Wyoming legislators are about to bail out the hardest-working, most deserving people they can find in the state.
Unwilling to accept $125 million this year from the federal government — and the guarantee of millions more in the future — to enable some of the neediest residents of Wyoming to get health insurance, lawmakers realize they are in a bind.
It’s not that the above two factors are likely to cost them their jobs, because they decided to reject Medicaid expansion last year and didn’t pay any kind of penalty at the ballot box. In fact, they actually increased their ranks, as voters put in a few more far-right legislators who said they would do the same thing to “protect” Wyoming’s best interests.
So the Senate rejected Medicaid expansion for the second time earlier this month, even though state negotiators returned from Washington, D.C., with exactly the type of deal to obtain a Medicaid waiver the Legislature sent them to get. When Gov. Matt Mead embraced the tentative agreement, legislators rushed to pack it with so many untenable elements that it sank like a stone on the final vote, with only 11 of 30 senators willing to support it.
So they threw away millions of dollars at a time when the state’s revenues are down due to shrinking energy prices, and they turned a cold shoulder to a segment of the population that couldn’t afford to wine and dine them after their labors at the Capitol each day. There is no Wyoming Association of the Working Poor, so the Republican legislative leadership was patting itself on the back while drop-kicking them to the streets.
After all, they likely reasoned, the unique coalition that came together to support Medicaid expansion — businesses, the energy industry, health care associations, insurance companies, churches, educators, city and county officials — would forget their decision to throw the poor under the bus by the time the 2016 election rolls around.
Yes, voters would be so happy with their ability to save billions for a rainy day and constantly stick it to the federal government, legislators would be able to rake in donations from political action committees and once again trounce their token opposition.
But they forgot one key segment of Wyoming whose opinion of them does affect their political futures: the medical industry.
The Legislature’s rejection of Medicaid had an Achilles heel — the possible closure of several hospitals throughout the state. By not expanding the program to the working poor, which would curb their need to use expensive emergency care, lawmakers did nothing to keep hospitals from needing to write off millions of dollars each year in uncompensated charity care.
When the legislative session started last month, the Wyoming Hospital Association estimated its 27 members are losing a total of more than $100 million annually. Earlier, other officials suggested the total loss for all health care facilities in the state was closer to $200 million a year in uncompensated care.
Whatever the correct figure is, everyone agrees it’s an unsustainable situation for both large and small hospitals in Wyoming. Lack of Medicaid reimbursements has naturally hurt hospitals in the two largest cities, Cheyenne and Casper, the most in terms of overall dollars.
But these facilities have more resources available to help cut their losses, while smaller hospitals don’t offer as many special practices or have as many providers. That makes hospitals in communities that don’t have any other health care options the most vulnerable, and the hospital association reported to legislators that at least three small hospitals need immediate financial help to stay afloat.
If you want to see politicians truly panic, wait until hospitals in their districts begin to close their doors. Voters can put up with a lot of incompetence — our current Legislature is ample evidence of that — but they will not abide finding out they have to drive hundreds of miles to get medical care that had always been available at their local hospital.
People in this new leaky boat who haven’t been paying attention to what goes on at the Capitol will be startled to learn the Legislature’s decision not to expand Medicaid has already cost the state $226 million for the 2014-15 budget cycle, and if it sticks to its guns, an additional projected $265 million will be thrown away for 2016-18.
“How did this happen?” these reluctant, uninformed voters will ask. When they find out their access to medical care has been the victim of legislators’ gleeful opposition at any cost to President Barack Obama’s health care reform, any ideological support lawmakers may have received in the past to cover their backsides will quickly disappear in the Wyoming wind.
Once they make that discovery, it’s not much of a leap to find the other advantages Medicaid expansion would have already provided: reduced money spent on services to the poor, an economy improved by millions of dollars in federal funds being circulated and a projected 800 new jobs, mostly in the medical care industry. As uncompensated care is reduced, insurance premiums should stop rising and might even be lowered for everyone.
Let’s not forget the biggest improvement of all: a healthier community.
But the self-serving GOP leadership has a plan to bail themselves out by throwing a little money at the hospitals. It’s called Senate File 145, and it would provide $5 million to Wyoming hospitals to help with uncompensated care. Last week, the Senate beat back an attempt by Sen. Tony Ross (R-Cheyenne), co-chairman of the powerful Joint Appropriations Committee, to cut the funds to $2.5 million.
The Senate then passed SF 145 by a 19-11 vote. If it is approved by the House, two-third of the funds will be distributed to hospitals with 100 or fewer beds, and one-third to hospitals with more than 100 beds.
Sen. Ray Peterson (R-Cowley) sponsored the bill because he said the Senate has to do something to help the hospitals. He pointed out, though, that he couldn’t vote for Medicaid expansion
If he and at least four other GOP senators had mustered up enough courage to join the four Democrats and seven Republicans who did vote for expansion, there would be no need for SF 145. In fact, there’s really no need for the bill at all, because it’s the equivalent of throwing a small bucket of water on a fire when you need a full tanker truck to have any hope of quelling the blaze.
It’s difficult to predict what kind of reception SF 145 will have in the House, which has more crazies per capita than the Senate. Anything could happen once its Tea Party brigade enters the debate.
Like Obamacare opponents everywhere, many Wyoming Republicans are hoping the U.S. Supreme Court will save their hide and overturn a major portion of the law this summer. But most legal experts say the challenge brought by the far right is incredibly weak and predict the law will remain intact.
That leaves SF 145 — which should be titled the Politicians Bailout Bill of 2015 — to help the Legislature head off a potential disaster at the polls next year. But the truth is, the measure doesn’t contain remotely enough money to actually help Wyoming hospitals. It’s just a feel-good measure.
If there’s any group of people in the state who don’t deserve to feel good, it’s the 19 GOP senators who told Wyoming’s working poor to drop dead.
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