Groups lobby for Wyoming Medicaid expansion

CHEYENNE, Wyo. (AP) -- A coalition of medical groups is urging the Wyoming Legislature to approve expansion of the federal Medicaid program, a key element of the national Affordable Care Act.

The Wyoming Coalition for Medicaid Expansion, a group that includes the Wyoming Hospital Association and other medical and citizens' groups, held an event Tuesday in the state Capitol to draw attention to the issue.

The Senate Labor Health and Social Services Committee is set to consider a bill Wednesday that would expand Medicaid eligibility.

Sen. John Hastert, D-Green River, is sponsoring the expansion bill. "I think it's critically important at this time," he said Tuesday of the expansion. "We're going to be able to insure well over 30,000 more people in the state of Wyoming, and it would save the state some money."

Gov. Matt Mead and some key lawmakers have said they oppose expanding the program, a key element of the national Affordable Care Act. Mead has recommended that lawmakers reject a proposed $50 million federal Medicaid expansion.

The Medicaid program currently serves over 77,000 people at an annual cost of over $500 million, split evenly between the state and federal governments.

Mead, a Republican, steered Wyoming into the largely unsuccessful multi-state legal challenge to the federal law that led to last year's U.S. Supreme Court ruling upholding many provisions. He's complained in recent months that the U.S. Department of Health and Human Services hasn't responded to his repeated demands for details of how the state would implement requirements of the law.

Recently, Mead has said that given the federal government's financial problems, he doesn't believe Wyoming can trust federal promises to pay 100 percent of Medicaid expansion costs over the next few years, after which it promises to pay 90 percent.

Sen. Charles Scott, R-Casper, is chairman of the Senate Labor Health and Social Services Committee. He said Tuesday he also opposes expanding the program.

"My personal opinion is that given the financial mess in Washington, the feds, no matter how much they want to keep that promise are going to be unable to do so," Scott said Tuesday. "I don't think they can afford it. I don't think they can get the debt ceiling increases needed to do it."

The Senate on Tuesday gave preliminary approval to a separate bill that Scott's committee had endorsed that would total repeal the cap on the number of people covered by Medicaid in assisted living facilities. Scott said the bill calls for other program reforms that could result in biennial savings of up to $113 million, split between the state and federal governments.

Dan Perdue, lobbyist for the Wyoming Hospital Association, spoke at the coalition's event on Tuesday in favor of expanding Medicaid. He said the Wyoming Department of Health has concluded the state would see $47 million in savings by expanding the program over seven years because of offsets to existing programs.

"Simply put, the expansion of Medicaid will allow the state to alter, reduce or eliminate programs that the state already pays for from the state General Fund," Perdue said. "So in essence, if we do nothing, it will cost us $79 million over seven years. However, if the state chooses to accept the expansion, the state will gain $47 million for the same seven-year period. And this represents a swing of $126 million."

In a later interview, Purdue said Wyoming hospitals provided over $200 million in uncompensated care in 2011, the most recent year for which figures are available.

"I think that's just because of the economic times, and the fact that people don't have health insurance and they still face some very serious medical challenges, but they just don't have the means to pay those bills," Purdue said. He said increasing Medicaid eligibility would reduce that by reducing emergency room visits.