Tom Morton, Townsquare Media
Tom Morton, Townsquare Media

Expanding Medicaid services in Wyoming would help lower bad debt and charity care at hospitals, the president of the Wyoming Medical Center said.

"Hospitals in the states where Medicaid expansion has occurred, hospitals have seen their bad debt and charity care decrease, so that means that that's better for the hospitals," Vickie Diamond said.

Expanding Medicaid in Wyoming probably would be good for its citizens, too, Diamond said. "Actually, in the first run of data it also shows that they're probably having healthier populations."

In the fiscal year ending June 30, the Wyoming Medical Center wrote off $26 million in bad debt from patients who did not pay for their care, and wrote off another $26 million in care for the poor and prisoners.

Proponents of expanding Medicaid -- the joint federal-state health insurance program for the poor -- in Wyoming say that the federal government would provide 100 percent of the $50 million in funding necessary for the first three years to cover about 17,000 citizens who do not have adequate health care insurance.

We're already paying for those without insurance, and the Medicaid expansion would create a more fair system, said Dan Purdue, president of the Wyoming Hospital Association.

"When a hospital does not get paid for services that it provides to individuals then it is either written off as charity care or it is cost-shifted to those individuals and also those those insurance companies who do have coverage for those individuals," Perdue said.

"We feel that providing coverage to these individuals will not only help in improving their health status, but also help Wyoming hospitals and other providers by being able to get compensation for services that right now are classified as unreimbursed care," he said.

However, the Legislature has repeatedly rejected expansion proposals, and Gov. Matt Mead also has voiced his opposition.

Mead's policy director Mary Kay Hill said the the governor has met with Diamond and representatives of the Wyoming Hospital Association.

Expanding Medicaid means expanding a federal presence in the state, Hill said.

"The governor weighs that against concerns that the federal government may impose requirements are difficult for Wyoming to accept, and even more important that the federal government doesn't always live up to its financial commitments," she said.

"The governor has never stopped working on a possible solution to the need that hospitals have for uncompensated care, to the need that Wyoming citizens have to be insured and taken care of," Hill said. "It is a complex project."

Perdue said potential legislation could have a trigger that would allow the state to leave the program if the federal government does not meet its commitment.

And something is still better than nothing, he said.

"Our contention is, well, if we are into this program for even just a couple of years, the health status of our Wyoming citizens will be improved, and it's anybody's guess whether the federal government will honor its commitment," Perdue said.