Medicaid expansion

Jan 20, 2014 By Steven R. Peck

Legislature is correct in agreeing to debate it

It is good to hear that the Wyoming Legislature is willing to at least have the issue of optional Medicaid expansion debated in the legislative session that begins next month. It deserves a full airing.

Wyoming is on board for the mandated portion of Medicaid expansion (we have no choice), but there is great reluctance among top political leaders to take the next step, which is a further expansion of Medicaid -- recommended but not required -- that would bring more uninsured residents under the Medicaid umbrella.

Money comes with part of that federal suggestion. The U.S. government would foot the bill for setting up the voluntary expansion. The Wyoming Department of Health says it would be a good way to cover more citizens -- about 17,000 more, in fact -- while saving more than $50 million in the process.

It sounds great in principle, but in Wyoming there are other principles involved. In today's political climate, there is a lot of mileage to be gained by questioning, criticizing and even condemning the federal government. In opposing the optional Medicaid expansion, that's the script top elected officials are following. Angry at the federal government for its decision to trim back a long-standing mineral reimbursement for the state, and generally disapproving of the Obama administration in general, the leaders are refusing to go along with expanded Medicaid because they "don't trust the federal government" to honor its commitment to pay for the bigger program.

It would be a lot easier to carry that position if it weren't for those 17,000-plus citizens of our state who don't have health coverage and who probably won't if Wyoming doesn't take this step. Perhaps they also don't trust the federal government, but this doesn't give them much faith in their state government, either.

One point of discussion is that if we are angry about losing tens of millions of dollars in revenue from the mineral reimbursement program, then accepting tens of millions of dollars to expand Medicaid is a way to get at least some counterbalance. This all has a bit a a cut-off-your-nose-to-spite-your-face feel about it.

This week Wyoming learned that it had earned an additional half-billion dollars from its investments last year thanks to the improving national economy. That, too, will be noticed by those who need health insurance but see the state refusing, one way or the other, to help them get it.

If there truly is the belief that the federal government can't be relied upon, then Wyoming ought too explore ways to expand the benefit on its own. Disliking the federal government is a philosophy that has ample legitimacy in Wyoming. But it's not much if a philosophical triumph to stand against helping the uninsured poor in a state so flush with cash. So it's good the Legislature is going to kick this around for awhile. This is an election year, and if Wyoming's leaders won't take this step, voters deserve to know why.

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