Readers learn that Rep. Cary Smith, a Republican who has sponsored several health care bills in the state legislature, believes that a high deductible plan “puts people in charge of their own health care. They have to go out and shop for their health care, so that drives down costs.” Cary apparently believes that if people choose not to have insurance and incurs a huge medical bill, they should suffer the consequences. “I’d have them paying it off for the rest of their life. Why should somebody get a benefit for being irresponsible?” Health insurance should be more like auto insurance, Smith argued. It should cover big accidents, rather than routine maintenance. It seems to me, and probably most folks in Montana, that their auto policy covers fender-benders, too.

Rep. Gary MacLaren, also a Republican, gave his take: “The idea is to get people at least partially responsible for health care. When people can save money if they don’t go to the doctor…they tend to take better care of themselves.” The RAND study points to a different conclusion.

All in all, Dennison delivered a good statehouse story, the kind that is much too rare. With the release of the RAND results, Dennison now has follow-up questions for Smith, MacLaren, and other legislators eager to get more Montanans into high-deductible plans. Dennison and other journos who want to write this story now have numbers that show the dark side of high-deductible health insurance.

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.