The Legislature's Joint Appropriations Committee's decision last week to reject the governor's proposal to expand Medicaid isn't about the money or trusting the federal government, local hospital officials said this week.

"It's cultural, they hate poor people," said Kimberly Holloway, a member of the board that oversees the Wyoming Medical Center's lease of Natrona County's hospital assets.

"As much as this may come down to anti-government baloney about they won't make good on the money, this is about a culture in a state that expects everybody to bootstrap it," Holloway said at the monthly meeting of the Memorial Hospital of Natrona County board of trustees.

Last week, the Joint Appropriations Committee -- with three Natrona County legislators -- voted 7-5 to again reject expanding Medicaid. Gov. Matt Mead put the proposed expansion in his proposed budget. Wyoming faces an estimated $617 million budget shortfall. The expansion would bring an estimated $268 million and would cover more than 20,000 low-income residents.

The Wyoming Medical Center, the Wyoming Hospital Association, and a coalition of health care providers, community and business leaders called Healthy Wyoming have called for Medicaid expansion.

WMC officials have said Medicaid expansion would save money for patients and hospitals that are put in the position of socializing their losses when they write off charity care and bad debt. Those losses are passed on to patients who can pay their bills.

Wyoming Medical Center Board Chairman John Masterson said the legislators on the JAC -- including Natrona County Reps. Tim Stubson and Steve Harshman, and Sen. Drew Perkins -- are nice people, but their decision simply stopped the discussion.

"It's one thing to not carry the day," Masterson said. "it's another where it just doesn't click."

Medicaid expansion critics in the Legislature have said they don't trust the federal government to keep its word about shouldering its share of the budget in the long run.

Holloway said that and other anti-expansion arguments mask a larger problem.

"When you come from a perspective of an already middle-class affluent lifestyle, you just presume that people who aren't where you are in life are not working hard enough, they're not praying hard enough, they're just not doing things the way that you did to get to where you are," she said.

"I would guess that when legislators think of when they hear of a poor person, a low income person, what have you, I have an image of what they conjure in their mind, and to me it's the person that is able-bodied but doesn't work for whatever reason because again, they're on the government dole, they're lazy, they don't have to work because they have other government resources that they can rely on instead."

Holloway has worked with several charities, and those who need help want to work, she said.

"They want to work," Holloway said.

"But guess what, it's really the jobs that are available in the state that don't pay well enough for people to afford their own insurance and to afford the cost of living," she said. "So maybe that's a whole another aspect of the discussion that should be had is why don't people have jobs in the state that allow them to afford things like health insurance."