Wyo. Officials Considering Medicaid Expansion Amid Budget Concerns
Wyoming Gov. Matt Mead (R) has entered into discussions with the federal government about expanding the state's Medicaid program under the Affordable Care Act amid pressure from hospitals and budgetary concerns, the Los Angeles Times' "The Economy Hub" reports (Hiltzik, "The Economy Hub," Los Angeles Times, 8/25).
Background
Twenty-six states have expanded Medicaid under the ACA (California Healthline, 4/24). Meanwhile, 24 states have declined to expand their programs (California Healthline, 8/11). Mead and Wyoming lawmakers have expressed skepticism over expanding the state's Medicaid program, questioning whether the federal government would continue funding the expansion as it has promised (Neary, AP/Seymour Tribune, 8/21). In December 2013, Mead said he would not support Medicaid expansion in Wyoming (California Healthline, 12/3/13). The state Senate earlier this year struck down a bill that would have expanded the program. However, state lawmakers have directed Mead to explore a possible Medicaid funding deal with the federal government (AP/Seymour Tribune, 8/21). A Medicaid expansion in the state would cover up to 17,600 additional low-income state residents and would make it the 12th state with a Republican governor to expand the program under the ACA.
Concerns About Costs of Non-Expansion
According to "The Economy Hub," the "reason for Wyoming's" consideration of the Medicaid expansion "is clear: It's money" ("The Economy Hub," Los Angeles Times, 8/25).
A study by the Wyoming Health Department found that expanding Medicaid would save the state about $50 million by reducing demand for other state programs. The department also said that -- without an expansion -- the state's Medicaid program would need nearly $80 million in state general funds (AP/Seymour Tribune, 8/21).
In addition, a recent report by the Urban Institute found that the 24 states that have not expanded Medicaid are projected to miss out on a total of $600 billion in hospital reimbursements and federal funding through 2022. Further, for every dollar a state spends on Medicaid, it receives $13.41 in federal funding ("The Economy Hub," Los Angeles Times, 8/25).
Meanwhile, the Wyoming Hospital Association -- which has supported a Medicaid expansion -- has said that hospitals have spent more than $200 annually in uncompensated care for individuals without health insurance (AP/Seymour Tribune, 8/21).
Political Concerns
A recent analysis by Sam Wang of Princeton University found that Republican governors who are up for re-election and have resisted expanding Medicaid have lower poll numbers relative to Republican governors who have embraced expansion ("The Economy Hub," Los Angeles Times, 8/25).
The governor and state Health Department Director Tom Forslund on Thursday met with federal officials to figure out "the best deal" the state could get for expanding Medicaid, according to the AP/Seymour Tribune.
Reaction
Mead said that while he still has reservation about the costs of expanding the program, "I juxtapose that against our hospital association saying we're handing out $200 million every year just in Wyoming. I contrast it with whatever that running total is now, I think it's about $60 million for this year, that Wyoming, if we were in Medicaid, we would have received." He added that he intends to present information on the federal government's proposal to the Wyoming Legislature when it reconvenes in January 2015.
Democratic gubernatorial candidate Pete Gosar, who is running against Mead in the upcoming election, said, "I'm happy to see the governor moving in the direction to granting access to 18,000 of our Wyoming workers to Medicaid, but I'd like to know the details." He continued, "I'm hopeful that the governor will come to his senses on this, it's been long overdue, and if you see the $70 million or so that's been wasted in Wyoming by not accepting Medicaid expansion since January 1, there are a lot of questions that have to be answered by the governor's office" (AP/Seymour Tribune, 8/21).
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