Earlier this month the state legislature ended funding for an experimental program called Healthy Frontiers, it was Wyoming’s latest effort to save the state health care money. The idea was also supposed to reduce costs to Wyoming’s Medicaid program and reduce the numbers of those who drive up costs by depending on the more expensive emergency room to cover their health care needs. Some say Wyoming’s problems will be solved by the federal health reform plan known as the Affordable Care Act, but the future of that plan is unknown. Wyoming Public Radio’s Bob Beck reports.
BOB BECK: When people complain to Governor Matt Mead it’s usually about health care. Mead says it didn’t get any easier when the Healthy Frontiers pilot program, that was designed to help those who couldn’t afford insurance and who also don’t get Medicaid lost its funding. Mead says the state has to keep working.
MATT MEAD: Listen the state’s spending a whole bunch of money on health care and if we don’t figure out a way to get better quality and lower costs, it’s going to continue to eat away at our budget. We have people who use and misuse our emergency rooms, we have people with pre-existing conditions that are having trouble. We have working families that despite their work are not getting the insurance they need.
BECK: Mead says he is firmly against the federal Affordable Care Act and Wyoming has joined other states in challenging the law. But he says if there isn’t a federal plan, the state needs a plan of its own.
MEAD: We have to be able to take chances and some of the things we are gonna try, undoubtedly will fail but Wyoming more than any other state because of our small population and can do attitude has an opportunity to address health care in new ways.
BECK: Mead has a list of ideas ranging from some public-private partnerships to expanding the ability for the state to be involved in electronically exchanging health information between medical providers. But these ideas are works in progress.
This is the downtown clinic in Laramie. It is where low income people who do not qualify for other benefits can get health care. Health care providers volunteer their time one night a week to see patients and it’s packed as usual. Sarah Gorin is the Director.
SARAH GORIN: We see low income uninsured and so if they are eligible for Medicaid, Medicare, VA benefits, we do not see them at the Downtown Clinic. We try to conserve our resources for those who have no other options.
BECK: Gorin is one who believes the affordable care act will solve a lot of problems. She smiles when she remembers a report lawmakers received concerning the impacts of the A-C-A.
GORIN: The first number was that the Medicaid budget will get bigger and everyone went…”gasp”…but the thing they didn’t then see is that all these other budgets get smaller. Almost all your other safety spending disappears because people will now get covered.
BECK: Gorin says the bottom line is that people in the state need access to health care.
Gorin : We had a relatively new client who came in last fall, was hospitalized here at Ivinson (Memorial Hospital) with a stroke, she’s in her early 50’s. When she was discharged they said you need to get your diabetes and high blood pressure under control or you are gonna die. Well, where does she do that? I mean diabetic supplies and medications cost hundreds of dollars a year.
BECK: The Downtown clinic helped her, but Gorin says there are not many clinics of this nature throughout the state.
Gorin did not like Healthy Frontiers for a variety of reasons, but she says what was positive was that doctors were paid to help patients.
She contends that if Wyoming is going to make any headway in health reform, the state will have to pay up front for care both doctors and hospitals will provide, because uncompensated care is a serious problem in Wyoming.
GORIN: Who is going to see all the people that need to be seen and how are we more effectively going to recruit and retain providers? And certainly uncompensated care is a big part of that…people don’t want to go and practice in a place where they aren’t gonna get paid.
BECK: While the governor is looking at meshing solutions together a number of solutions, some lawmakers say they will take a wait and see attitude. Elaine Harvey chairs the committee that oversees health in the Wyoming House of Representatives.
ELAINE HARVEY: I still think there are good things that can happen but I think right now we are still in a wait and see, study everything, commit to nothing type of pattern.
BECK: Harvey says that one big roadblock is that the majority of legislators oppose a government health care approach. For Wyoming Public Radio, I’m Bob Beck.