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As Democrats took the stage this week for the first presidential primary debate, the question of how best to continue improving health care for Americans was appropriately at the forefront of the discussion.

Having worked on health care reform in Montana for the past nine years, I am a firm believer that our best option is to continue improving on the hard-fought progress we’ve made with the Affordable Care Act. I believe what we need are improvements to the ACA, particularly when it comes to managing costs and streamlining access.

But the current administration has gone so far as to cut funding intended to help make it easier for people to find and sign up for health coverage. President Trump and Republicans in Congress — to this day — continue to try to chip away at key provisions of the ACA, including rules prohibiting insurance companies from denying coverage and hiking premiums for those with pre-existing conditions.

While some in my party, including a number of presidential candidates, have suggested a government-run health plan is the fix, I don’t believe that is the best approach. In an ideal world, yes, I would love to see a simpler, single payer health care system. But we have to be pragmatic.

I agree with Sen. Jon Tester, who recently said that complicated issues like health care cannot be fixed overnight and require “realistic” approaches. What is realistic is for us to continue to work to protect the ACA and improve it, and to fight any efforts to weaken or damage it. The Affordable Care Act is the best vehicle we have to improve access to quality, affordable health care.

This past legislative session I was proud to work on the reauthorization of Montana’s Medicaid expansion program. Nearly 100,000 Montanans are now covered and for most, health coverage of any type was unattainable before the ACA and before expansion. To abandon this game-changing program for alternatives that are not yet fully thought out would be unfair to hardworking Montanans who rely on this coverage to keep their families healthy.

Prior to the ACA,more than 90 percent of Montanans with a drug or alcohol problem were not receiving treatment. But now, we are providing these services on the front end. In Yellowstone County alone, nearly 10,000 individuals have accessed treatment for mental health or addiction in the past four years. This has eased pressure on law enforcement and emergency responders. It has lessened the burden on our overcrowded jails, helped to unclog the courts and we are avoiding expensive hospitalizations.

The ACA may not be all that some of us wanted when this process started, but it has proven to be an incredible start. Rather than abandoning our past accomplishments in favor of a “one-size-fits-all” approach, we need to work together to strengthen and enhance the ACA.

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Jen Gross, a Democrat, is a state senator from Billings. She represents Senate District 25.

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