Several Insurance, Medical Bills Vetoed by Governor
Cancer, PTSD, Medicaid reimbursements and behavioral health bills saw vetoes
By Jordan Hansen, Daily Montanan

Montana Governor Greg Gianforte vetoed several medical insurance and healthcare bills last week, including one that would have allowed first responders to get workers’ compensation for post-traumatic stress disorder.
Senate Bill 394, Senate Bill 422, House Bill 585 and House Bill 643 were all among a slate of vetoes last week.
SB 394, the post-traumatic stress disorder bill, essentially would have added the condition as eligible for workers’ compensation for firefighters, law enforcement and emergency medical technicians.
The bill drew significant debate in the Legislature.
In his veto letter, Gianforte said it would have added $100,000 annually to state insurance premiums, which was also reflected in the bill’s fiscal note. He also wrote it was a “fundamental issue of fairness” as work-related PTSD claims would not be eligible for other state employees.
“Senate Bill 394 threatens the progress we’ve made over the past four years to protect hardworking Montanans’ tax dollars and decrease worker compensation coverage by reducing the number of wage-loss and medical-only claims filed,” the veto letter reads.
An attached letter from Department of Administration (DOA) head Misty Ann Giles said the state could be subjecting the “state and employers to inequitable treatment,” though added that the DOA was “committed to supporting all first responders.”
Gianforte, a Republican, also vetoed two bills dealing specifically with medical insurance.
Senate Bill 422 would have required insurance providers in the individual or group market in the state to cover the cost of any Food and Drug Administration approved medication for terminal cancer.
A letter attached from Giles said the legislation would increase costs to the state insurance plan by $500,000 annually. The impact on the Montana University System (MUS) would have been high too, and the bill was an unfunded mandate, Giles said.
Ali Bovingdon, chief legal counsel for the MUS, wrote in a letter attached to the veto the impact for fiscal year 2026 would be nearly a million dollars.
The bill could put “the financial stability of the entire MUS plan at risk,” Bovingdon wrote.
House Bill 585, meanwhile, dealt with reimbursement rates for physical, speech and occupational therapists at 122% of the Medicare reimbursement rates.
Gianforte wrote in the veto letter that while the bill was “well intentioned” it does not cover other providers like optometrists, psychologists and licensed professional counselors. There was also a price tag with the bill, coming in at about $13 million during the next four years.
Some clinics and organizations have already begun an effort to override the veto. The governor also noted budget challenges in his letter.
“The budget and other bills with hefty price tags that the Legislature passed, however, are not fiscally responsible,” Gianforte wrote. “Therefore, I will keenly review the budget and spending bills the Legislature passed, making some difficult decisions to protect taxpayers and their hard-earned resources. Hardworking Montanans expect us to be fiscally responsible.”
Gianforte also vetoed House Bill 643, which sought to change the payment structure for costs associated with the use of detention centers.
The bill would have increased reimbursement for local governments holding prisoners for the State of Montana or the federal government. Gianforte wrote in his veto letter it would have cost Montana $24 million during the next four years and the $6 million appropriation the Legislature approved would not be enough to cover the bill’s cost.
The bill sought to address some behavioral health challenges, and the governor noted in his veto letter that the state is addressing waitlists at the Forensic Mental Health Facility in Galen. One issue for counties is that they’ve been forced to hold prisoners who are waiting for a bed at the Galen facility.
“This issue requires a permanent, comprehensive solution,” Gianforte wrote. “ But House Bill 643 only applies an expensive Band-Aid.”