Kerry Drake pleads for Medicaid expansion at the Labor Health committee meeting in Cheyenne on Thursday. (Ron Feemster/WyoFile – click to enlarge)
Kerry Drake pleads for Medicaid expansion at the Labor Health committee meeting in Cheyenne on Thursday. (Ron Feemster/WyoFile – click to enlarge)

Medicaid Expansion: Some messages need to be delivered in person

— January 14, 2014

Kerry Drake

I did something last Thursday that I had never done in my 38 years as a journalist. I’ve been to hundreds of legislative committee meetings, but always to observe and take notes. This time I sat at a table in front of 12 Wyoming lawmakers and told them why they need to expand Medicaid.

As a columnist and editor, I’m used to giving legislators and others unsolicited advice, so that wasn’t new. But this was the first time I did it in public, with an audience, and I knew most members of the panel didn’t want to hear what I had driven to Cheyenne to say to them in person.

Others who came to speak were heartfelt but skeptical, already convinced that whatever points they had to make would fall on deaf ears. And why not? The Republican-controlled House, along with Republican Gov. Matt Mead, killed Medicaid expansion last year, refusing to take $50 million in federal funds to provide health care to about 16,000 low-income adults without children as dependents.

Nothing changed in the past year except more people would now be eligible for Medicaid – 17,600 — and the lawmakers’ obsession with hating the Affordable Care Act (ACA), or Obamacare, has grown exponentially.

Edna Ramsey was in line ahead of me, and when it was her turn she stood before the Joint Labor, Health and Social Services Interim Committee. She explained she doesn’t qualify for Medicaid because she lives in Wyoming, which won’t expand it, and she makes too little to get subsidies the ACA provides to help the poor obtain a policy from the health insurance exchange. I knew what she said was true, because I’m in the same position.

This insane Medicaid gap is hurting 5 million people in 25 states. With Edna and me, at least two of them were in the meeting room.

“I don’t go to the doctor unless I absolutely have to because I can’t afford it,” she said, explaining why she wants them to take the federal money for the expansion. But in less than a minute she stopped reading from her piece of paper and looked directly at the legislators, her voice quivering.

“Now that I am here, I don’t think it’s going to happen because I don’t see anyone that cares,” Ramsey said, and briskly left the room.

Part of me wanted to bolt, too. Based on the panel’s discussion so far, it seemed like a lost cause. Yet I knew I had to go through with it, because the people who made a terrible decision last year should spend a few minutes hearing about the problems from someone who has to deal with them. They don’t have to read my column, but they couldn’t get up and leave. At least they didn’t.

I asked them to imagine that 17,599 people were in line behind me. These are the working poor – the store clerks, day-care providers and janitors they see all of the time, and who they are supposed to represent. All of them are caught in the Medicaid gap the Legislature and Mead created.

I reminded them that a Wyoming Department of Health (DOH) study found the state could save $47 million over the next six years by expanding Medicaid. If they didn’t, it would have to spend $80 million more than planned during the same period.

“I am perplexed as to how you could turn down such a large amount of money, and help no one, simply to cling to abstract political ideals,” I said.

Then I mentioned another part of the study that hasn’t gotten much attention, but should. It noted that people with insurance can obtain health care on a regular basis, so they lead healthier lives and live longer. The DOH estimated if Medicaid is expanded, within five years, 111 deaths could be prevented annually in Wyoming.

“So say goodbye to 111 people in the group behind me, you don’t have to imagine them anymore; you can pretend they didn’t exist,” I said. “Next year, forget about another 111. And then another …”

I told them my story: Fired a year ago, I lost my health insurance and couldn’t afford COBRA coverage. When I tried to sign up for Obamacare, I was told my wife and I couldn’t get Medicaid because of Wyoming’s decision, and we weren’t eligible for ACA subsidies. Our only choice was to buy health insurance for $1,300 a month. It was the cheapest plan available.

But later that week I learned from a Medicaid official in Denver that our income is close to the federal poverty level figure that could trigger the subsidies. If my wife and I can make a little more money – which we certainly plan to – we can get a better insurance plan that would only cost us about $30 a month. The plan we would have been charged $1,300 a month for would likely be free.

So a childless adult can be so poor he or she would qualify for Medicaid – but can’t enroll because of Wyoming’s callous decision – and would not get a subsidy, either. Reach the magic income level, though, and the insurance becomes incredibly inexpensive.

That doesn’t make any sense to me. I hope it didn’t to the committee, either, because it’s a real-life example of how messed up this system is, and that was the message I wanted to send – along with the fact that their political games to destroy Obamacare are killing some of us, especially vulnerable workers stuck in minimum-wage and part-time jobs.

The committee still rejected Medicaid expansion as the federal government now defines it, but did approve two watered-down bills that keep the issue alive. Co-Chairwoman Rep. Elaine Harvey (R-Lovell) told The Associated Press there is a tremendous amount of interest in Medicaid expansion throughout the state. In fact, while the hearing was in session, scores of citizens rallied outside the Herschler Building in Cheyenne to show how upset they are at Mead and the Legislature over the issue.

“I think it is the responsibility of this committee to bring it forward for a full legislative discussion,” she said. “I would hate to think that 12 people would decide for the whole state to not do any kind of Medicaid expansion at all.”

I would, too. The entire Legislature has nearly a month before the budget session begins to prepare for that debate by learning why Medicaid expansion is vital to the state’s health, and while the compromise bills would help some people, they wouldn’t be remotely as effective as the expansion planned under the Affordable Care Act. I’ll explain why in another column.

— Veteran Wyoming journalist Kerry Drake is the editor-in-chief of The Casper Citizen, a nonprofit, online community newspaper. It can be viewed at www.caspercitizen.com.

— Columns are the signed perspective of the author, and do not necessarily reflect the views of WyoFile’s staff, board of directors or its supporters. WyoFile welcomes guest columns and op-ed pieces from all points of view. If you’d like to write a guest column for WyoFile, please contact WyoFile editor-in-chief Dustin Bleizeffer at dustin@wyofile.com.

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Kerry Drake

Veteran Wyoming journalist Kerry Drake has covered Wyoming for more than four decades, previously as a reporter and editor for the Wyoming Tribune-Eagle and Casper Star-Tribune. He lives in Cheyenne and...

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  1. You are correct, Cecil–but they will never get it–the insurance card is a symbol of being insured, it does not afford you care.

    Dewey. Your mentality–shared by many as this country drifts toward government dependency and loses it’s foundation of self reliance–IS the problem.

    And cut the crap/progressive talking point on “we are paying for it now”. Under Obama does not care there are now 3 million more folks uninsured than a month ago. that number will swell by tens of millions in the coming year. Who is paying for their visits to ERs? And folks who with hope grab some policy with a deductible double or triple their previous–who will pay when they need services and don’t have the money to pay the deductible (promised not to go up–another lie.) Millions will lose jobs, not get hired or see their hours cut to 29–that does not cost us all? And finally, millions upon millions will curtail other expenditures as they struggle to pay doubled or more premiums (another lie)…affecting the overall economy and millions more. Who pays that cost?

    In the last article I gave you five bullet points on how to simply, and comprehensively begin fixing this system, lowering costs, providing greater access, covering the uninsured, providing the safety net for those deserving of it, and keeping the goodies of Obama does not care–as paltry as they are relative to the rest of the fiasco. Aint that how this tub of lard was fraudulently sold? You scoffed and ignored. Re-read them.

    And as for the single other salient comment in your continuing math/reality unconscious diatribe–damn right I don’t want to pay for your health care–nor have I asked you to pay for mine. Let’s separate the your sense of social justice (spelled green rings) from real need, shall we? Someone old, sick, or truly unable to provide for themselves deserves a helping hand, and my hand is there–always has been, always will be. Putting aside coverage of existing conditions, etc. which have merit, someone, like yourself who is perfectly capable of working (and apparently has the time judging by your incessant posting) deserves nothing. You want a hand–look at the end of your arm. Welcome to America. Don’t like it? Move to Britain where NHS can coddle, then kill you.

  2. at the cost of Wyoming people thinking for themselves. but then how can anyone admit to being a republican or democrat these days.

  3. Succinctly, tomorrow the sun rises over the Tetons and sets to the east of Newcastle and everyone has a single payer, government provided, “health insurance”.
    Now the big question, who provides the medical care and at what cost?
    Do Not confuse “health insurance” with “medical care”.

  4. the one-payer system would work best in low population states, and the multi insurance payer works best in high pop. states.

  5. Wow, Reid, your rightwing ranting is way over the top from the topic at hand, which is Healthcare in Wyoming. I am not the issue. I would apologize to you for calling you a name, but I just read back thru my posts and I see no name calling. Please point that out to me. What did call you exactly ?

    National Public Radio ran an incisive piece on Tuesday that described Wyoming’s situation to a T…being among those states ( all red, all Republican governors ) that have rejected adopting Medicaid Expansion as a component of ACA. The net result as Kerry Drake so eloquently describes and I second is that those states will suffer mightily. ACA was designed from the getgo to insure the uninsured, but it backfired badly …mor ep[eople are losing insurance altogether, and in the states like Wyoming that will not step up medicaid to cover their own unisured, everything that was bad before gets worse. This is NOT due to OCA or Obama, it is the fallout of Big Insurance jacking the system and heaving folks over the rail, and the State s right there helping the, It’s that ” market solution” you so love, at work, on the ground. ACA was written tof abvor private insurance and increase their pool and get everyone under the umbrella, bt instead Big Insurance severed thousand upon thousands of insurees and have just walked away off from ACA in Wyoming where Medicaid will not be expanded. Will the federal insurance exchange work for those folks. No. Becuase it depends on insurance companies having plans and programs available in Wyoming. They do not. Your market solution is draconian. Run by some guy we better know as the Grim Reaper.

    IUt is aboput the money , as you say . Yet you propose NOTHING that will lower costs and reign in the greed and oppression of For Profit medicine. What I ehar you promoting can only lead to a degradation of Wyoming helathcare and will increase, not decrease, the number of uninsured. My local Cody hospital is scared of ACA if Wyoming does NOT adopt Medicaid Expansion…emergency room visits to West Park Hospital will increase, available funding for indigent care will decrease, and the bad situation gets worse. It’s right there on the front page of the Cody Enterprise… if the ACA remains law but Wyoming does not adopt Medicaid Expansion ,we slide backwards and everybody’s bills go up, and up, an up. Got a remedy for that .

    YOUR problem is you hate paying anything towards someone else’s healthcare costs, period. Somehow that is totalitarian socialized medicine to you , no matte r if it’s a dime, a dollar or a hundred dollars of your own insurance premium and payroll taxes. But guess what , Reid, you already are paying for everyone’s healthcare. Your own private insurance has a buffer in its premium to go towards indigent care and extraneous costs. You are already enrolled in a socialized medicine system . It’s just disguised as free market. But if it walks like a wounded duck, quacks like a wounded duck , it must be a wounded duck whose care will be paid for by all of us even if the duck has no insurance.

    I’d love to hear you explain away Big Insurance’s built-in profit margin and greed as being helpful in reducing healthcare costs. I’d also like to hear you explain why insurance companies denying coverage for preexisting conditions is being helpful. I’d like to hear from you why an insurance agent’s marching orders for a handling a claim start out with trying to deny that claim from the outset.

    I’d really like to hear you explain in no uncertain terms why Wyoming should not adopt medicaid Expansion in full if it does in fact lower the state’s costs and cover the uninsured without consideration for preexisting conditions and allows our state medical facilities to breathe easier and maintain level of service. The only reason to oppose medicaid Expansion seem to be either rhetorical or ideological. They are not grounded in financial reality. And since lives are at stake, if you don’t mind I will go with the reality on the ground instead of the right wing talking points and scaremongering and hyperbole.

    Wyoming needs Medicaid Expansion and the ACA more than any other state , near as I can tell. Now.

  6. DeweyV

    Your problem is not with health care. You begrudge profits and capitalism. You simply do not like anyone, or anything that you perceive is somehow better off than you. That you cloak this disdain and envy in name calling is self evident. You would prefer universal mediocrity administered by far off faceless folks you don’t know so long as they were from the coddling (lying, self serving, power hungry and corrupt) government you worship and no one else was “getting ahead”. That is your choice. I believe otherwise. That is my choice.

    Obama care is so far from a market solution as to be absurd. Price fixing with government complicity? limitation on competition? mandates on personal and business activities and choices? Insurance companies–in a dazzling display of dirty crony capitalism–guaranteed no losses? What is wrong with health care is not health care–it is the filthy, incompetent self serving fingers of government in the provision, approval, “funding” and over control of the health care sector. You scream and shout for the single payer–yet, like socialism and communism, there is not a single TRUE example of it’s cost efficient success, ever.

  7. Sorry , Reid, but your continued insistence that a For Profit market solution is the best path to healthcare in the USA , cannot be justified .

    Observation shows in no uncertain way that the medical market solution …isn’t. It has become the problem.

    I reiterate: America needs a vaccine for greed. Rightwing Conservatives should get the first innoculations , since to them ” personal responsibility” is a euphemism for that greed. Our healthcare system runs on greed from basement to penthouse. That has to change. People’s bodies are not a fungible commodity to be bought, sold or brokered, nor is their health a package unit in the service sector. Why is such a large percentage of personal bankruptcy in America due to medical bills ? Do you deny that America’s performance in providing healthcare to its citizens, the abyssmal moving average of success with that healthcare across the board and inconsistent medical practices , is not somehow hard coupled to our singular system alone in the world of doing medicine for money rather than health ? As much as you hate government, I stand hard on the fact that the private sector is the larger villain.

    It sure looks to me like Obamacare is a market solution , for profit since the Insurance companies still get everything they want and a larger pool to draw blood from. I’ve heard Obamacare described as selling out to or appeasing Big Insurance and medical consortiums in order to get the bill passed. In doing so it became a bad government mandated ( but not government run ) enterprise solution to healthcare on top of a much worse for profit corrupt private healthcare system. The best of both ” worsts”.

    Which is why I say we need to trash to whole system, show the money grubbers to the door, and start over. When Kerry Drake went to Cheyenne and told our policymakers his tale of medical misfeasance, that was a step in the right direction.

    Maybe you should show your face at those hearings and lay it on as thick as you do here. Somewhere besides AM rightwing talk radio blathering.

  8. Gwarnock–you wrote, “The Right, and some on the Left, are the ‘I got Mine And I Need More’ advocates, the rest of us just want government to work for All of us, like our founding fathers intended, “of the people, by the people, for the people!”
    We agree. There is only one way to accomplish that mutual end–less government. You refer to the Founders. Their vision was not an overbearing, uncaring, corrupt Federal machine. We agree also on the tilted playing field of costs/benefits that existed prior to Obama Does Not Care. Again–that wobbly system grew from previous government interventions and crony capitalism–Obama Does Not Care merely exponentially exacerbates those problems and creates many others–because the ACA is NOT about health care.

    DeweyV–Medicaid D is no less abhorrent, though slightly less corrupt, than Obama Does Not Care. Understand my position clearly–The smaller the government finger in any pie, the better the recipe, and the more pie there is for the folks–with far less waste of, and tampering with the ingredients. “That government which governs least, governs best” Henry David Thoreau. And while you may or may not be right on the Koch Bros.–the truth , as you well know, is that there are just as many “Kochs” on the left…SEIU, AFLCIO, Imel, Buffet and Soros to name just some, who mutually fawn with/over the Admin and Dems in congress. The answer here is to strip them of their power (not their money–but the use of it) through constitutional amendments regarding taxation, lobbying, campaign contributions, term limits, etc. Ironically those big steps will also pave the way for a functioning, true market health care system, and many other wrongs which need righting (no pun intended).

    To both of you–the invitation was made to check out the articles on NHS directly form British sources–let me assist:
    http://www.telegraph.co.uk/health/nhs/10387187/NHS-faces-bankruptcy-over-ageing-population.html

    http://www.wsws.org/en/articles/2013/10/19/heal-o19.html

    http://www.theguardian.com/society/nhs

    the last is a compendium of many British articles. Open your eyes. In fact I read many left leaning dribbles. And many “mainstream” sources, including the economist. I also read the right leaning spews, like Beck, on a selective basis. At various times a point is better stated by one or the other, regardless of slant. We are all bright enough to sort most of the wheat from the chafe, regardless of source, are we not? You would do well to read, rather than decry right leaning sources. Somewhere in the maze of information twisted by all (or in the case of MSM, purposefully ignored) is the truth.

  9. Reid- don;t ever try to get me to read The Blaze .com or any other certifiable rightwing dogma tripe. It takes your credibility down below zero. The Blaze online and its silly TV channel are utterly discounted. Glenn Beck wears no clothes.

    Since you insist on dragging me there, let me respond with an article in the Toronto Star from just across the river from Detroit. By Ralph Nader ( I’m sure you are a fan ) , comparing the US – ACA and Canadian systems. I do not support Obamacare, but I totally decry the present system or any expansion of For Profit Big Medicine in the US that discriminates by ability to pay . That needs to come out of the equations. Canada still does that.
    http://www.thestar.com/opinion/commentary/2014/01/12/canadian_health_care_better_than_obamacare.html

    When as the last time you read The Economist ? Seems like you live exclusively in Rightwingtopia. Not healthy.

    I’m curious what your opinion might be on the big Bush-Cheney medical initiative c. 2006 , Medicare Part D and its infamous ” donut hole” for prescription drugs ? D can cost an individual in Wyoming an addiitonal $ 40- $105 per month and comes with a whole lotta strings attached. But Republicans thought it was just peachy ‘cuz their friends in Big Pharma got the requisite largesse, just from different payment plans. I still get certain non-Rx drugs from Canada when I can because the same stuff bought in Cranbrook or Nelson B.C costs me a third of what it does in the US. My friends in BC tell me their RX drugs cost far less than US…the come down here to buy groceries and stuff, but don’t go near the pharmacies. Same drugs, same makers, just different point of sale. The gap is even more pronounced south of the border. The difference? Greed.

    We gotta get a vaccine for greed , and innoculate Wall Street with it. otherwise, any talk of reforming the American healthcare system, is wasted breath. You waste a lot of it, defending the ” market solution”.

  10. “political games to destroy Obamacare”,
    That is it in a nut shell, ALEC Mead is following the “prepared legislation” of ALEC and their co-sponger The State Policy Network — The Powerful Right-Wing Network Helping to Hijack State Politics and Government, (Wyoming)
    Mr. Reid Lance Rosenthal’s links to News Max and The Blaze is another joke, a right wing hate site and a “to crazy for Fox” host, Glen Beck.
    Employer based healthcare worked 50 years ago, hence the Conservative bias, but as failed this country since, slowly but surly, today if you can’t maintain a steady and gainful employment you are screwed, and I do not mean WalMart taxpayer subsidized employment either.
    If the ACA is not the right path then fix the damn thing!!
    Our government gave us Social Security, Medicare, Medicaid, all to the chagrin of the Right, even though the “keep your gobmint hands off my Medicare” crowd doesn’t understand that, and these programs Work!!
    Just because we elected the “Black guy to the White House” Twice, Does Not give the Right, the right to penalize us for doing so!
    The Rights Ringleaders The Koch (Tea) Party has one agenda and one agenda only, to make themselves richer, and the rest of us subservient to their wishes, and when the puppets of these masters realize that they are fodder for the .01% too, it will be to late!
    The Right, and some on the Left, are the “I got Mine And I Need More” advocates, the rest of us just want government to work for All of us, like our founding fathers intended, “of the people, by the people, for the people!
    Note: quit spending/ wasting money on fake anti-Obamacare votes, and $24 Billion on the “government shutdown”! The “job creators” have had banner profits and record bonuses for the last 3 years, plus,, where are the jobs?

  11. why can’t wyo. have its own single payer system? that is the problem that needs to be solved for the future.

  12. Lioness–your misunderstanding of the Wyoming real estate market (demand), a function of net in-migration (folks voting with their feet for Wyoming) is remarkable. So, too, is your cherry picking statistics–what about comparative unemployment rates, cost of living indexes, economic freedom, ease of beginning a business, state government fiscal stability, lack of income tax, and a host of other economic factors which contribute to quality of life?

    DeweyV–incorrigible but consistent. Single payer is the answer, you say? In the previous article you pointed to Canada and the UK? Canada is dismantling it’s centralized system, affording greater and great latitude to the Provinces, with increases in service quality, and reduction of costs. The UK? Phew. read just these articles. There are thousands more–a score a week in English media sources and a growing clamor to repeal,/significantly revise their NHS, should you care to check–and by all means–go direct to the many English sources out there:

    http://www.theblaze.com/stories/2013/07/12/so-much-harm-to-patients-british-doctors-describe-nhs-as-worse-than-communist-china/

    http://www.theblaze.com/stories/2012/12/10/u-k-politician-gives-gut-wrenching-account-of-husbands-final-treatment-by-nhs-normalization-of-cruelty/

    Daddy’s Girl–I am glad we agree that Liar in Chief does not have legal or constitutional authority to change Obama Does Not Care–or any other law. Perhaps you might explain, then, your position on his seventeen (fourteen material) unilateral waves of the imperial wand relating to Obama care. Those are ok? Far more important than health care is freedom. Our liberties flow from and are protected by, the constitution. Each chip in that collective armor by the acts or lack of acts of this, or any president/government “official” (our supposed fiduciaries) is a lessening of the rights and protections of us all–no exceptions

    RBD is correct. This is far bigger than simply Dem or Repub, Liberal or Conservative. Apparently you all believe that the funding pit is bottomless, that fiscal stability does not enter into the equation of health or quality of life. As I attempted to demonstrate in the previous post (Obama care allows for collection of your medical costs under medicaid from your heirs) in the end the government has only two sources of revenue–your pocket and your property. Given the examples of Canada and England, the woeful state of finances in other social “democracies”, and after the last fifty plus years of government waste, fraud, abuse, incompetence in virtually any undertaking in this government, do you really think in your heart of hearts that it is government that is best suited to doling out health care, decreasing costs, maintaining access and quality? Given the irrefutable lies, subterfuge, and concealment of this administration (NSA, IRS, Benghazi, the video”, no taxes on those under 200k, you can keep your doctor, you can keep your policy, the program will cost 900 billion, and the list is endless and continuing daily) do you really think you can believe their projections–or promises to you or the state of Wyoming?

  13. I find it interesting – ok, maybe not so interesting or surprising – that those of us challenging the underlying assumptions and misconceptions of the ACA are called racists, economic terrorists……and the list goes on. But I have learned a few new words.

    I really do not care if it is the democrat plan or the republican plan – it is fiscally unsustainable. You cannot continue to spend money this country does not have – you cannot continue to put the burden on a minority of the country to fund the ACA and other entitlement programs. At some point, the well is going to run dry. Again, let me be clear, I do not care what political party drafted/imposed the ACA, their color, their age, the wealth or lack thereof – it is bad law and unsustainable.

    Does health care need to be fixed? Sure, costs are out of control, access is difficult. Could the ACA be part of the answer? Sure, it is one facet of a much larger and complex problem and getting more people on health insurance is a good first step. But the ACA, as enacted, is bad law with many unintended consequences. Some of those unintended consequences are apparent, some are yet to come.

    This country is founded on good debate, good discussion. We are not all sheep, following the good orator who promised change. Call me names, debunk me, play the shell game and shift the argument to a personal attack, call us incessant, but I won’t drink the koolaid. The law is flawed and we are all going to pay for it someday.

    Daddy’s Girl, you might want to educate yourself on how laws are written and interpreted in this country. The Supreme Court ruled on the legality of the law as drafted and passed by the Obama administration. Don’t pass the buck and blame the court for a poorly written law. If the law is so good and well written, we would not need all of these executive orders to fix it. Take a minute, step back and forget whether the ACA is republican or democrat. The underlying language, inconsistencies in the 2,300 page document is and of itself flawed. A law written by very young staff people with little or no experience in the real world. A law twisted with political maneuvering not necessarily focused on providing a solution for health care, but creating more entitlements. A law focused on pandering to the entitlement society.

    Take a minute, review Mr. Obama’s numerous executive orders. Mr. Obama could quickly fix the problem with an Executive order. He fixed the cancellation of existing policies, delayed the small business mandate and the list goes on. One stoke of the pen……..

  14. Mr DeweyV, please take a deep breath and be calm. It will help your blood pressure. I do not want to cause you any further deterioration in your physical state by my comments and the preceding advice might ameliorate your situation. By you comment I am accused of crimes against humanity, being a racist and finally a “rabeler” (perhaps you can define that for me).
    With regard to the first accusation there are millions of health care providers that are as surprised as me. As to the second “can the pot call the kettle black?” Finally, I equate being a “rabeler” with “borogove” and if so I plead guilty.
    As you stated “The solution to my mind is to scrap the entire American healthcare system , raze the edifice from dungeon to penthouse, and start over with Single Payer Public Option in one swoop.” With that diagnosis I offer the following:
    Take two aspirin and see me in the morning.

  15. Kerry,

    Love your chutzpa… You are spot on about Wyoming’s inane recalcitrance to expand Medicaid to those who truly deserve and need it. I was shocked that this opportunity was missed (by Governor Matt Mead and the last Wyoming Legislature), at the outset, and suspect it will go down again in our upcoming Wyoming Legislature’s Budget Session, if it even sees the light of day for a whole House and Senate vote. Social Darwinism lives and thrives in Wyoming. Blaming the victim is the oldest, most cynical sport in conservative America. If you’re down… So what? Pick yourself up by your own bootstraps, even if you can’t bend over to tie your shoes.

    I knew Senator Charlie Scott (R-Natrona) when he and fellow Republican Senator Irene Devin (R-Albany) would come to Ivinson Memorial Hospital in Laramie to push their compassionate bills… bills that helped the unfortunate. As the then-Public Relations Coordinator there, I helped coordinate their luncheon-talks and came to admire both of them, greatly. Where has the Charlie Scott I knew gone? He is not the same man who wrote legislation to educate young single mothers on how to do a better job of caring for their babies and young children. Was the sad loss of his wife the cause of this obvious transformation? His father was a medical doctor, and he has two Harvard degrees. When did this mean-spiritedness begin?

    Robert Hopkins is spot on, except for one thing. Wyoming does not simply need a “Moral Monday” movement. It needs a 24/7, Monday-Sunday “Moral Week” movement. I too have been a victim of this state’s callousness. As a single woman with three accredited college degrees, including one Ivy League university, I now struggle with two serious disabilities that the federal government calls “permanently and totally disabling.” When I needed Wyoming Medicaid, just for a while, to fill the gap until I could have health care through Medicare, I was turned down. Childless individuals need not apply, I was told. After working 35 years, while attending graduate school part-time, I struggled to keep my head above water, with my eye on a Ph.D., which I did obtain after many hard, long years of sleepless nights and stressful days.

    I don’t need Medicaid now, as I collect a pension and full Social Security, but when I was in dire straights, the Wyoming Dept. of Family Services yawned, lacked sympathy, and did not point me to programs, such as HUD Section 8, that would have helped with housing costs. I reported their deficiencies to the then-head of WDFS, and several social workers were taken to the wood-shed.

    Those of you who believe that social programs make parasites out of those of us in true need might walk in our moccasins for just one day.

    And Kerry… PLEASE try tele-commuting Websites. With your decades of journalistic experience, high level of investigative reporting, superb writing and editing talent, reams of completed work for an outstanding portfolio… You could remain in Wyoming and do contract writing/editing or freelance writing/editing. I see Forbes and The Atlantic in your future. One of the best Websites for locating tele-commuting positions is FlexJobs… They screen for scams and list only legitimate employers… https://www.flexjobs.com/Members/Flexers/Register.aspx

    Wyoming has some of the worst social conditions in the United States, e.g., the highest suicide rate of all 50 states. New Jersey is dead last, with the lowest suicide rate. Go figure… With all the scenic beauty of the Cowboy State, you would think people would be lined up to move here. Not… except when they smell oil and natural gas, trona, and coal… and when those high-paying jobs end, they scoot out of their tiny house trailers back to homes in other states that feel like home. Shame on Wyoming. Bless those who speak out. If this state is going to change, it will take compassionate natives like Kerry to make it happen.

  16. Those here of the right wing persuasion who are con-damning the Affordable Care Act and Wyoming’s oppressive reluctance to expand Medicaid are arguing instead that somehow our American medical system ” market solution ” is fine and no government assistance can ever do better than good ole’ capitalism and private industry in assuring we can all draw breath another day.

    Which is utterly patently absurd and flies in the face of the factuality when comparing American health care to the rest of the world for quantifiable medical results, ease of accessibility to the general population, and total cost per capita whether by taxation , insurance premium , or out of pocket. America fails at all of those in any side by side comparison.

    The message that Kerry Drake and countless others are attempting to lay at the feet of policy makers is a simple one. It’s not that the quality of overall health care is bad in Wyoming and the USA, but the way that care is parsed out to citizens . Most importantly the costs are completely out of control. The American medical ” market solution ” is a monster.

    Yet the conservative small government ideologists and the far right ‘ gubbamint haters’ defend the beast that must be fed with exponentially increasing amounts of vast bulks of money. The gluttonous beast has three heads: Big Medicine, Big Pharma, Big Insurance. These rabid anti- Obamacare anti-Medicaid Expansion anti-socialized medicine provocateurs refuse to consider the dignity of life and well being of the people as being more worthy than return on investment. Which to my mind is either sinful or criminal depending on which book of laws you care to throw at it. I’m sorry, but when it comes to people’s lives and health , there is no place at the table for the worship of money. For Profit Medicine is a crime against humanity.

    Today as I write this, 1/6th of the gross national product of the USA is buying into or selling from helathcare. That will rise to 1/3rd of our total economic engine in the coming 15 years. The nation cannot survive that . So much for the ” Market Solution ” . American healthcare could very well die of its own gross obesity, and bring down the rest of the country .

    Yet the rabelers ( you know who you are here ) propose no solutions or betterments or alternatives that will lower medical costs nationwide , statewide, or locally. Just more of same and oh by the say screw Obama. Tom Bell is spot on here. If the Affordable Care Act were also known as McCainCare and Sarah Pallin was the spokesmodel for it, the Republicans would say it was holy scripture. Just like their abyssmal Bush-Cheney spawned Medicare Part D rollout back in 2006 was the greatest thing since low-dose aspirin. The unspoken resistance and rabble against ACA is racist. Black president. White outrage at it. I can see that plainly on the political CT scans

    The solution to my mind is to scrap the entire American healthcare system , raze the edifice from dungeon to penthouse, and start over with Single Payer Public Option in one swoop.
    *
    A shout out to Daddy’s Girl for teaching me a new word in this discussion : pettifoggers. There certainly is a lot of that succulent definition at work here emanating from the ACA/Medicaid Expansion detractors. Pettifoggery, indeed! .

  17. I shouldn’t have to repeat this to you, rbd. The Supreme Court created the gap. Presidential executive orders are subject to judicial review. The Supreme Court has already reviewed the law. The president can’t change anything that has already been reviewed.
    Another tactic of the right-wing: make junk up.

  18. Again–RBD is right on. But, suuuuurpriiiiise, Daddy’s Girl, Robert and Kerry. Careful what you wish for. Did you know that under Obama Does Not Care–and the supervision of HHS–your heirs will repay the state for your medical if received via medicaid? And almost a million bucks in exclusions from assets in qualifying (no doubt so those assets can be taken by the state in repay down the road) Neither did I. No end to the goodies in here by the Dems and president who care soooooooooooo much about the little guys, and good health care for all. Rubbish. Enjoy (and perhaps step out of that ideology cocoon you folks wrap yourselves in and think): http://www.newsmax.com/Newsfront/obamacare-medicaid-healthcare-costs/2014/01/15/id/547232?ns_mail_uid=3915178&ns_mail_job=1553431_01152014&promo_code=163C4-1

  19. “We are not just going to be waiting for legislation in order to make sure that we’re providing Americans the kind of help that they need…….I’ve got a pen, and I’ve got a phone. And I can use that pen to sign executive orders and take executive actions … and I’ve got a phone that allows me to convene Americans from every walk of life”

    And there you go. Please pick up the phone, call Mr. Obama and he will fix the Medicaid gap. Simple and just another day in America, just another executive order.

    But, the President will not fix this with his executive authority because he chooses to play politics and with sleight of hand, passes it off as the Republican’s not be cooperative.

    There you go Daddy’s Girl, one simple stroke of the pen and your problem is solved – Medicaid for the masses, regardless of what the State will do.

  20. The Jackson Hole News & Guide this morning had an interesting story about right wing rich man Foster Friess’ views on how to dismantle Obam(ney)care–get more rich people pushing on politicians to repeal it.

    “The politicians he knows don’t respond to emails, letters or phone calls from constituents, he said. They respond to donors.”

    http://www.jhnewsandguide.com/news/health/friess-talks-health-care-reform/article_22c1986a-c15e-5daa-b69f-fdef5395be2b.html

    We should pay close attention to the meaning and threat of the above quotation.

    RH

  21. To the incessant arguers:
    It is not up to me or Mr. Drake or anyone else to answer your questions, because if you would read the columns and comments you would already know those answers. You do not pay attention, you muddy the waters with your pettifoggery, and you believe dollars are more important than people’s lives and health. If you want to know answers about dollar amounts, look them up yourselves. And then ask yourselves why you value money over people’s lives and health. Here is your answer: You only care about your ideology.

    No matter how many times you are debunked, you continue to argue. It is apparent you only want to confuse people with your constant barrage. It is a common tactic right-wingers employ — not sticking to the facts, changing the subject, splitting hairs, being heartless.

  22. Tom–
    Social Security is 46-56 TRILLION under water projected by CBO , SS Trustees, and SS actuaries. If that is a success–what exactly is your definition of failure?

    Daddy’s Girl–
    Obama Does Not Care CREATED this gap, among many others–not the states. And contrary to knowingly false promises, there now 4 million more uninsured (taking as true the lies of 2 million sign ups) then before the law. That will increase by tens of millions next year (Per IRS study, no less). If you had a shiny new car that looked good on the outside, and you discovered the engine was a lemon–unfixable, a money drain, and could cause the deaths of others on the highway–would you not get a new car?

  23. Daddy’s Girl: Instead of incessantly complaining about those asking the questions about the 10% to be incurred, how about educating yourself on what that amount might be and the unknown future ramifications. Unfortunately, nobody wants to answer that question. I suspect the reason nobody is answering the question is it will quickly exceed any projected savings by the State adopting ACA and ultimately cost the people of this state far more than anybody anticipates.

    The same mentality clamoring to adopt the ACA – adopt it now, maybe save a few dollars today – worry about the true costs tomorrow is what is driving this country into bankruptcy. Those like Mr. Bell calling Social Security a success ignore the pyramid scheme Social Security really is. Sorry, one arm of the government borrowing money from another arm of the government and calling it a trust fund is seriously out of touch with reality.

    As done numerous times through this debacle called ACA/ObamaCare, the President could easily issue an executive order and mandate the Medicaid gap be closed and bring on those caught in the politics of Washington. It is easier to let these people dangle than properly take care of them. There is more political wealth in using folks caught in this gap than actually fixing it.

    Perfect example of the over use of the Executive order function – after lying to the American people they could keep their existing plan – only to find out he knew millions would lose their plans early on – Obama issues an Executive Order providing that people can keep their plan. But he cannot issue an Executive Order to fix this Medicaid gap? Who is really playing politics………

  24. Dear Mr. Drake,
    In your column you reference a study regarding deaths attributable to WY DOH, paraphrasing, 111 deaths in WY to not expanding Medicaid to the new Federal recommendations. It is important to note that this study could not put any mortality figures on what would happen with this increase in Medicaid patients in view of the availability of healthcare. As of 8/12, 99% of WY physicians do not participate in Medicaid.
    From Kaiser Health News 8/8/2012: New Jersey had the nation’s lowest rate of non-participation at 40 percent, while Wyoming had the highest, at 99 percent, according to a survey last year of doctors by the U.S. Centers for Disease Control and Prevention.
    My point, and it is not to denigrate your personal situation , is that the ACA and the decision to increase Medicaid to 133% of the poverty rate is a political ploy nothing more, nothing less.
    Once Health Care becomes run by the government, what ox is next to be gored? Should the government demand that groceries should not exceed a pre-determined cost? Certainly food is a necessity for life. Then we can move onto housing. Why should another family live in a better house?
    What you are editorializing for is redistribution of income, interestingly not redistribution of wealth. You want those paying income taxes to support your choices, not those who have wealth; i.e. Gates, Buffet Kennedyc,etc. and a myriad of other who protect their assets through Trusts rather than subject their incomes to the taxes the great majority of US citizens pay.
    I sincerely hope that you are not a person who is complacent with a political elite running this country; who will give you” a piece of bread”, in return of your vote. Would you be writing these columns regarding Medicaid in WY if you had health insurance?
    WY opted out of the Medicaid option as per the Supreme Court as per their ruling. It is disingenuous of you not to let your readers know that WY is in compliance with the US Supreme Court ruling. You may disagree with this ruling but it is the law of the land at this time.

  25. Well, you’ve done it again, Kerry – hit the nail right on the head. In spite of all the Republican haranguing against the Affordable Care Act, it is working and will eventually be very successful just as Social Security is today. What is so ironic to me is the fact that the while the concept of ACA was conceived in the Republican stronghold of the Heritage Society, the concept then put into practice by that great Republican Governor of Massachusetts Mitt Romney (where it is doing very well, thank you), then the concept was adopted by President Barack Obama and made into law by Congress, it was immediately repudiated by the Republicans. You can’t tell me there isn’t rampant racism in the Republicans. If it weren’t for that black guy in the White House, the concept would be embraced by the Republican establishment.

  26. Does health care need to be as expensive as it currently is? that is the Question?
    How do other countries provide better care for a lot less. when we answer that question the numbers work, regardless of calling it Obama-care or Romney care.

  27. “These are the working poor – the store clerks, day-care providers and janitors…”
    Mr. Drake you trot out the “working poor” as examples of those left behind. Don’t you understand that these are people who are least able to afford higher taxes necessary to pay for such programs?…and they will be asked to pay additional taxes if they are working.

    More Gov’t programs = more taxes for everyone. Without solving some of the basic problems in healthcare throwing more $$$ does nothing except help an inefficient corrupt system remain on life-support.

  28. RBD–

    Amen to your discourse. The problem is not the “callous” decisions of WY legislators thus far–it is the callous, mechanically unworkable, financially doomed and ideology driven Obama Does Not Care act, itself. Kerry continues to argue for a band aid to a fatal wreck not created by WY. Triage on a dead patient is doomed to fail. Relying on liars who illegally change law at whim, and spew false statistics and projections (not to mention continual, blatant, intentional fraud on their constituents–the American people) is simply cementing a bad result–for ALL of Wyoming’s residents.

    How many folks nation wide–not just WY–are being/will be materially adversely affected, and yes–die–due to lapse in other forms in coverage, rationing, narrowing of medical networks, elimination of drug coverage, reduction in medicare funding? How many will see their standard of living dramatically reduce due to extra costs (both premiums and deductibles) contrary to promises by Obama and crew?

    I would note Kerry has yet to report back to us on what he learned at the STATE Medicaid offices, or in his discussions with private brokers–both of those contacts suggested by several commenting on previous article, and if I remember correctly, acknowledged by Kerry with a “I will check it out and get back to you.”

  29. “Build support for Medicaid expansion based on the underlying needs and gap Obamacare created, not your typical one sided liberal slant.” — rbd

    That’s exactly what Mr. Drake is doing. He pointed out that of the 17,000+ people who would be covered under Medicaid expansion, 111 a year are projected to die due to the governor’s and legislators’ refusal to take the federal offer. The flimsy excuse, which rbd and other incessant commenters continue to allege, is that the federal government’s 100% funding will eventually drop to 90%. Apparently 111 people a year aren’t worth saving if the state has to pay 10%.
    And the gap was not created by Obamacare. The Supreme Court decided states could opt out, so that’s what most republican states did. No Democratic states opted out.
    Don’t forget that the plan that has been dubbed Obamacare originated with the right-wing Heritage Foundation and was first implemented by Republican Romney. It is the republicans’ own plan. But because our president is hated so intensely by republicans, they want to destroy everything he tries to do to help people. Yes, the ideological divide is wide and cannot be ignored. One side seeks to improve people’s lives, and republicans have chosen the opposite.

  30. If I may throw out some unsolicited advice, I would ask that you look at this issue in an unbiased manner and leave the politics at home. Take the time to really drill down on the true costs of the Obamacare, not just the projected savings over the next couple of years. Drill down on the long-term costs, the costs when the 10% cost sharing kicks in, drill down on the assumptions Obamacare used to project all of these “savings” the plan in general was going to provide. Let’s look at the entire package in a non-political approach vs the anti-republican/anti-democratic slant this issue has evolved into.

    Build support for Medicaid expansion based on the underlying needs and gap Obamacare created, not your typical one sided liberal slant.

    In reality, considering how many Executive Orders Mr. Obama has made regarding the ACA, this entire issue could be resolved with one Executive Order eliminating this Medicaid gap. Unfortunately, politics is getting in the way similar to how you claim politics is getting in the way of the State accepting the ACA. The President’s game of poker is leaving you hanging……..