Wyoming’s Medicaid killers: No heart and no sense

I can think of no better illustration how much people wanted to see Medicaid expansion in Wyoming — and how they were blatantly ignored — than the scene last Friday in the Capitol’s largest committee room.

The House Labor, Health and Social Services Committee heard testimony on House Bill 245, a measure designed to keep the Medicaid expansion issue alive if the Senate killed its own version. After listening to several speakers discuss how imperative it is to expand the program to help the state’s working poor, Chairwoman Elaine Harvey (R-Lovell) asked the audience in crowded Room 302 if anyone wanted to speak against the bill.

No one stirred. Harvey repeated the question a couple of times to give opponents every opportunity to address the most controversial issue of the session. No one wanted to touch it.

It was the same response legislators received at public hearings during the past two years. Lobbyists were joined by people who showed how much the bill’s passage would mean to the health and well-being of themselves and family members.

The coalition that came together was remarkable, and unlike any I’ve ever seen. The Wyoming Business Alliance, one of the most conservative organizations in the state, made a powerful argument that Medicaid expansion not only makes sense fiscally, but it’s the right moral choice.

“These people are our neighbors,” said WBA president Bill Schilling. Well, not exactly, because the population Medicaid expansion is designed to help can’t usually afford to live in the same neighborhoods as legislators. But Schilling’s point was well taken: Lawmakers see the working poor every day, behind the convenience store counters, bagging their groceries, delivering pizzas and newspapers.

The business community was on board with expansion, which would normally mean quite a lot to lawmakers. So were energy companies, the Wyoming Hospital Association, physicians, clergy, city and county officials, teachers, college students, economic development interests and just about every professional discipline one can name.

Ordinarily, a coalition this size would have no trouble getting a bill through the Legislature, even if it wasn’t considered perfect. There was just too much at stake not to pass Medicaid expansion this session, a point Republican Gov. Matt Mead made clear in his State of the State address to lawmakers. Doing nothing, he stressed, was no longer an option.

Mead opposed expansion of the program for two years, costing the state at least $125 million in lost federal funds while an estimated 17,600 low-income, childless adults in Wyoming — a new, Medicaid-eligible population made possible by the Affordable Care Act — were denied desperately needed health insurance.

Legislative opponents knowingly lied about these would-be recipients, painting a picture of them as lazy deadbeats living off the government. In fact, 57 percent (according to Wyoming Department of Health) of them are employed; they just can’t find anything besides part-time, minimum-wage jobs. Another 30 percent are too sick to work, largely because they have never had access to affordable health care that is taken for granted by the vast majority of Americans.

I was sickened by many things Friday when the Senate voted 19-11 to kill Senate File 129, a far-from-perfect bill that nevertheless would have helped a lot of people. Make no mistake, the bill didn’t get bludgeoned because of its weaknesses, because many of those — including a requirement that all able-bodied recipients work at least 32 hours a week — were added by opponents who knew federal officials have never approved a Medicaid waiver with a work requirement.

No, the majority of Senate Republicans thumbed their noses at the governor and thousands of poor people simply because they knew they’d get away with it. Well, that and the fact they are heartless, self-important hypocrites who never miss an opportunity to remind people they’re in control.

That was made evident during the past two years when the GOP legislative leadership completely botched its effort to take control of the superintendent of public instruction’s office, got called out by the Wyoming Supreme Court, and just laughed it off.

Their arrogance knows no bounds. Many should have been defeated last November, but only one — former House Education Chairman Matt Teeters — lost his seat directly because of the superintendent debacle. Meanwhile, there was no outrage about who voted against Medicaid expansion.

I didn’t wince much during the Senate’s final debate on SF 129, mostly because I’ve heard this same nonsense spewed before. Sen. Charlie Scott (R-Casper) railed at the proposal because he’s upset poor people use medical services when they can get them. He blames our ailing health care system on their “overutilization” and won’t spend a dime to help others, even though he’s pocketed tens of thousands of dollars in agricultural subsidies for his ranching operations, as reported by the Casper Star-Tribune.

I’ve also seen hypocritical action on SF 129 by Senate Majority Floor Leader Eli Bebout (R-Riverton), a wealthy businessman who bolted the Democratic Party years ago because he knew the path to power was controlled by Republicans. Bebout repeatedly said he wanted to give SF 129 a fair hearing, then added the “poison pill” work requirement that doomed it.

At a GOP Senate caucus prior to the vote, Republicans presumably let a few members vote their conscience on the issue because they had more than enough votes to kill the bill. How big of them; how could anyone call them bullies?

What really upset me was the morning session of the House Labor Committee, before the panel came back at noon and killed their own Medicaid bill because there was no way they could get any expansion accepted by the Senate.

Rep. Norine Kasperik (R-Gillette) questioned witness after witness about why should we even consider helping the poor. The nadir of her embarrassing time in the spotlight was when she asked Wendy Curran of Blue Cross-Blue Shield why Medicaid expansion wasn’t helping people like her.

“So we expand Medicaid, and we have people on board and it’s reducing the debt we’re seeing in uncompensated care,” Kasperik began. “My insurance premiums have gone up 80 percent, my co-pay is more than I can meet every year, I’ve had hospital charges this past year with a 400 percent markup.

“What’s insurance’s plan to reduce premiums and get to a lower cost of care?” Kasperik asked.

Curran said Medicaid expansion should help relieve some of the pressure on the health care system and the insurance industry will continue to work collaboratively with others to bring down costs.

Kasperik shot back: “So there’s no plan to take the burden off of hard-working citizens who are paying increased premiums, having to pay for their own health care, having to pay 400 percent markups in some cases. There’s no plan to decrease the burden on those people. … I’m struggling to see how we’re going to make it better, because it seems it’s going to be the same.”

Hard-working, of course, is code for people so they can distinguish themselves from the riff-raff demanding “entitlements.” Unbelievably, after three years of discussion, Kasperik doesn’t know Medicaid expansion is not for people like her and her friends. While she may lament rising costs, most of the people expansion would help have never had any money or health insurance, and likely never will as long as legislators like her run the show.

Rep. Mary Throne (D-Cheyenne) was the last to testify. “We are not talking about solving the problems of the entire health care system,” she related. “Medicaid expansion will not do that. But there’s absolutely no evidence — zero, none — that says expanding Medicaid to this population will make our healthcare system worse, and there is every single indication it will make it better.”

“We’re disappointed,” reflected Marguerite Herman of the Wyoming Coalition for Medicaid Solutions. “We thought we made a strong and compelling case to expand Medicaid.”

She added, “I think a lot of the opinions expressed on the floor of the Senate are ideas that have been disproved and disabused, and it’s kind of disappointing to see these straw men brought up time and time again.”

Herman said there are political action committees and other interest groups who, with their campaign contributions, “can definitely reach into the legislative process and control votes and control influence.”

“I think we saw their hand here today,” she said.

And what a crushing blow it landed.

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