Montana’s health care system does an adequate job of meeting the needs of low-income families, although it’s nothing to brag about, according to a report released Tuesday.

Montana ranks 27th, according to a Commonwealth Fund scorecard that was designed to evaluate how well state health care systems are working for low-income Americans. Wyoming ranked 31st.

It is the first scorecard of its kind on this issue.

The Commonwealth Fund is a private foundation that supports independent research on health policy reform.

The report provides a state-by-state comparison of the health care experiences of the 39 percent of Americans with incomes less than 200 percent of the federal poverty level, or $47,000 a year for a family of four and $23,000 for an individual.

Low-income people account for at least 25 percent of total state populations, and as much as nearly half, 47 percent, in some states, including Arkansas, Louisiana, Mississippi and New Mexico.

Richard Opper, director of the Montana Department of Public Health and Human Services, said that while the state has programs in place to help residents, more could be done.

“Everyone deserves access to quality health care,” said Opper, director of the Montana Department of Public Health and Human Services. And there are programs in place to help make that a reality, he said.

At DPHHS, thousands of adults and children have received health benefits through Medicaid and the Healthy Montana Kids plan, a free or low-cost health coverage plan that provides health coverage to eligible Montana children and teenagers up to age 19.

Unfortunately, Opper said, the Montana Legislature did not authorize Medicaid expansion — a decision that would have made 70,000 more low-income Montanans eligible for Medicaid.

“Why is that important?” Opper asked. “Because then those folks have the opportunity to see a primary care doctor when they get sick, instead of going to the emergency room every time. In general, access to health care lands people on the course to better health.”

John Felton, president and CEO of RiverStone Health, Yellowstone County’s public health agency, said the report is accurate in that Montana has room for improving the health and quality of care for low-income residents.

With more than 60 percent of Montana’s low-income residents uninsured or underinsured, enrollment in the Health Insurance Marketplace offers access to an ongoing affordable source of primary care, Felton said.

“Health insurance is inextricably linked to access to health care, but community health centers, such as RiverStone Health Clinic, provide high-quality primary and preventive care to everyone, regardless of their insurance status,” Felton said. “This past year, more than half of the people we served did not have health insurance. But, beginning January 2014, more people will have access to affordable health insurance because of the marketplace.”

However, having health insurance alone does not increase access to health care, Felton said.

“We must continue to invest in developing our health care workforce, expanding our clinical capacity and creating environments where the healthier choice is the easier choice,” Felton said.

The Commonwealth report also compares the health care experiences of those with low incomes to those with higher incomes — over 400 percent of poverty, or $94,000, for a family of four — and finds marked disparities by income within each state.

Yet, the geographical differences often put higher-income as well as low-income families at risk.

Higher-income people living in states that lag far behind are often worse off than low-income people in states that rank at the top of the scorecard, according to the report.

“We found repeated evidence that we are often two Americas, divided by income and geography when it comes to opportunities to lead long and healthy lives. These are more than numbers,” said Cathy Schoen, Commonwealth Fund Senior Vice President and lead author of the report. “We are talking about people’s lives, health and well-being. Our hope is that state policymakers and health care leaders use these data to target resources to improve access, care and the health of residents with below-average incomes.”

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