In the six years since former Gov. Matt Mead began championing expanding Medicaid in the state, much has changed – including the state’s financial house and the hearts and minds of some state senators and representatives. 

In opposing previous attempts to expand Medicaid coverage in the state expansion, many state lawmakers were fearful that the federal government would pull out of its 90% federal match for newly covered individuals, leaving Wyoming with the bill. The latest attempt at expansion ensures the state would withdraw from the federal program if the ratio were to decrease.

Will expanding Medicaid cost the state more money? Yes. But that cost is offset by a six-fold increase in additional funding provided to the state.

The latest federal stimulus bill sweetens the deal for Wyoming. Under the stimulus bill that was signed into law earlier this month, the 12 states that have not expanded Medicaid, including Wyoming, would gain a 5% boost to their traditional Medicaid matching program. Traditionally, states and the federal government split Medicaid expenses 50-50 for a far wider population than the expansion-eligible one. Boosting the fed’s share by 5% would bring an estimated $120 million per biennium to Wyoming — much more than the estimated $20 million per biennium that expansion would cost the state.

In a February report, the Wyoming Department of Health found that expansion would likely result in better health outcomes for newly insured residents. Citing a Kaiser Family Foundation report, the health department noted more people on Medicaid are likely to report themselves in “good or excellent health” than those uninsured, and rates of depression tend to decrease. The report also noted expansion could prevent early deaths, notably in aging residents who are not yet eligible for Medicare.

Expansion could also be a boon to Wyoming hospitals and every privately insured person in the state. When a patient shows up in the emergency room sick or injured, the hospital is obligated to provide care, irrespective of the patient’s ability to pay. Statewide, hospitals have taken on more than $100 million in uncompensated care annually, to the Wyoming Hospital Association. Some of those costs are then passed along in the form of higher medical bills to those with insurance or who can pay out-of-pocket. The insurance companies respond to the higher costs by jacking up their insurance premiums. 

On Monday, a House bill to expand Medicaid in Wyoming and give an estimated 25,000 additional residents health insurance passed an initial vote. 

Those voting for the bill included a number of representatives who had repeatedly opposed expanding Medicaid in the state. 

“I voted no multiple times on this issue,” House Speaker Eric Barlow, R-Gillette, said. “I’m going to vote yes this time, because I haven’t seen any other solution. No one has brought anything forward, and I’ve looked myself.”

“I’ve had kind of a change of heart, frankly,” Rep. Steve Harshman, R-Casper, said. 

The bottom line is expanding Medicare just makes sense. It helps ease Wyoming’s budget woes, it helps local hospitals like Johnson County Healthcare Center by paying for more services and it creates better outcomes for the working poor in our county and statewide.

This should be a no brainer. Let’s not let politics get in the way of good fiscal and health policy.

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