Many in the health care world are worried about more shifts in an industry that has seen a lot of top-down change from Washington D.C. over the past eight years.  Bob Olsen from the Montana Hospital Association says the recently proposed American Healthcare act still has lots of unknown factors that worry health providers.

"What we don't know is what will the insurance products look like given the changes in the requirements for insurance plans," said Olsen. "I think we do have that concern that as people lose their coverage, or that their coverage is not as good, that they are going to over utilize emergency services."

Many Montanans still oppose the last major health care overhaul, called the Affordable Care Act, or Obamacare. Olsen acknowledges that it hasn’t proven to show the savings it promised, but says it needs more time.

"We really haven't shown yet the cost reductions that people hoped with the initiatives that the American Healthcare act allowed things like accountable care organizations, different payment models for bundled payments, primary care medical homes, things like that are going to take some time to show results," Olsen said. "We think that that takes a little more time and it could use some more support from the federal government."

One of Olsen’s biggest concerns is that the amount of health insurance coverage in Montana will decline under the proposed changes in the American Health Care Act, leading to lower levels of care.