A coalition of health care advocates hung a large banner off the South Reserve Street pedestrian bridge during rush-hour traffic on Tuesday evening to encourage others to pressure members of the U.S. Senate to keep Medicaid intact as debate continues over the future of the nation's health care system.

Hours earlier, Montana's two U.S. senators split their vote on whether to debate a bill to repeal the Affordable Care Act and, along with it, make deep cuts to the Medicaid program.

Sen. Steve Daines supported Tuesday's motion to proceed with the debate on repeal while Sen. Jon Tester opposed it. The measure passed on a 51-50 vote, with Vice President Mike Pence breaking the tie.

On Twitter, Daines said he would push for repeal – a position he has held for years.

“It's time we debated Obamacare repeal and replace on the floor of the U.S. Senate,” Daines said on his Twitter account.

Daines got that opportunity later Tuesday, when the Senate voted on a measure to repeal the Affordable Care Act and replace it with a new, stripped-down GOP plan. Daines voted "yes." while Tester voted "no."

The repeal/replace vote failed on a 57-43 vote, a significant defeat for Senate Republicans and Obamacare opponents.

Daines' position on the issue concerns those who showed up Tuesday evening to protest the push by Republican lawmakers to undo the nation's 7-year-old health care law.

While other rallies have targeted Daines specifically, Tuesday's event took a broader stance, saying cuts to Medicaid would hurt Montana's most vulnerable citizens.

“There are tens of thousands of people in Montana who rely on Medicaid for basic health care and basic aid,” said Denver Henderson, a member of SEIU 775, a home health care union. “If they succeed in repeal, those are people out of work, people who can't provide care for themselves or can't live on their own. They'll basically be left out in the cold.”

More than 120 organizations across Montana launched an ad campaign last month urging Daines to reject any health care bill that would cut the state’s Medicaid program, or result in the loss of coverage for an estimated 22 million Americans.

The coalition of Montana health care providers, including those present Tuesday evening, fear that current deliberations within the Senate will eliminate the state’s own efforts to expand Medicaid, resulting in the loss of coverage for 75,000 people.

Health care workers and other Medicaid supporters rally passing motorists on Tuesday evening, several hours after the U.S. Senate voted 51-50 to move forward with a debate on repealing the Affordable Care Act. (Martin Kidston/Missoula Current)
Health care workers and other Medicaid supporters rally passing motorists on Tuesday evening, several hours after the U.S. Senate voted 51-50 to move forward with a debate on repealing the Affordable Care Act. (Martin Kidston/Missoula Current)
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“This is a critical vote and it's critically important, and we're incredibly disappointed by Sen. Daines' vote today,” said Henderson. “But this by no means is the end. What's critical is that normal, working people speak up and speak out, because it's our seniors, people with disabilities and low-wage workers and their kids that are getting ready to lose health care if this goes through.”

Those low-wage workers, including members of the home health care industry and direct-care workers, are of special concern to state Rep. Marilyn Ryan, D-Missoula.

In the last Legislature, she worked to obtain pay increases for direct-care workers, saying they have some of society's most difficult and under-appreciated jobs.

“They take care of our most vulnerable citizens and they're paid horribly” Ryan said. “Many have to rely on services from Medicare and (Temporary Assistance for Needy Children), and it doesn't seen right in society that people who do the work that's so necessary get paid nothing. What happened in the Senate today, I'm very disturbed about.”

Ryan accused Senate Republicans pushing for a repeal without a firm bipartisan replacement of ignoring the cost of prescription drugs (something Tester is working to fix), profits to insurance companies and the impacts cuts to Medicaid would have across society.

A recent study by the Montana Budget and Policy Center said health care reforms proposed by the GOP would cost Montana $5.3 billion in federal Medicaid funds, jeopardizing the state’s Healthy Montana Kids program.

It also found that half of all births in the state are covered by Medicaid, and 51 percent of all Medicaid enrollees in the state are children.

“There have been multiple rallies and numerous attempts to get Daines' attention, and he hasn't been listening, but we're not giving up,” said Henderson. “These rallies are a critical opportunity to remind our friends and neighbors what's at stake if they don't speak up.”

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