At last, after throwing away $360 million, keeping almost 18,000 poor people from getting health insurance and putting several county hospitals in turmoil from lack of payment for care, opponents of Medicaid expansion have finally revealed their alternative plan to save Wyoming’s health care system.
They don’t have one! Three years after first rejecting the program’s expansion to cover extremely low-income, childless adults — the state’s working poor — the geniuses who run the Wyoming Legislature haven’t presented a single idea for consideration.
They don’t even pretend anymore that they’ll try to find the elusive “Wyoming solution” to the state’s health care crisis they supposedly sought. As far as conservative Republicans are concerned, it’s a dead issue. Even if they sponsored a bill, it would be guaranteed to fail next year because there’s no way it could obtain the two-thirds support needed in both chambers to be introduced during a budget session.
In fact, the only legislators working on the issue at all are members of the Joint Labor, Health and Social Services Interim Committee. The committee is contemplating a last-ditch, stop-gap effort to provide a modicum of financial relief — what could amount to a local tax hike — to county hospitals who otherwise might have to close their doors.
I’ll give them an “A” for effort, but considering how much money the Legislature has squandered that could have been spent on health care and keeping hospitals afloat, it’s a crazy idea. This can’t be the best Wyoming can do.
The labor and health committee wants to expand counties’ authority to raise or shift more property tax revenue to keep hospitals operating. Wyoming’s hospitals now rack up more than $100 million a year in uncompensated care expenses. Expanding Medicaid would have helped reduce uncompensated care. Now some hospitals are so desperate for funding they’ll take anything they can get, which may be more taxes via local mill levies.
They can’t count on any additional tax money, though, because vindictive right-wing extremists who sank Medicaid expansion could easily nix the committee’s proposal, simply because they can. As fiscal conservatives, these legislators pledged not to raise taxes for any purpose, no matter how necessary it is to provide people adequate health care.
This is what all of the Republicans who axed Medicaid expansion don’t want you to know: Wyoming residents have already paid the federal taxes that would enable thousands to enroll for health insurance. The $360 million in federal funds our lawmakers have turned down since 2012 won’t help anyone in this state, but I’m sure residents of the 31 states that have expanded Medicaid are happy to divvy up the tax revenue that legislators decided we didn’t need.
Those lucky states should send a thank-you card to the Wyoming Legislature for making their good fortune possible.
There’s absolutely no reason Wyoming couldn’t have used the federal funds to stem the tide of monetary losses needlessly suffered by county hospitals. If the working poor were allowed to be on Medicaid it would reduce the frequency of expensive emergency rooms for routine health care. Instead they could visit physicians who can treat their illnesses and offer preventive care to keep them well.
But Wyoming can’t do that, because a majority of GOP legislators decided long ago they won’t allow any aspect of the Affordable Care Act (ACA) to succeed. If that means property owners must pony up more in local taxes — even though Wyoming residents have already paid to expand Medicaid — it’s a sacrifice these tax-hating lawmakers are happy to make.
And why shouldn’t they be? Wyoming politicians in charge are never punished for making stupid decisions, because Republicans are so used to voting straight-party tickets. It effectively means most elected Republicans can keep their seats for life.
So what if they foolishly reject hundreds of millions of dollars and prevent the poorest of our needy residents from staying healthy? They’ve already shown they don’t give a damn about fiscal responsibility or the Wyoming Department of Health estimate that not expanding Medicaid will result in the premature deaths of 111 residents per year.
Conservative lawmakers don’t feel responsible for having to bury family, friends and co-workers, because these deaths are just collateral damage in their must-win war on Obamacare. We have degenerated into such a heartless society that our out-of-control lawmakers aren’t held accountable by anyone.
The outrageous series of events that began with the Legislature’s first defeat of Medicaid expansion has now reached ridiculous heights.
It wasn’t enough for the majority to lie and claim its opposition was fueled by fear that the feds won’t keep their promise to fund at least 90 percent of expansion costs. Not one of the 31 expansion states has been cheated out of a dime in the program’s first three years. Cowboy State lawmakers have almost never told the feds to keep their money when it comes to other programs.
Legislators couldn’t just give the poor insurance coverage, even though the money to do so had already been collected. No, expansion opponents had to shame people who can’t afford insurance even though they work one or two minimum-wage jobs. The bizarre Tea Party contingent never thought any punishment the state dreamed up was severe enough on the working poor for having the audacity to need health care, so they killed Medicaid expansion anyway.
Lawmakers demanded a Wyoming Medicaid solution that was ultimately negotiated by the executive branch and the federal government. Republican Gov. Matt Mead told the Legislature it had to pass the SHARE plan because the state can no longer afford to turn down Medicaid expansion. The GOP leadership ignored his plea and could hardly wait to deep-six the only homegrown solution we’ll ever see.
GOP leaders like Sen. Eli Bebout (R-Riverton), the Senate Majority Floor Leader, kept up the charade that they would find a “Wyoming way” to improve our health care system. Bebout, who controls the Senate’s lawmaking agenda and chairs its appropriation committee, told his colleagues before they adjourned in March they had done the right thing. The Legislature had considered expanding Medicaid before, Bebout noted, but he claimed the timing was never right.
“I think being cautious, and doing it the Wyoming way, is the way we do things,” Bebout said.
But being cautious has absolutely nothing to do with throwing poor people under the bus, or wasting millions, or pretending to want a state healthcare solution when all the Legislature knew it would do is loudly register its disgust with and distrust of the president.
Instead of acting like statesmen and women, the Republicans who organized the attack on Medicaid expansion behaved like bozos. When you go to the polls next year, remember the shameful legacy of Medicaid opponents, and seriously consider voting for a Democrat or moderate Republican.
It’s important to remember not every Republican is at fault. In the Senate, all 19 members who voted to kill the bill were Republicans, but seven moderate GOP senators sided with the chamber’s four Democrats on the losing side.
Wyoming’s health care system is a mess after years of GOP leadership and its empty promises to fix it on the state’s terms. It’s way past time to take their power away and give others a chance to show what a combination of compassion and sensible, sane fiscal policies can do to make this a healthier state.
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