Medicaid expansion

Bob Beck

Wyoming Governor Matt Mead says it’s time for the state to dip into its rainy day funds to get through some lean economic times. 

Falling oil and gas prices and declining coal revenues are reducing state revenues. He says the state will need to use some of the nearly two billion dollars in savings to get through the next two year budget cycle. While the state can reduce spending, Mead says there are still a lot of needs such as funding for local governments.

Bob Beck

Earlier this year when the legislature voted down Medicaid expansion, lawmakers realized that some hospitals were struggling to make up for the fact that some people cannot afford to pay their medical bills.  So after a lot of discussion, they provided roughly three million dollars to be spread among the smaller rural hospitals. But some thought that was not enough, so two legislative committees are looking into what else can be done to help. 

Wyoming’s decision to not set up a set health care marketplace could haunt it if the United States Supreme Court rules that federal marketplaces or exchanges cannot receive federal subsidies. The King vs. Burwell case could impact close to 20 thousand Wyoming residents, especially the 17 thousand who would lose subsidies to purchase insurance. 

Wyoming lawmakers are considering working with communities to allow them to determine their own health care needs.

The Joint Labor and Health committee is trying to find ways to improve health care in the state and reduce costs to hospitals. Hospitals say the care they are required to provide to poor and uninsured patients is costing them millions.

Melodie Edwards

This year, while Wyoming lawmakers were voting down Medicaid Expansion in the state, they also approved a Medicaid Waiver for the state’s two tribes, potentially pumping some $16 million of aid into the reservation’s health system. The health crisis on the Wind River Reservation is now at critical levels, but tripling the amount that the tribe’s receive for health care could help.

In March, Northern Arapaho member Cherokee Brown’s daughter brought her a tooth. She didn’t think much about it. Kids lose teeth.

Melodie Edwards

In the recent legislative session, lawmakers approved a Medicaid Waiver for tribes on the Wind River Indian Reservation that could give the tribes federal money to expand healthcare.  But there’s still one more hurdle: approval by the Center for Medicaid Services, a federal agency.

Representative Lloyd Larsen of Lander says he expects the process to go smoothly. “We don’t expect the application process to take too long because they’re working closely with CMS.”

Bob Beck

A few weeks ago the Wyoming legislative session came to a close and Governor Matt Mead admitted that he had a number of concerns. The biggest was the failure of the legislature to pass Medicaid Expansion. The governor tells us that he knew it would be a tough sell, but it was tougher than he thought.

The Wyoming Legislative session ended today and in his closing remarks Governor Matt Mead urged lawmakers to find a solution to a number of health care problems in the state.   The legislature voted against taking more than 100 million dollars in federal money to expand Medicaid and provide health care services to 17,600  people. Mead said legislators need to find solutions.

Medicaid expansion has been defeated again. 

The Wyoming House of Representatives soundly voted down an amendment to the state supplemental budget that would have provided federally funded Medicaid services to nearly 18-thousand low income Wyomingites. 

Cheyenne Republican Sue Wilson said the people who would qualify are working, but cannot afford insurance.

Even though Medicaid Expansion was killed in the State Senate last week, Wyoming’s free clinics will continue providing primary care to the so-called “working poor.”

Sarah Gorin is the Executive Director of the Downtown Clinic in Laramie, which supported the bill.

"It’s pretty disappointing because it would have benefitted our clients," she said.

Bob Beck / Wyoming Public Media

The Wyoming Senate has killed a bill that would have provided Medicaid Services to nearly 18 thousand people.  Only 11 of the 30 Senators voted for the bill.   Riverton Republican Eli Bebout said the time was not right, but Laramie Democrat Chris Rothfuss disagreed.  He said the need for expansion is great.

“For the last three years we’ve have the lives of 17,600 folks here in Wyoming in our hands to some degree with their access to affordable health care.  And we’ve worked hard over those years to come up with the best approach for Wyoming that we could put together. “

While a Medicaid Expansion bill has its skeptics in the State Senate this week, a waiver to expand it for Native Americans is getting warmer reception.

The Joint Appropriations Committee has included a waiver in the state supplemental budget that would provide health care to some 3,500 low-income Northern Arapaho and Eastern Shoshone on the Wind River Indian Reservation. Representative Lloyd Larsen from Lander says just last year about 40,000 health care visits went uncompensated. Larsen says Wyoming has a legal obligation to pay up.

The State Senate gave initial approval to a bill that would remove binding arbitration in collective bargaining cases between cities and firefighters. That is when an arbitrator rules on a dispute and both sides must accept the decision. 

Republican Dave Kinskey, the former Mayor of Sheridan, says his community has too often been forced to live with the ruling of an arbitrator who lives out of state. 

He says non-binding arbitration would lead to quicker negotiations and return accountability to local government.

Bob Beck / Wyoming Public Radio

The Wyoming Senate gave initial approval to a Medicaid Expansion bill, but added an amendment that could keep the state plan from being adopted by the federal government. 

Riverton Republican Eli Bebout added a requirement that participants work up to 32 hours a week unless they’re disabled. The government has previously refused to consider such requirements, and Gillette Republican Michael Von Flatern called it a poison pill that hurts the bill. 

Bob Beck / Wyoming Public Media

The State Senate has started debate on legislation that expands Medicaid to more people in the state. The bill is based on the SHARE plan that was developed by the State Department of Health. It provides health care services to participants who pay into the program like typical health insurance. 

The Senate rejected a plan by Casper Republican Charles Scott to require Health Savings Accounts. Bill Sponsor Michael Von Flatern of Gillette says he supports an amendment that requires the expansion be paid for mostly with federal money.

Bob Beck

For the last few years Wyoming has considered taking advantage of part of the Federal Affordable Care Act which pays states to expand Medicaid services to the so called working poor. While states have some up-front costs, the federal government pays for 100  initially and 90 percent after that. In Wyoming it would pay for close to 18,000 additional low income people to get health care coverage. Despite the federal money, lawmakers have consistently refused to adopt expansion. Why? The answer is varied.

The Senate Labor and Health Committee has approved a Medicaid Expansion bill on a 4 to 1 vote.

The bill models the Wyoming Department of Health’s Share plan, but also includes a Health and Wellness account that participants would use for medical co-pays. Despite the vote, the bill continues to have lukewarm support. 

Casper Republican Bill Landen voted for the bill in committee, but he may not support it on the Senate floor.

Bob Beck / Wyoming Public Media

A legislative committee considering legislation to expand Medicaid will now consider a second expansion proposal. 

This proposal is one favored by Governor Matt Mead and crafted by the Wyoming Department of Health with help from federal health officials. The so-called Share plan legislation is sponsored by Gillette Republican Michael Von Flatern and three other Republicans.

"To show those in the legislature as well as the rest of the public that the Republicans, there is actually quite a few of us that consider this the way to go, and we need to expand Medicaid.”

The Director of the Wyoming Department of Health says if the state approves Medicaid expansion it could be awhile before it gets implemented.  

Tom Forslund told the Joint Labor, Health, and Social Services Committee last night that he predicts that it wouldn’t take effect in Wyoming until January 1st of 2016. Co-Chairman Elaine Harvey said she was told that if Wyoming adopted a simple plan that it could be approved by the Spring. Forslund said a simple plan would help.

Bob Beck / Wyoming Public Media

Business leaders, health care providers, and members of the Wind River Reservation all urged a legislative committee to approve some form of Medicaid Expansion during a hearing today (Monday).  

The Senate Labor, Health, and Social Services Committee is considering a bill that would provide health care services to some 18-thousand people who currently cannot afford health insurance. If Wyoming’s plan is approved by the federal government, 100-percent of it would initially be paid for with federal money. 

Wyoming Governor Matt Mead is calling on legislators to pass a bill that expands Medicaid services in the state. During his State of the State message Mead argued that failing to offer Medicaid to more people will hurt hospitals across Wyoming because it increases their uncompensated care.  

A legislative committee recently rejected an expansion plan developed by the State Department of Health, but Mead said that doesn’t matter.

A legislative committee has rejected the Wyoming Department of Health's proposed Medicaid Expansion plan in favor of a bill crafted by the committee.  The Share plan was also endorsed by the governor.

The bill  approved by the committee would provide participants with a Medicaid-funded health savings account that they could use to purchase private insurance.  Senator Charles Scott said that he believes that will encourage participants to be careful with their health care spending.

Gillette Representative Eric Barlow said that remains to be seen.

Bob Beck

Members of a legislative committee say they plan to support at least one bill that would expand Medicaid services in the state to provide Health Insurance to a low income population that can’t afford health insurance.

The committee is looking at two bills and there is a chance they may be combined into one piece of legislation.   The state has proposed a plan where it would use federal dollars to provide health insurance.  Senator Charles Scott has crafted a plan that uses Medicaid dollars to fund a health savings account that participants would use to purchase private insurance.

Wikimedia Commons

The federal government has provided millions of dollars to states to offer Medicaid Health Insurance to what’s known as the working poor. Last week, after months of discussion, the Wyoming Department of Health unveiled its plan for expanding Medicaid in the state. 

Low income people who do not currently qualify for Medicaid and do not make enough money to be able to get insurance via the Affordable Care Act would be eligible. Governor Matt Mead and several health care organizations support the plan, but it still has the difficult task of getting through the legislature.

After months of negotiations with the federal government, the Wyoming Department of Health unveiled a plan today/Wednesday for using federal dollars to expand Medicaid in the state. The proposed state plan is called Share and it includes provision for work training, Co-pays and Health Assessments.  Laramie Democrat Chris Rothfuss is a supporter of expanding Medicaid. He says he's okay with the requirement that some people pay a small amount into the plan.

Wyoming Governor Matt Mead says the federal agencies in charge of Medicaid are open to innovative expansion proposals. He says that could convince legislators to adopt a Medicaid Expansion program in Wyoming. The proposal the state is working on would require those eligible for the program to contribute to it. 

While Wyoming residents strongly oppose the Affordable Care Act, residents are supportive of expanding Medicaid to provide health care to those who cannot afford it. A University of Wyoming election year survey conducted in mid - August found that only 24 percent of state residents approve of the Affordable Care Act, while 70 percent oppose it.  

University of Wyoming Political Scientist Jim King says people have a different opinion about Medicaid expansion.

Wyoming Governor Matt Mead says he continues working with federal officials to craft a Medicaid expansion plan for Wyoming.                  

Mead says that he’s concerned that the federal government will not be able to afford the program, but he says it could help people in the state and so he is moving forward with a good faith effort.

Stephanie Joyce

Governor Matt Mead may be changing his mind when it comes to expanding Medicaid services for low income people in the state. After publicly rejecting the notion of Medicaid expansion late last year, the governor says he is negotiating in good faith with the federal department of Health and Human Services to develop a Wyoming specific Medicaid expansion plan. 

Wyoming Medicaid Numbers Remain Steady

May 13, 2014

Earlier this month the U-S Department of Health and Human Services indicated that Wyoming’s Medicaid and the Children’s Insurance Program known as CHIP had lost four thousand participants. 

But the Wyoming Department of Health says both programs are very busy.  The Department’s Jan Stahl says Wyoming numbers go up and down throughout the year.                 

“Our numbers indicate that we had dropped down up until the end of December, but since that time our numbers have been climbing back up.”

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