Montana Free Press is taking an out-of-office holiday break Dec. 26-30. Instead of new stories, we’ll be publishing MTFP editors’ and reporters’ looks back at their most impactful, interesting, challenging, and just plain favorite stories of the past year. Today is Mara Silvers’ turn.
I spent much of 2022 pulling on similar threads as last year — abortion politics, mental health care, addiction treatment, public health in general, LGBTQ+ social issues, foster care reforms — but under the new title of health and human services reporter. If you’ll permit me, now feels like the time to publicly crow about how much I love this beat. I’m learning about the health care systems and social issues that impact countless Montanans, and I couldn’t be more grateful for the sources who give me their time, share their experiences and lend me their insight.

On the abortion and reproductive health care front, some things certainly happened. The U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health overturned the landmark Roe v. Wade decision, ending 50 years of federal protections for pre-viability abortions in America. The map of states where abortion remained a legal medical procedure began to flicker, but Montana remained lit up. We covered the protests, the planning of abortion providers, the strategies of the state’s anti-abortion movement, and delivered an in-depth profile of how one independent clinic was faring months later.
We also continued tracking the ongoing lawsuit between Planned Parenthood of Montana and the state, which originated in 2021 with a challenge to the constitutionality of three abortion restrictions signed into law during the last Legislature. And we tried our darndest to explain the origin, architecture and ramifications of another bill that put Legislative Referendum 131 on voters’ ballot this November. Montana voters ended up rejecting the ‘Born-Alive’ Infant Protection Act, which had bupkis to do with abortion policy but carried serious consequences for parents who delivered newborns with fatal medical conditions, by a 5% margin.

In other parts of my beat, the spotlight continued to shine brightly on the Montana State Hospital in Warm Springs, which lost federal accreditation in April because of failing safety and health standards. That crisis presented a tremendous challenge for the Gianforte administration in a year marked by leadership changes in the state health department and a growing reliance on a now nearly $7 million contract with private consultants to right the state’s behavioral health ship. We’ll look forward to keeping tabs on these issues throughout the next year.

This year, Montana continued to see the domino effect of pandemic-era debates about public safety and private medical choice. Multiple lawsuits were filed over House Bill 702, the Republican-sponsored measure that made it illegal for Montana employers and almost everyone else to discriminate on the basis of vaccination status in the workplace and in public accommodations. The legal challenge that made the biggest splash was filed by an assortment of health care providers and immunocompromised patients — they argued in federal district court that vaccine requirements are essential in health care settings to prevent the spread of infectious disease and protect the rights of disabled patients who want to be treated by vaccinated staff. Federal Judge Donald W. Molloy decided this month that their arguments held up under the Constitution and federal law, and struck down HB 702 in health care settings.
Somehow, there’s still so much else. Debates over religious exemptions to vaccines in childcare settings, a genuine legal and bureaucratic dumpster fire over whether transgender Montanans can update their birth certificates to accurately reflect their gender identity, an endlessly surprising fight over the rainbow color scheme in the new Montana State Library logo, and much, much more.

I’d be remiss to not mention two stories I found particularly impactful this year: a profile of Helena’s LGBTQ-owned Montana Book Company that MTFP co-published with The Guardian, and a deep-dive into how the state wants to change Medicaid rules for inpatient mental health and substance use disorder treatment. Maybe those pieces best explain the breadth and depth of this beat — I’ve loved digging into all its potential this year.