Medicaid Expansion Still A Possibility In Wyoming

CHEYENNE, Wyo. (AP) — Despite the Wyoming Legislature's recent rejection of a plan to extend Medicaid coverage to 17,600 additional low-income adults, the state's Department of Health continues to study the possibility.

Expanding Medicaid is a cornerstone of the Affordable Care Act, and the federal government has pledged to initially pay the total cost of the optional expansion that lawmakers rejected last month.

Wyoming lawmakers rejected the plan, with many saying that given the financial uncertainties facing the federal government, they didn't trust its promises to cover expansion costs in coming years.
Gov. Matt Mead has directed the Wyoming Department of Health to continue studying the issue this year to be ready in case the Legislature reverses itself next year and decides to expand the program.

"I don't think it is a done deal, and I don't think we've left any money on the table," Mead said Tuesday of Wyoming's position on possible Medicaid expansion.
"I think we're going to learn a lot over the next 10 months about rules, regulations funding, or lack of funding," Mead told The Associated Press. "And when sequestration goes through on March 1, and I think it will, where does that leave the federal government in regards to the overall budget picture?"
If Wyoming decides next year to further expand Medicaid, it would still be in position to avail itself of the federal matching money, Mead said. "For Wyoming, I think it was wise to say no for now," he said.

Mead, a Republican, had steered Wyoming into the multi-state legal challenge against the Affordable Care Act that resulted in last year's U.S. Supreme Court ruling that upheld critical portions of the law. Among the court's findings were that the federal government has authority to require citizens to maintain health insurance.

Tom Forslund, director of the state health department, said Tuesday that although the Legislature voted against the optional expansion, many lawmakers said they should revisit the issue next year.

The medical program currently serves over 77,000 people in Wyoming at an annual cost of over $500 million, split evenly between the state and federal governments.
The state doesn't have any choice over adding some new participants to the program next year. Officials say the state will add roughly 10,600 new people, mainly newly eligible children and an estimated 3,700 people now eligible for the program who are expected to sign up only after a provision of the federal law requiring everyone to have health insurance takes effect.

The state health department has prepared studies that conclude that it would save money by expanding Medicaid.
The federal government has said it would pay 100 percent of the cost to fully extend the program for three years starting in January 2014. Support would reduce after that.

Forslund said that by adding only the mandatory groups to Medicaid, the state is likely to need an infusion of nearly $80 million in state general funds over the next seven years. "If we did the full expansion, we feel that over seven years, we could have a net $47.4 million savings," he said.
Forslund said doing the full expansion would save the state money by freeing up state funds that currently are going to subsidize health care costs for some of the people who would be added to the Medicaid rolls.

Sen. John Hastert, D-Green River, had sponsored the bill that failed in this session to approve the optional Medicaid expansion.
"As far as leaving anything on the table, the issue is that with us, moving forward, I'm concerned that we may not have the resources available in a timely manner next year by not kind of jumping into it right now," Hastert said.