With its employee health plan in financial crisis, Montana hired a former insurance insider who pushed back against industry players with vested interests in keeping costs high. She proved, essentially, that bargaining down health care prices works.
Western states rich in coal, oil and natural gas—among them Wyoming, New Mexico and Montana—already rely heavily on those industries and have had their budgets hit hard in recent years by falling energy prices.
U.S. Department of Agriculture loans and grants have helped fund water infrastructure in rural localities like Hysham, Montana. The Trump administration’s proposed budget would nix funding for the program that provided this assistance.