Bill to block Medicaid expansion for 2 years dies

A bill to block future legislative bodies from expanding Medicaid died in the House of Representatives on Monday, ensuring that expansion will be a topic in upcoming legislative races.

Senate File 86 “Medical Assistance Program Design” also called for a 2-year study for how to help provide health insurance to low-income working adults. Only after that could the Legislature consider Medicaid expansion again, the bill said, which would have effectively taken the issue out of the upcoming primary and general election arena.

The bill, sponsored by Medicaid expansion opponent Sen. Charlie Scott (R-Casper), included a work requirement.

Critics of SF 86 regarded the bill as a political maneuver by Scott. He made an impassioned speech earlier in the session against Medicaid expansion just before the Senate killed the health program for the fourth year running.

“The prohibition on the Governor and the Legislature taking action in future years seems extraordinarily short-sighted,” Phyllis Sherard, chief strategy officer for Cheyenne Regional Medical Center, said in an email. “Critics of SF 86 are quite correct — the problem of covering the safety-net population has been studied, studied, and restudied.”

Many regarded the original $20,000 appropriation in SF 86 as not nearly enough to complete a 2-year study, in any case. Then the House amended the figure to $10,000.

“The woefully inadequate amount of money indicates a sort of lack of purpose,” said Marguerite Herman, who represents the Wyoming branch of the League of Women voters. “The things that are studied in the bill are elements of a Healthy Frontiers plan, which this state gave a good shot to and it did not work. So really, we’re not really clear what the purpose is.”

On Monday, House leaders repeatedly moved SF 86 down the general file list, effectively killing the bill and others that failed to make the second-reading deadline.

Expansion denied

After opposing Medicaid expansion for years, Gov. Matt Mead (R) shifted his position late in 2014. In December, he included expansion in his budget proposal to the Legislature, but the Joint Appropriations Committee removed it in January.

An amendment to place Medicaid expansion back into the budget bill and add a 2-year sunset date failed on an 11-19 vote in the Senate on Feb 19. Expanding the program would have provided insurance for some 20,000 working adults, saved more than $33 million in state’s biennium budget and overall reap about $268 million for health care providers and patients statewide, according to the state’s top health experts.

But opponents handily won, arguing that the federal government will eventually renege on its commitment to help fund a majority of the cost of expansion. Sen. Larry Hicks (R-Baggs) said the state has an obligation to live within its means. “I worry — is history going to judge us as so selfish that we can’t live within our means?”

Gov. Mead has said he will not move to expand Medicaid without the Legislature’s approval.

We are left with “absolutely nothing for these people. Literally nothing,” Sen. Chris Rothfuss told WyoFile. “That’s what we’re offering them, that’s what we’ve given them for the last five years is no hope, no solutions, no leadership, no effort, really.”

Medicaid expansion in elections

Overwhelming opposition amongst legislators does not accurately represent Wyoming’s attitudes toward Medicaid expansion, according to proponents. Healthy Wyoming, a coalition of Medicaid expansion proponents, counts in its ranks the Wyoming Hospital Association, dozens of civic and business groups and the conservative Wyoming Business Alliance.

“We’ll see what November brings,” said Brianna Jones, executive director of the Equality State Policy Center. Jones spoke on behalf of Healthy Wyoming at a Feb. 19 press conference immediately after the Senate killed Medicaid expansion for the fourth time.

Others at the press conference said legislators are counting on the Republican party to win the White House and maintain majorities in Congress and begin to dismantle President Obama’s Affordable Care Act. Eric Boley of the Wyoming Hospital Association said “it’s the biggest fallacy out there. They’d have to replace it with something. … The Affordable Care Act is here to stay.”

Wyoming legislators first delayed action anticipating that the U.S. Supreme Court would overturn the ACA in the spring of 2012, then they refused expansion expecting a GOP White House win in the 2012 election. Those predictions didn’t pan out.

In local elections, many Representatives said they ran on the promise of resisting Medicaid expansion and all things related to the ACA. Still, proponents say they see an opportunity to make it more of an issue in legislative races this year.

“[Wyoming Medical Center] cannot legally support candidates,” CEO Vickie Diamond told WyoFile via email, “but each of us will support those candidates in the next election who favor caring for our citizens versus a philosophical issue with no merit.”

Sen. Rothfuss said, “I think people should really look to that when they go to the polls.

“I know that there is widespread support around the state, most every organization in this state over the past few years has really transitioned to the point where they support Medicaid expansion. The major insurance company in the state supports Medicaid expansion openly. There’s really very few entities left that oppose it with the exception of a large number of people in the Legislature.”

It was unclear Monday evening whether the SF 86 idea of a 2-year study would continue as an interim topic for the Labor, Health and Social Services Committee.