Wyoming let victims of one disaster go it alone

— May 06, 2014

Gov. Matt Mead (R) recently traveled to Jackson, where he did what all governors must do when disaster strikes. He donned a hard hat and was escorted to see the damage caused by a slow-moving landslide that destroyed homes and devastated businesses and forced residents to evacuate.

When he was done, he did what any good state chief executive would do. Mead expressed sympathy for the victims, and talked about the mutual effort it will take to fix things. Working together, the town, county, state and federal government will pool their resources and try to make the situation better, so people can get on with their lives.

He had no qualms at all about asking the federal government, through the Federal Emergency Management Agency (FEMA), for disaster relief. It’s what the agency is supposed to do, and in the post-Hurricane Katrina world, it usually does its job effectively. That’s what we all expect, because Wyoming pays its federal taxes to the government, and when a disaster hits, state officials ask the feds to come in and get involved.

There’s no worry that the U.S. government isn’t trustworthy enough to fulfill its commitment to assist the state. We know that because we rely on it for so much in Wyoming. The state takes federal money for all sorts of expensive projects, including public education, health and transportation infrastructure. The federal government helps pay for social services, to protect the environment and to manage wildlife, just to name a few.

Per capita, Wyoming receives more money from the federal government than any other state. For every dollar we pay in federal taxes, we get back $1.37 in federal spending. As WyoFile reporter Gregory Nickerson calculated in a May 13, 2013, feature story “Wyoming: Where independent people rely on federal funds,” the state used federal money for 41 percent of the state’s spending for the 2011-12 biennium.

Wyoming clearly has no problem sticking out its hand and asking Uncle Sam for money – with one notable exception. It’s also a response to a disaster, but a different kind; This one is man-made, and state officials could easily fix the situation, but have flatly refused to do so.

Maybe that’s because it’s relatively easy to visit a site and declare a disaster, but when health emergencies threaten some of our residents’ lives, it’s not as obvious. In the state’s failure to do what’s right and take federal funds to expand Medicaid so an estimated 17,600 of our poorest residents can have affordable health care, Mead and the Legislature ignored their responsibility to help people in need.

Make no mistake; the failure of Wyoming and 23 other states to accept Medicaid expansion and eliminate the gap that has cruelly affected so many has been a disaster. If thousands of Wyomingites suddenly fell into holes in the ground and couldn’t get out, state officials would use federal resources. Not one would fail to launch a rescue effort.

But the state turned its back on the thousands of people who fell into the Medicaid gap. Mead and the Legislature could easily pull them out, but they treat these citizens as not worthy of their help. These victims are forced to fend for themselves, perhaps even dying in the process, while state government moves on to tackle other problems.

The Medicaid gap was caused in states with Republican governors like Mead, who refused to take millions of federal dollars to expand the Medicaid program to include childless, low-income adults, who would be receiving such health coverage for the first time under provisions of the Affordable Care Act (ACA), better known as Obamacare.

Although Medicaid expansion is considered a key part of the ACA, the U.S. Supreme Court allowed states to opt out of expansion. Mead and most GOP governors suddenly were in a race to turn their backs on federal assistance.

What Mead did — blocking Medicaid expansion — needlessly put the 17,600 Wyoming residents in a terrible situation. They likely have minimum-wage jobs, but because they fell below the federal poverty line, these “working poor” didn’t qualify for other assistance available under Obamacare, including federal tax credits and subsidies.

So they were abandoned, because Republicans who gambled their political futures on Obamacare failing saw a great opportunity to kill it. These GOP officials didn’t hesitate to put the lives of the Medicaid gap victims on the line. Without adequate health care available through Medicaid, the Wyoming Department of Health estimates that within five years, at least 111 people will die annually.

They aren’t the only ones who have been put at risk by Republicans playing politics instead of helping people they were elected to serve. The future of the state’s entire health care system is on the line.

The vast majority of Medicaid-eligible people who can’t be added to Medicaid go to the nearest hospital’s emergency room when they need either basic health care or have a medical emergency. Since they can’t afford to pay for the care they receive, the hospital provides it as charity care. The millions of dollars Wyoming hospitals lose are passed on to patients who have insurance, and as a result, already high health care costs continue to soar into the stratosphere.

On February 18, I sat in a legislative committee room in the Capitol and watched Laramie County commissioner Buck Holmes plead with lawmakers to pass a bill to expand Medicaid. He noted under state law, Cheyenne Regional Medical Center has to take care of the poor and indigent, and it is losing $12 million a year in uncompensated care. That’s obviously unsustainable.

“[I]f we do not get some help for our hospital, we are going to have to increase our taxes at a local level,” Holmes said.

You might think a legislative panel comprised of seven GOP members and only two Democrats would perk up a bit at hearing their non-action will result in higher taxes for their constituents. After all, Wyoming Republicans are supposed to be united in their opposition to all new or increased taxes.

But Holmes’ warning was ignored, and the committee didn’t even bother to vote on the bill he favored. It died of natural causes – in this case, total Republican indifference. Apparently if it’s local and not state taxes being raised to solve a problem the Legislature could have fixed, they don’t care.

If they cared, Gov. Mead and state lawmakers would take the logical, fiscally responsible action and save $43 million a year, instead of doing nothing, which will make the state unnecessarily spend $80 million.

In January, when I testified in favor of Medicaid expansion at a joint legislative committee hearing, I asked legislators to imagine 17,600 people in line behind me, representing the additional people eligible for the program. Then I asked them to picture 111 people yanked from the line each year, because without adequate health care, they would die.

Today, I’ve asked officials to imagine the unfortunate 17,600 swallowed up by the earth unless they lift them out of this man-made gap they helped create.

Folks, I’m running out of analogies. I can come up with more, but they’re not going to help. If I could take Gov. Mead on a tour of the damage caused by his poor political gamble that Obamacare will fail, I would volunteer to do it. But that’s not possible, nor is it necessary. All the governor really needs to do is open his eyes and actually talk to some of the victims of his Medicaid decision, so he can finally recognize it as the disaster it is.

Then he can direct the Department of Health officials to begin negotiating a state plan with federal health officials to do everything they can to strike a deal, without insisting it be Wyoming’s way or the highway.

— Veteran Wyoming journalist Kerry Drake is a contributor to WyoHistory.org. He also moderates the WyPols blog.

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