A House bill to expand Medicaid in Wyoming and provide health insurance to about 25,000 additional residents passed on Monday after Senate lawmakers rejected a similar proposal hours earlier.
As the evening wore on, it looked like the House would act as the Senate had done and reject the proposal by burying it under a procedural delay. But leaders agreed to hear House Bill 162 as the last bill of the evening.
“It gives health care to people who don’t have it,” the bill’s sponsor, John Romero-Martinez, R-Cheyenne, said of the bill when it was introduced to fellow lawmakers.
Wyoming lawmakers have tried to extend health insurance to low-income residents through Medicaid expansion for nearly a decade, and every attempt so far has been defeated, often early in the legislative process.
House Bill 162 still needs two more readings in the House before heading to the Senate. But several staunch opponents of the expansion over the years now support the effort. Those who have found themselves championing legislation they previously opposed include Rep. Steve Harshman, R-Casper.
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“I had a kind of change of heart, frankly,” he explained to his colleagues during the presentation of an amendment to rewrite the Romero-Martinez bill to make it identical to the file. of the Senate rejected earlier in the day.
“I voted no many times on this issue,” said House Speaker Eric Barlow, R-Gillette. “I’m going to vote yes this time, because I haven’t seen any other solution. No one advanced anything, and I looked at myself.
“I have to admit that even though I was one of those who resisted this, I really thought about it and I think it’s time.” Rep. Mark Kinner, R-Sheridan, said.
The federal government already guarantees that it will cover 90% of the costs for residents enrolled in expansion programs. For reference, those enrolled in the basic program, with no extension, receive a federal match of approximately 50% in Wyoming.
But the additional residents covered by the eligibility expansion are covered to a much greater degree by federal dollars.
The expansion of Medicaid broadens the eligibility criteria for the federal insurance program. Currently in Wyoming, eligibility is limited to low-income children, people with certain disabilities, pregnant women, and certain long-term care residents. As of Feb. 1, about 65,000 Wyoming residents were covered by Medicaid, according to the state health department.
The proposed expansion would open eligibility to any “non-disabled adult without children” under 138% of the federal poverty level (an annual individual income of just under $18,000). The Wyoming Department of Health says it could serve between 13,000 and 38,000 residents, but it’s likely the actual enrollee count would be somewhere in the middle; the health department estimates nearly 25,000 people.
The bill enshrined this 90% federal match in law and ensured that the state would opt out of the federal program if the ratio were to decline.
A similar Senate bill, sponsored by Sen. Chris Rothfuss, did not advance on Monday, rejected without a hearing by a procedural deadline. Backed by 12 bipartisan co-sponsors, the bill would have expanded Medicaid eligibility in Wyoming while blocking federal matching of costs to ensure the state never pays more than 10% of costs for residents enrolled in the expanded program.
“I am very disappointed that we did not have the chance to hear or debate the bill. Providing affordable health care to all citizens of Wyoming is really important to us,” Rothfuss said. “It’s the only possible vehicle to do that,” he said at the time.
He lamented that Senate Majority Leader Ogden Driskill had “buried” the bill, Rothfuss said, dropping the possibility of at least having a debate on the floor. Not expanding Medicaid “is going to affect a lot of people in Wyoming,” he said.
The bill received an affirmative vote from the Senate Labor, Health and Human Services Committee earlier this month, but required three readings by each legislative chamber and governor’s approval to become law. The bill was not debated beyond the committee room.
In order to get a debate, the Senate bill would have had to be heard on the floor convened as a “committee of the whole” by Monday. However, Harshman’s amendment to rewrite the House Bill will breathe new life into Rothfuss’s proposal. His name just won’t be on it.
Rothfuss made an impassioned plea to move the bill forward to allow for discussion at this committee meeting in early March. He faced committee members’ skepticism about “socialized health care” and worries that the expansion would not be economically sound for the state. Rothfuss responded to those concerns by citing the 25,000 people who could benefit from coverage.
“The struggle I have is that we take a principled stand against the wrong hand that is being given to us by the federal government and not with our own health care individually… we take a principled stand with the life of 25,000 Wyomings who don’t. have the luxury of sitting here today, having this conversation,” Rothfuss said in that meeting.
“People who are our working poor, the single mothers we’ve heard of with two kids, probably have to work two or three jobs, the mentally ill — those are the lives we’re playing with,” he continued. “And we haven’t offered them anything for the last decade.”
“That’s 25,000 Wyoming residents that we’ve failed to provide solutions to year after year since I’ve been in the Legislative Assembly” for more than a decade, he added. “It’s not like there are alternatives on the table.”
The Wyoming Department of Health released a report Feb. 1 detailing what expanding Medicaid could offer the state. That report found the expansion could cover an additional 25,000 Wyomingites with Medicaid for $20 million per biennium.
The report also noted that the expansion would likely lead to better outcomes for newly insured residents. Citing a Kaiser Family Foundation report, the health department noted that more people on Medicaid are likely to report “good or excellent health” than those who are uninsured, and depression rates tend to decrease.
The report also noted that the expansion could prevent premature deaths, especially among aging residents who are not yet eligible for Medicare.
While the benefits for newly insured people are clear, the health department report explains that the expansion would not bring more money to Wyoming. This could, however, offset some of the state’s costs.
“By itself, the Medicaid expansion…will not generate any revenue for the Wyoming state government,” the report read. “What the expansion could do is allow for potential efficiencies at the state level by replacing one dollar of state general funds with 10 cents of state general funds plus 90 cents of federal funds in some programs.”