Q and A with Chuck Hunter, Former Representative from Montana

Chuck Hunter was a member of the Montana House of Representatives for eight years and its minority leader for the last four. Before running for the Montana legislature, Hunter spent over two decades working for Montana’s executive branch, running the child welfare system, refinancing health care, and administering part of the Medicaid program. He attended his first Reforming States Group (RSG) meeting in 2009, which was also the first year he served as a legislator. A long-time RSG Steering Committee member, Hunter retired at the end of 2016. The Fund recently spoke to him about how the RSG influenced his legislative work.

Can you describe the RSG’s impact?

RSG has been helpful to me in so many areas that it’s almost impossible to list them all. In some ways, it’s been about the identification of opportunity. When I go to an RSG meeting, I am constantly amazed at the things I learn about how to improve the health of the people of Montana.

In a broad sense, I think the RSG helps state policymakers in three ways.  It serves as

• Inspiration:  The RSG gives us an opportunity to see what is possible and, more specifically, what other states are accomplishing.
• Benchmark:   It enables us to determine where our state is in relation to others on specific topics—and how we are changing.
• Resource:  Because the RSG is bipartisan and discussions are open, we can learn what legislators across the aisle are thinking and doing. Then we move forward together. It also serves as a technical and knowledge resource. We have an opportunity to meet leading experts in health care—and expand our network of contacts.  We also have the opportunity to seek and find common ground.

Here’s an example of all three of these elements from an RSG meeting this past fall. After November 9, the election and the possible changes in health care were on everyone’s minds. Recognizing this, leadership at the Fund and the RSG Steering Committee thought this topic needed to be acknowledged—and altered the meeting program to enable RSG members to talk about the election and possible changes in health care that it might bring. The critical element of the RSG process is to provide a climate where people with different political views can get beyond the politics to talk about the both the underlying issues and the variety of options for dealing with those issues.

What kinds of health issues did you focus on in Montana?  

We look at issues in which the state plays a key policy role, such as Medicaid, children’s health, mental health, and public health in general.  I played a key role in the expansion of Medicaid last session. It was a lot of work over four years. We tried to pass an expansion in 2013 and it failed. We were pretty satisfied when it passed in 2015. I’d have to say it’s one of the aspects of my work I’m most proud of.  I give the RSG a lot of credit for helping us—both Democratic and Republican legislators from Montana—formulate the path to that legislation. They held meetings in which we learned from other states where there had been reluctance to expand Medicaid. The conversations mainly focused on the underlying dynamics, such as overcoming the political and financial problems associated with the expansion. These interactions helped us prepare for some of the problems inherent in expanding Medicaid.

What health care topics discussed at RSG meetings had the most impact in your state?

There have been RSG discussions and presentations on a number of topics, including the integration of behavioral health and primary care, the social determinants of health and how they factor into health care, and paying for health care.  I have learned about these topics—and this information has shaped my views.

In Montana, we have made significant progress in terms of mental health services. We’re nowhere near as far along as I’d like to be, but we are moving forward. It’s a topic that’s on people’s radar. That’s an RSG benefit. There is multi-payer payment reform activity going on in Montana. I can’t take particular credit for that myself. But it is an attempt to align payment incentives across all payers in Montana, public and private—and that’s good for the state.

What plans do you have for the future?

Over the years, I gained a broad background in our health care systems—both in how they work and how they are financed. That background was very useful at the policy level. I would love to continue to work on health care policy with both my state and with the RSG as a retired legislator.