According to a new study, Montana ranks in the middle of the states for health care for low-income residents.

The Commonwealth Fund, a private U.S. foundation that seeks to promote a high-performing health care system, ranked Montana 27th in terms of what health care is available for the state’s low-income residents. 

To put that in perspective, 19 percent of Montanans have incomes under the federal poverty level and 41 percent have incomes below twice the poverty level. 

Poor marks on the state’s record include a high out-of-pocket medical spending rate, with 40 percent of the low-income population forking over large sums to stay healthy. Montana ranks 48th in this category.

Another black eye for the Treasure State is the 54 percent of low-income folk who have not visited a dentist, dental hygienist or dental clinic in the past year. Montana ranks 44th in this category. A full 44 percent of poor adults are uninsured — 40th in the nation.

But the state does have a few feathers in its cap. 

Big Sky Country is the best state in the union for surgical patients getting proper care to prevent complications. It is also second in two categories. Poor Montanans are second only to Nebraskans in getting proper treatment for heart failure of pneumonia, and are behind only Idahoans for readmission rates that are part of Medicaid.  

Each state is ranked in a quartile measurement, with the best states in the top quarter and worst in the bottom quarter. States also are graded through four categories: Access and affordability, prevention and treatment, potentially avoidable hospital use and healthy lives.

Montana has six rankings in the top quarter, five in the second, 12 in the third and four that land in the very bottom of the country. Due in part of remoteness and the independent nature of Montana, the state ranks very low in access and affordability.

The potentially avoidable hospital use is in the top quarter of states.

The worst state in dealing with low-income residents is also the state worst at dealing with the health of its population at large: Mississippi. Hawaii, along with the upper Midwest and New England, rank at the top. The deep South and Nevada are the worst states in regards to health care for the poor.

Montana is sandwiched between New Jersey at 26th and Michigan at 27th. Idaho and the Dakotas rank well above Montana (South Dakota is eighth overall) and Wyoming falls below.

A disturbing trend nationally is that even in the best state, more than half of lower-income Americans over the age of 50 are not receiving vital preventive care such as cancer screenings and vaccinations.

The Commonwealth Fund doesn’t tend to align itself politically, but it is pushing for health-care reform in the most recent report. 

Full results of the survey can be found at www.commonwealthfund.org.