During a pandemic, it seems like the understatement of the century to say that health care is the most important issue for families in Montana.

But it’s true. With the Supreme Court set to hear oral arguments on the Affordable Care Act on November 10, a week after the election, Montanans’ access to quality, affordable health care is under threat like never before.

And with a newly-seated justice on the court, the Affordable Care Act will likely be eliminated entirely - a result that would prove catastrophic for Montana.

Overturning the ACA would scrap Montana’s Medicaid expansion program, and strip health care coverage away from 1-in-10 Montanans and remove protections for folks with pre-existing conditions in the middle of a pandemic that has killed more than 200,000 Americans and more than 160 Montanans.

It is unconscionable.

We know that Medicaid works for Montana. It keeps families and communities healthy. It’s been a lifeline for our rural health system. It’s created thousands of good-paying jobs.

Folks from Miles City to Missoula depend on Medicaid expansion for access to quality, affordable health care that they deserve. And so do the rural communities where they live.

Our rural clinics and critical access hospitals depend on the ACA to keep their doors open and continue serving the rural parts of our state. Repealing the ACA would sever a critical lifeline for those critical access hospitals and care facilities.

And I don’t need to tell you what happens to a rural community when folks can no longer get the health care they need.

So, what can we do? At this point, little can be done to stop Rep. Gianforte and his buddies in Congress from scrapping the ACA and Medicaid expansion and throwing massive uncertainty into the health care system.

But as your next governor, if the ACA is overturned and Medicaid expansion eliminated, I will bring Republicans and Democrats together to codify, in state law, the critical and popular protections offered by the Affordable Care Act.

We will keep protections for folks with pre-existing conditions, so they cannot be denied coverage or forced to pay a drastically higher rate.

We will prohibit annual or lifetime caps on coverage, and we will ensure the ten essential health benefits that plans must cover under the ACA like ambulatory care, mental health and substance use disorder services, and maternity and newborn care are covered.

These measures will limit the fallout, and protect some of the Montanans who would be left out to dry should the ACA be scrapped. But we must be honest - getting rid of the ACA will be terribly destructive for our state.

I am disgusted that we are in this position. My opponent says he supports Montanans having access to health care: but his actions speak louder than his words.

Greg Gianforte and his DC allies have put us in this position. He has consistently opposed the ACA, and voted to fund the lawsuit that threatens to overturn it, causing 90,000 Montanans - and millions of Americans - to lose the health care they need to stay alive and to thrive.

It is a tragedy. But we will keep fighting, and we will persevere. As governor, I will fight tooth and nail to keep Montanans healthy and make sure each and every Montanan has access to the quality health care they deserve.

Mike Cooney is Montana's Lt. Governor and is the Democratic nominee for Governor.