Medicaid Expansion Faces Challenges In Wyoming

Feb 14, 2014

Chris Rothfuss in the Wyoming Senate.
Chris Rothfuss in the Wyoming Senate.
Credit Bob Beck

For over a decade the state has struggled with making sure all citizens had access to health care.  Much of this had to do with the fact that many Wyoming citizens can’t afford health insurance.  The federal affordable care act was supposed to help.

A key part of the act would provide states several million dollars to provide Medicaid to the working poor, in Wyoming that could help between 17 thousand and 18 thousand people.  States have to opt into the program, Wyoming legislature will consider one bill , but it may have a long road ahead.   Wyoming Public Radio’s Bob Beck has more.

BOB BECK:  In his annual state of the state message Governor Matt Mead made it clear that due to problems with the affordable care act he does not support expanding Medicaid.

MATT MEAD:  Now I recognize this is a position, but it is far from an answer in addressing the needs of over 17,000 of our citizens that do not have access to health care. 

BECK:  The governor is the first to admit that he doesn’t have any ideas to address this population and apparently nobody else does either.  The legislature considered and voted against introduction of two Medicaid funded bills that were supported by the legislative committee that works on health care issues.  One compromise bill did get approved for debate by the Senate, but it remains to be seen if it can get enough support to get to the governor.  Chairman of the Senate health and labor committee Charles Scott voted against it.

CHARLES SCOTT: You gotta recognize that there is a set of people who simply can’t afford health insurance now and we gotta be kind of sympathetic to that. 

BECK:  But just not this way?

SCOTT:  Yeah, I’m not satisfied with the options we got at the current moment.

BECK:  Scott was the main architect of a health care program called Healthy Frontiers which gave poor people access to doctors.  It started under governor Freudenthal but ran out of money and was dropped. Scott says health care reforms always have a tough time in Wyoming.

SCOTT:   Health care is very complicated, people know it can be very expensive and care wreck your budget if you are not careful.  And we’ve got a block of very conservative legislators who are opposed to government health care programs.

BECK:  Scott did try a bill this year that would help both the uninsured and those who have seen their insurance rise thanks to the Affordable Care Act.  Senate President Tony Ross announced the outcome.

TONY ROSS:  Senate file 108 is…is…screwed. (laughter) Has failed introduction…(laughter)….sorry.

BECK:  But for those who want Medicaid expansion this is no laughing matter.  Last month a number of people who can’t afford health insurance told legislators heart breaking stories of health care issues and what the bill would mean to them.  One of those committee members was Representative Mary Throne of Cheyenne.  The opposition to taking federal money to expand Medicaid mainly centers around the fear that the federal government will not have enough money to sustain the program which would force the state to either drop it….or spend millions of dollars to sustain it.  Throne says if the state has to drop it…so be it. 

MARY THRONE:  Getting three years of health care, good health care to people who haven’t had it, it could change their lives.  We could get a whole population healthy. 

BECK: Elaine Harvey who chairs the House Health and Labor Committee sits quietly in a capitol hallway and says kicking people off Medicaid would be too difficult.

ELAINE HARVEY:  One of the hardest things I ever done is to take healthy frontiers away from people.   Because we gave them hope and then we took it away from them.  So to start something that we can’t finish…hmmm…I really hesitate to go there.

BECK:  But Harvey does think something needs to be done for the uninsured.  She favors an approach that would use the federal Medicaid money to help people purchase private insurance.  Some doctors don’t like Medicaid and Harvey says if people have private insurance it would mean that medical providers would be more likely to see people. 

HARVEY:  But if we pass nothing I think we are going to have a year of extreme struggles for our small rural providers, both hospitals and doctors, and I think they are going to have a terrible time trying to make up the difference, because all of the programs that help supplement that uncompensated care are gone.

BECK:  Dan Perdue is worried about that too.  He is the President of the Wyoming Hospital Association. 

DAN PERDUE:  It’s very frustrating, I’ve been doing this for 22 years, and this is the most frustrating issue that I’ve dealt with.  On paper it looks like a no brainer that the lawmakers should step up and take the expansion.  But I think their reluctance is based on philosophy and not really wanting to have anything to do with Obamacare.  

BECK:  Friday morning the Senate agreed to support a compromise Medicaid expansion pilot program that would run for three years.  Sponsored by Laramie Democrat Chris Rothfuss it brings in some of Harvey’s ideas and tries to address concerns people have had with the federal government’s plan.  Rothfuss is among those who have strongly advocated for Medicaid expansion and has shared Perdue’s frustration.

CHRIS ROTHFUSS:   You have to lead or get out of the way.  We’ve got a lot of people who have just spent a lot of time in the way as I see it.  They’re not providing solutions but they are certainly standing against the suggestions that other legislators are making and I’m hopeful that something will come out of this session, but there is a good chance that nothing will be done for these 17,600 people and that’s disappointing.

BECK:  The Rothfuss bill now heads to a Senate Committee for consideration.   For Wyoming Public Radio, I’m Bob Beck.