was medical degree = profit, then they really aren’t very good at providing for need and probably should go to work for Wall Street. (Just in case you didn’t notice, it was your own links that point out that it is insurance companies now firmly bedded by financial structures that are the real problem.) What we have today is forcing change, where the status quo of 6 years ago was only forcing profit. As I, and your own links, have clarified people will choose what gives care over ambitions of Wall street, Insurance companies or doctors.

          So, no assumptions and my questions still stand. What do you want, Craig?

          • Craig is crowdsourcing for enough cash for gender reassignment so he appeals to Art Wittich, Rob; but, he knows nobody will pony up so screw the rest of Montana.

          • As I wrote above, that you apparently missed: As to medicaid expansion, what happens when the doctors say, ‘No!’ Making doctors the financial shock absorber has its limits before the whole system go over the cliff.
            What I want? Redisign the healthcare delivery system in a private – public partnership that focuses on quality of care first and foremost. That quality is dependent of the mental health of the providers. Second, expand the healthcare delivery base to meet rising demand so wait times don’t kill people. Third, address funding.

            As to expanding Medicaid in Montana, I want the governor to address the size and source of the funding that will be necessary on into the future after federal funding stops. I want to see honesty and competency to prevent the dive off the cliff when the euphoria wears off.

            • Craig: wishing for economic collapse under a black president will not make it so.

            • It appears you may have a problem with your reading comprehension, Craig. Not only did I deal directly with your link, your fear-mongering comment about doctors ‘saying no’ is not supported in that link. What is supported is exact;y what I discussed in my earlier comment, including the idea that it is the profession itself which is causing a good portion of the stress that doctors find themselves suffering.

              Almost comically, the response of medical leadership—their solution— is to call for more physician testing. In fact, the American Board of Internal Medicine (ABIM)—in its own act of hostage-taking—has decided that in addition to being tested every ten years, doctors must comply with new, costly, “two year milestones.” For many physicians, if they don’t comply be the end of this month, the ABIM will advertise the doctor’s “lack of compliance” on their website.

              That’s truly a circumstance of ‘physician, heal thyself’ don’t you think?

              I remain curious exactly how a ‘public-private’ partnership to redesign health care delivery is supposed to work if funding is dealt with as a tertiary afterthought. No matter, there still seems to be little basis either in your links or analysis for the doom you predict. Change, absolutely. Adaptation, a necessity. Adoption of single payer seems an ever more likely outcome. So, I guess that I’m at least one person unfazed by the alarm you are trying to sound.

    • I love that this story is all over the national media. That young man may think again about his job with AFP, though I fear his arrogance will overcome any humility he might have left – after all he worked for Daines.

  6. Garner deserves credit for not signing AFP’s pledge and for disrupting AFP’s ambush in Kalispell. But he is not yet a Medicaid hero.

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