Highlight on Wyoming: Medicaid Expansion Evolving into Political Tug-of-War

Wyoming’s Governor Matt Mead and its Republican led legislature have reiterated their position that they are rejecting federal money to expand Medicaid coverage in Wyoming citing issues with the implementation of the Affordable Care Act (ACA) (P.L. 111-148). Mead who has opposed the ACA since the very beginning also stated that he thought the ACA would hurt more than it helped the people of Wyoming and that he was skeptical the federal government would be able to keep its promise to cover 90 percent of the costs of Medicaid expansion during its implementation.

On the other side of the debate is the state’s Democratic Party that continues to push for Medicaid expansion, citing the positive impact the ACA has had in Wyoming. Led by Pete Gosar, the Wyoming Democratic Party’s Chairman, Gosar argues that if Wyoming expanded Medicaid, the savings in healthcare costs to Wyoming would be approximately $48 million during the first few years of implementation.  Wyoming Democrats also assert that because of Governor Mead and the Republican led legislature’s decision to decline Medicaid expansion, approximately 18,000 of Wyoming’s working poor have been denied access to basic healthcare. Further, Democrats argue that Governor Mead’s decision does not help the state save money in uncompensated care costs that hospitals provide to the uninsured.  The Wyoming Democrats are ramping up their campaign efforts for Medicaid expansion when the state’s legislature reconvenes in  February 2014.

The Billings Gazette cautioned readers that the Medicaid expansion debate faces another tough year in 2014. It also noted that Medicaid expansion would provide health care coverage to more than 15 percent of the state’s uninsured population and that the federal government would pay for almost all costs, which will allow Wyoming to spend less on its own health care programs.  The article observed that among Wyoming’s politicians the benefits brought by Medicaid expansion are clouded by its association with the ACA; and even if the ACA were not part of the issue, expanding Medicaid eligibility would still be difficult because there is no consensus among state officials how to actually expand the program.  In 2013, Governor Mead commissioned a study for alternative methods to expand Medicaid and the state health department recommended a program titled “Medicaid Fit,” which Mead rejected at the end of last year.

Dan Neal, Executive Director of the Equality State Policy Center, wrote that opponents of Medicaid expansion argue the federal government cannot be trusted to honor its funding commitments under the ACA.  Neal notes that there is a flaw in this argument since Wyoming already accepts federal funding for other state programs such as education, and highway and transportation projects.  In 2013, the Wyoming Medicaid program served over 77,000 people at an annual cost of over $500 million, divided evenly between the state and federal governments.  The Director of the Wyoming Department of Health, Tim Forsland, claimed that expanding Medicaid program in Wyoming would save money by getting people off other programs.  State Senate Minority Floor Leader, Chris Rothfuss (D), declared that Wyoming is going to pay for healthcare; it’s just a question of how to do it and if people are pragmatic, it’s an awful lot of money to turn down.