UPDATE:Friday Afternoon 3:30 pm: The State Senate has decided to lay back further consideration of first reading of the Medicaid Expansion Bill until Monday morning. The Bill must go through a total of three readings before a final vote is taken. Several different amendments to the legislation remain under consideration.

The Wyoming Senate on Friday narrowly voted against an amendment to add Health Care Savings accounts to the state's Medicaid Expansion plan.

The amendment was approved on Wednesday by the Senate Labor, Health and Social Services Committee,, but the Senate Appropriations Committee on Thursday voted against it.

Sen. Charles Scott (R-Casper). chair of the Labor, Health and Social Services Committee, asked senators to approve the amendment, arguing it is crucial to getting Medicaid recipients to refrain from running up healthcare costs with unnecessary medical procedures and visits to the emergency room, which tend to be the most expensive form of health care.

Under the proposal, which is part of Indiana's Medicaid Expansion Plan. recipients would start with an account of $500 in "virtual money" (essentially healthcare credits). They would make monthly payments adding $50 to the accounts.

Scott argues the fact the recipients  have an investment in the accounts would give them an incentive to keep their costs down.

But in floor debate, several Senators questioned the "virtual money" concept, saying it is confusing and might be a deal breaker in terms of getting Wyoming's plan approved by the federal government.

There were also questions about the cost of administering the accounts, and what would happen to the money in the accounts if the participant leaves the Medicaid program.