This May, Big Sky voters in both Madison and Gallatin Counties will decide whether to establish new local hospital districts and create a structure that allows existing tax dollars to remain in Big Sky rather than leave our community.

Two hospital districts in Big Sky would be created: one in Madison County and one in Gallatin County. Each district would have a locally elected board. The two boards would coordinate through an inter-local agreement to implement one shared vision for health and wellness in Big Sky.

This is the final step in a multi-year effort to keep Big Sky dollars in Big Sky. Madison County Big Sky residents already contribute significant funding toward a hospital district, but today those dollars are exclusively allocated for Madison Valley Medical Center in Ennis. The Montana Legislature passed Senate Bill 260 in 2025, creating a path for Big Sky’s Madison County taxpayers to withdraw from the Madison Valley Hospital District and instead redirect those dollars back to Big Sky through a local hospital district over an 8-year step down period.

Big Sky voters in Gallatin and Madison counties must approve the formation of the new districts or the Big Sky community will not have full access to funding collected through existing taxes.

If voters approve formation of the Hospital/Wellness District in both counties, this will:

• Unlock and redirect existing tax dollars to support the healthcare services for the residents of the Big Sky community.
• Ensure funding decisions are made by locally elected leaders who live here and understand the community’s needs.
• Provide sustainable local funding for health and wellness providers to help close healthcare gaps and expand services more quickly.

If the measure fails:

• Big Sky misses its best opportunity to align existing funding with local healthcare needs.

The ballot measures in May do not increase existing or create any new taxes. This year, voters are simply deciding whether or not to create a structure that allows existing tax dollars to remain in Big Sky rather than leave our community. Any proposed new or expanded levies would require voter approval in the future.

If approved, the two boards would establish criteria and priorities for allocating available funding. Under Montana law, hospital and health care facilities and services are broadly eligible and could include hospital services (including inpatient and 24/7 emergency care), ambulance, primary and specialty care, mental health, substance abuse care, counseling, and other social wellness services. Funding decisions would be made in accordance with statute and alignment with community priorities.

Hospital districts are a common tool used to provide locally governed support for essential health services, particularly in rural and geographically isolated communities. Under Montana law, these districts are created by a vote of residents, cover specific areas of a county, and are funded through local property taxes. They are managed by an elected board of 3 to 5 trustees.

We use the term “Hospital/Wellness District” to reflect the community’s broader goal of supporting physical, mental, and social health at every stage of life.

Transparency and public engagement are core to the proposed District. If formed, the trustees would be elected public officials subject to Montana’s open meeting laws and public records acts. This ensures that all deliberations, budgets, and decisions are conducted in the public eye, providing a framework for meaningful community engagement in district operations.

No. In some communities a hospital district does directly operate and govern the community’s hospital and health system, but that would not be the case in Big Sky. Big Sky Medical Center will continue to be independently operated and governed by Bozeman Health.

Registered voters who are considered ‘active’ will receive a ballot in the mail after April 15. Ballots must be returned on or before election day on May 5 (postmarks are not accepted). You are strongly encouraged to mail your completed ballot by April 27 to ensure it arrives before the deadline.

Alternately, you may drop off your ballot on or before May 5 at:

GALLATIN COUNTY VOTERS
BASE Community Center, 285 Simkins Drive, Big Sky
Gallatin County Election Office: 311 West Main St, Room 210, Bozeman

MADISON COUNTY VOTERS
Madison County Election Office, 103 W. Wallace St, 1st Floor, Virginia City

For more information, contact your county election office

Visit VoteMT.gov to check your voter registration, make sure you are ‘active’, and see that your address is correct.