Helena, Montana – Montana leaders are calling for stronger state involvement in overseeing Medicare Advantage plans, arguing that local officials should have greater authority to protect seniors when problems arise with coverage, provider networks, or plan compliance.
In a joint opinion piece published in the Billings Gazette, Congressman Troy Downing and Montana State Auditor James Brown outlined their concerns about the current system and urged support for federal legislation that would give states a more active role in enforcing Medicare Advantage rules.
The two officials emphasized that Medicare Advantage is not merely a policy debate in Washington but a program that directly affects the lives of thousands of Montana seniors who depend on it for healthcare services, prescription medications, and financial security.
According to Downing and Brown, seniors deserve quick answers and meaningful protection when they encounter problems with their healthcare plans. They argue that the current structure often leaves state officials unable to intervene effectively, even when issues directly impact residents within their own states.
Concerns over limited state authority
The opinion piece focuses on what the authors see as a major weakness in the current regulatory framework.
While Medicare Advantage plans operate in Montana and serve Montana residents, state governments have limited power to independently enforce federal Medicare Advantage requirements. Downing and Brown contend that this restriction prevents state regulators from acting quickly when concerns arise.
The authors argued that state officials are often the first people consumers contact when they experience difficulties with insurance coverage or healthcare access. Yet despite being closest to the problem, state agencies frequently lack the authority needed to address those concerns directly.
They pointed to past advertising campaigns that featured well-known television and sports personalities such as Joe Namath and Jimmie Walker promoting Medicare Advantage plans through lead-generation operations.
According to the opinion piece, situations have arisen where seniors enrolled in plans that did not have adequate provider networks. In those circumstances, the authors said states often had little ability to enforce compliance or intervene against potential bad actors because enforcement responsibilities rested largely with the federal government.
They specifically criticized the responsiveness of the federal Centers for Medicare and Medicaid Services, commonly known as CMS, arguing that the agency has not adequately addressed the growing challenges associated with Medicare Advantage oversight.
New legislation seeks stronger state role
To address these concerns, Downing highlighted legislation he introduced in Congress known as the Protecting Authority and Restoring Tools Necessary for Enforcement by Regulatory States Act of 2026, or the PARTNERS Act.
The proposed legislation is designed to give states the authority to help enforce federal Medicare Advantage requirements for plans operating within their borders.
According to Downing and Brown, the bill would direct the U.S. Department of Health and Human Services to coordinate enforcement efforts with states where Medicare Advantage organizations are licensed or conduct business.
The lawmakers stressed that the proposal would not create new regulations or additional requirements for insurance providers. Instead, they said it would simply allow states to help enforce standards that are already part of federal law.
They described the measure as a practical effort to improve communication and cooperation between federal regulators and state officials while providing consumers with more accessible avenues for assistance.
Focus on Montana seniors and rural healthcare challenges
The authors also emphasized the unique challenges faced by Montana residents, particularly those living in rural communities.
Large distances between healthcare providers, limited medical resources, and transportation difficulties can already make access to care more complicated for seniors in many parts of the state.
Because of those realities, Downing and Brown argued that responsive oversight is especially important. They said local officials better understand the conditions facing Montana families and are often able to respond more quickly than federal agencies located hundreds or thousands of miles away.
The opinion piece also highlighted the role of the Montana State Auditor’s Office in educating consumers and helping residents navigate insurance-related issues. The authors maintained that state agencies are often more accessible to citizens and better positioned to provide timely assistance when healthcare concerns arise.
They argued that when healthcare is involved, delays can have serious consequences, making rapid responses essential.
Throughout the piece, the two officials repeatedly emphasized accountability, transparency, and consumer protection. They maintained that any program serving seniors should be subject to strong oversight and that states should have the authority to ensure existing rules are being followed.
The authors concluded by arguing that the PARTNERS Act represents a practical solution that would strengthen protections for Medicare Advantage beneficiaries without creating new mandates. In their view, the legislation would help ensure that seniors receive answers more quickly, improve coordination between state and federal regulators, and provide Montana consumers with oversight that is closer to home.
For Downing and Brown, the goal is straightforward: give states the tools necessary to help protect seniors, defend consumers, and ensure that Medicare Advantage plans follow the rules already in place.
