Senate looks to bar officials from expanding Medicaid

2013-02-25T22:30:00Z 2013-02-26T07:30:08Z Senate looks to bar officials from expanding MedicaidBy JOSHUA WOLFSON Casper Star-Tribune The Billings Gazette
February 25, 2013 10:30 pm  • 

CASPER, Wyo. — Legislative critics of Medicaid expansion want to prevent Gov. Matt Mead and other state officials from growing the government health care program without their approval.

A month after rejecting expansion, the Wyoming Senate passed legislation Monday that would prohibit officials from following the federal health care reform law and unilaterally extending coverage to thousands of low-income adults.

Mead has given no indication he would do so. He has opposed optional parts of Medicaid expansion and repeatedly said lawmakers should be involved in any decision to extend coverage to more people.

But Sen. Charles Scott, one of the most prominent critics of expansion, said lawmakers should make sure a state agency doesn’t make commitments without the Legislature’s blessing.

“Sometimes, a bad idea keeps coming back,” the Natrona County Republican said.

Asked Monday about the legislation, Mead spokesman Renny MacKay said the governor would wait until the bill reaches his desk before commenting.

“He continues to maintain his position that decisions related to Medicaid expansion must be endorsed by the Legislature,” MacKay said in an email.

Medicaid expansion is a key part of the Affordable Care Act, the federal health care reform law passed by Congress in 2010. According to some estimates, it could extend coverage to an estimated 28,200 poor and medically needy people in Wyoming.

In a ruling last year, the U.S. Supreme Court gave states the power to reject certain parts of the expansion. In Wyoming, those optional components would cover roughly 17,600 adults.

Both houses of the Wyoming Legislature have rejected optional expansion, primarily over concerns the federal government would break its funding promises. A number of other red-leaning states, though, have indicated a willingness to participate. Florida Gov. Rick Scott recently announced support for expansion despite his vocal opposition to the law that spawned it.

To keep Wyoming officials from following in Scott’s footsteps, the Wyoming Senate included the prohibition in a bill to study health insurance exchanges, which are also part of federal health care reform.

Lawmakers originally sought a ban that would run through April 2015. But that sparked concerns the legislation would prevent state health officials from studying other ways to cover the expansion population. Mead has asked Department of Health Director Tom Forslund to explore options for an alternative Medicaid program that might be better suited for Wyoming while still meeting federal approval.

“I would like the agency to simply keep us up to speed so we can make informed votes,” Sen. John Hastert, D-Green River, said.

As a compromise, Sen. Drew Perkins, R-Casper, convinced his colleagues to replace the two-year prohibition with an amendment specifying that expansion would require Legislative approval. Perkins' amendment would not preclude the health department from studying alternative Medicaid designs after the legislative session, department spokeswoman Kim Deti said.

The Senate changes must still be approved by House members. The House narrowly rejected the Senate’s bill Monday, meaning lawmakers will have to form a conference committee to work out their differences.

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