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State weighs Medicaid options

Nov 9, 2012 - By Ben Neary, The Associated Press

CHEYENNE -- A top Wyoming lawmaker says he believes the state should opt out of expanding its Medicaid program, a key component of the federal Affordable Care Act.

Sen. Phil Nicholas, R-Laramie, is co-chairman the Legislature's Joint Appropriations Committee. Speaking at Thursday's committee meeting in Cheyenne, he said he believes that Wyoming is likely to get stuck ultimately with the extra costs if it buys federal promises to pay most of the tab for expanding the low-income health program.

"I think in a general sense, Wyoming does not want to be pushed into an expansion of its Medicaid program," Nicholas said.

Tom Forslund, director of the Wyoming Department of Health, briefed the committee on proposals for how to cut the state's Medicaid bills. He said the Medicaid program served more than 77,000 people in Wyoming last year at a cost of more than $500 million split between the state and federal governments.

Gov. Matt Mead told reporters this week he will decide by next month whether to recommend lawmakers accept the federal Medicaid expansion offer, which he has said could increase the state's Medicaid enrollment by 30,000 people.

Mead also has said he doubts the federal government could honor its promises to cover most of the increased costs given the shaky condition of the federal budget.

Forslund said his department needs legislative direction on how to proceed on Medicaid. He presented three options for trying to cut costs of the program, ranging from modest tweaks through to what he said would be a transformational change: turning management of the program over to private industry.

Wyoming is the only state that doesn't employ private industry, or "managed care," to keep at least some aspects of its Medicaid expenses down, Forslund said.

Forslund said his agency hasn't yet calculated how much savings the state could expect from the proposed Medicaid cutbacks. He said he expects to present that information to another legislative committee next month.

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