CHEYENNE, Wyo. — A range of citizens and professional groups urged Wyoming lawmakers on Monday to accept federal money to expand the federal Medicaid program to offer health insurance to thousands of low-income adults.
Medicaid expansion is a key element of the federal Affordable Care Act. The federal government has offered to pay most of the cost of adding coverage to an estimated 17,600 low-income, uninsured adults in Wyoming.
The overwhelmingly Republican state Legislature has rejected the federal expansion offer repeatedly in recent years. Many critics say they don't trust federal promises to continue to pay for the program.
The Senate Labor, Health and Social Services Committee took public testimony Monday on a committee bill that would allow expansion of the Medicaid program while requiring recipients to pay into health savings accounts. Supporters say requiring such payments would encourage responsible behavior but it's unclear whether the state could get federal approval for the plan.
Gov. Matt Mead has urged the Legislature to approve the expansion this year without the savings requirement. He said last week in his state of the state address that he still believes that the Affordable Care Act is bad law but doesn't believe Wyoming should pass up the federal money that's now going to other states.
The committee didn't vote on the bill Monday. Committee Chairman Sen. Charles Scott, R-Casper, said he intends to allow committee members time to draft amendments and intends to hear from the state Health Department before holding a vote later in this legislative session.
Wyoming Health Department Director Tom Forslund has said expanding the Medicaid program would save the state money by getting people off other programs. The state's Medicaid program would likely need an infusion of nearly $80 million in state general funds in coming years without the expansion, while expanding the program promises the state nearly $50 million in savings, he has said.
Supporters who testified in favor of expanding the program included representatives of the business and health care industry as well as church and social welfare representatives and several tribal members from the Wind River Indian Reservation.
Bill Schilling, president of the Wyoming Business Alliance, testified his group concluded that the state should proceed with expansion. He said hospitals around the state are in danger of closing if they don't get help covering the cost of care for the uninsured.
"To the extent that working poor — people who want to aspire from poverty to middle class — can be assisted in that arena by the costs they are paying for health care, that would be an advantage to our state," Schilling said.
Eric Boley, president Wyoming Hospital Association, told the committee that hospitals around the state are losing $110 million a year by providing uncompensated care to the uninsured.
"That means our hospitals, our safety net hospitals, are in jeopardy," Boley said. "We're facing narrow, narrow margins in operations."
Boley said other states that have expanded Medicaid have seen a decline in the cost of uncompensated care borne by their hospitals. He said preventative medical care, such as colonoscopies and controlling diabetes, also can find illnesses earlier and save health care costs.
Glen Fowler, health care analyst with the Northern Arapaho Tribe, testified Medicaid saves lives on the Wind River Indian Reservation. He said the health care system there receives about $17 million, of which half is Medicaid money, for more than 11,300 people.
Micah Carpenter-Lott, 21, a member of the Northern Arapaho Tribe, testified he received Medicaid coverage for medical procedures when he was a teenager. He said he lost that coverage when he turned 18 and still is uninsured.
"So for someone to say, who does this help? It would help me," Carpenter-Lott said. "I fit into that category, I fit into the guidelines. I'm the scenario, it would help me. That's all I have to say."
Rep. Marti Halverson, R-Etna, was the only speaker against Medicaid expansion. She said other states that have opted for Medicaid expansion have seen new enrollment exceed its predictions.
Halverson said it's not true that other states are getting Wyoming's share of Medicaid program funds. She said it's an entitlement program and there's no fixed amount allocated from state to state.
"I urge the committee and my fellow legislators please remember those for whom Medicaid was originally intended: poor children, impoverished seniors and individuals with disabilities," Halverson said.