The state’s failure to implement Medicaid expansion has aggravated a sharp rise in the uncompensated care written off by the Wyoming Medical Center, hospital officials said recently.

From July through September, the hospital wrote off $15.4 million in uncompensated care, which was $2 million more than it had budgeted, its chief financial officer Yvonne Wigington said in late November.

Uncompensated care is the combination of charity care required of public hospitals by state law, and bad debt, which happens when patients cannot or will not pay for services.

The WMC budgeted $13.4 million for uncompensated care from July through September, with $6.5 million of that for direct charity care and $6.9 million in bad debt, Wigington said. She gave this report to the Memorial Hospital of Natrona County board of trustees that oversees the nonprofit Wyoming Medical Center Inc.'s lease of Natrona County's hospital assets.

But the amount written off for bad debt rose to $9.3 million as charity care came below projections at $6.1 million for a total of $15.4 million.

If this trend continues, the Wyoming Medical Center will write off $63 million in uncompensated care for the 2015-2016 fiscal year, and that will impact the entire community because other patients will cover those costs in their own bills, Wigington said.

This cuts severely into the hospital's budget, and far exceeds national rates, she added. “For September, we’re at almost 13 percent of uncompensated care and August it was 14 percent, which is double the national average.”

The collapse of oil prices, the ripple effects through the state’s energy industries and their employees are part of the problem, Wigington said.

And many patients are working, but either cannot afford insurance or cannot afford some policies’ very high – upwards of $5,000 – deductibles, she added.

Expanding Medicaid, the federal health insurance program for the poor, would help in Wyoming like it has elsewhere, she said. (Wigington made her comments before Mead announced his proposed budget, including Medicaid expansion, on Dec. 1.)

“We do know that when we look at other states, for example Colorado, the latest report that was given from our president of our Wyoming Hospital Association just last week was that because they are a Medicaid expansion state, every hospital in the state of Colorado since then has operated at a profit," Wigington said.

“So we are feeling the impact of a declining economy locally and we’re also feeling the impact of the uninsured population,” she said.

Wyoming Medical Center President Vickie Diamond said the state's inaction on Medicaid expansion is severely hurting hospitals.

“Other states have dropped because of Medicaid expansion,” Diamond said. “This is really, really hurting us."