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Lawmakers weigh Medicaid expansion in state
State Rep. Lloyd Larsen, R-Lander, looked up from his notes during a meeting of the Wyoming Legislature's Joint Labor, Health and Social Services Interim Committee on Tuesday in Lander. The group heard discussions about Medicaid expansion in Wyoming under the Affordable Care Act. Photo by Alejandra Silva

Lawmakers weigh Medicaid expansion in state

Nov 6, 2013 - By Alejandra Silva, Staff Writer

Health officials say the move could save millions of dollars for Wyoming, but Gov. Matt Mead so far has resisted the idea as proposed under "Obamacare."

Supporters of Medicaid expansion in Wyoming were up early Tuesday greeting Wyoming legislators and others attending the Joint Labor, Health and Social Services Interim Committee at The Inn in Lander.

"It's the common sense thing to do," said Fremont County Democratic Party chairman Bruce Palmer of expanding Medicaid in Wyoming under the Affordable Care Act. "It would save the state $47 million."

Palmer was joined by members of the Wyoming Association of Churches, the Lander Ministerial Association, Wyoming Coalition for Medicaid Expansion, and others from the Wind River Indian Reservation and surrounding communities.

Most of the discussion on the proposed bill was fleshed out during the public comment session, when citizens shared with the committee how they would benefit from the legislation if it passed.

A Lander resident expressed his support for the expansion by differentiating for the committee that this was "a need, not a want."

He said people less fortunate would benefit from the expansion.

A Casper resident said she applied for health care coverage through HealthCare.org and later on the phone and was told she was ineligible. If the state didn't expand Medicaid to increase eligibility, she said, she would be left without health insurance. The assistance her mother receives for prescription drugs also would be cut, she said.

Another community member, Laura Davidson, said she was afraid of a higher premium on top of an already expensive one she was dealing with that required a $10,000 yearly deductible.

"I don't know how long I can do that," she said. "I'm frustrated with the system."

Davidson also praised the committee for working toward making improvements and "being on the front line."

Fort Washakie resident and Fort Washakie school district board member Karen King asked the committee to consider individuals who, like her, had successful careers, have worked for most of their adult lives and are not necessarily below the poverty level but still have to deal with "exorbitant rates."

"To me, it's 'kick them while they're down,'" King said. "I applaud your public diligence, but I also implore you to act quickly on behalf of those who need help."

Not everyone in the audience was in favor of the expansion. One local resident emphasized that the finances with the Social Security, Medicaid and Medicare were "broke" and expanding the program would be less then beneficial.

"How are you going to afford Medicaid and not run us into the ground?" the man asked the committee.

Medicaid legislation

Before public comment was taken, the committee briefly discussed legislation relating to Medicaid.

Committee co-chairman Sen. Charles Scott, R-Casper, revisited previous information provided to the committee regarding Gov. Matt Mead's request for studies that showed how the expansion would affect the state.

Mead has resisted the Obama administration's recommendation that states ex-and Medicare eligibility under "Obamacare" with federal assistance, saying he didn't fully trust the federal government to make good on its financial support.

The director of the Wyoming Department of Health has recommended it, however, calculating the $47 million savings figure mentioned by Palmer.

Scott pointed out specific provisions that summarized cost-sharing and benefits packages and added that by applying the assistance to people well below the 100 percent poverty level, their objective of insurance stability could be met.

The committee also reviewed another bill, the Healthcare Independence Act, that -- with Medicaid expansion -- would give people a choice to select a private insurance company and take a subsidy for health insurance premiums. The committee discussed language used in the bill that was drafted mostly with verbiage from an Arkansas bill that was made for the same purpose.

Scott suggested the removal of a line that said people would "enroll in a qualified health plan through the health insurance exchange." It was mentioned that Arkansas did create its own portal for efficient search of private insurance companies rather than use the system already in place that has shown flaws in its functionality.

"It strikes me that you could retain the requirement," Scott said to the individuals who drafted the bill, adding it would make enrollment much easier if it were dropped from the bill.

A health savings account requirement, Scott said, could "break ground" for this bill. He said the Arkansas bill doesn't have that provision. By having that account, Scott said, people could see the money in it as their own and be "incentivized" to conserve it and be careful on what services they use it for.

"The amount, plus expected incentive contributions authorized by this act, shall be enough to enable an ordinary individual to make required cost-sharing payments," the draft bill read. "The intent of the payments under this subsection is to increase participation and competition in the health insurance marker, intensify price pressures, and reduce costs for both publicly and privately funded health care."

The committee agreed to revisit the bills at its next committee meeting in January. The 2014 legislative session convenes in February.