CASPER, Wyo. — A new report from the White House Council of Economic Advisers released Wednesday found more than 16,000 Wyoming residents would gain coverage if the state were to expand Medicaid under the Affordable Care Act.
The White House report utilized data from the Urban Institute, a nonprofit social and economic policy research group, and a study of the Oregon Medicaid expansion conducted by the National Bureau of Economics. The report lauds the 26 states that have already elected to expand Medicaid and argues that choice improved access to care, boosted job creation and state economic activity.
Wyoming lawmakers chose not to grow Medicaid in accordance with the federal health reform law. That decision means some state residents aren’t receiving preventative care, according to the report.
With expansion, more than 2,300 additional people would receive cholesterol-level screenings and 700 additional people would receive mammograms with an expansion.
More than 4,000 people would gain access to regular clinical care, adding an 43,000 additional doctor’s visits in Wyoming each year, according to the report.
Although Democrats say the need for expansion is obvious, Medicaid expansion has posed a difficult political question for the Republican-dominated Wyoming legislature.
“A lot of this has gotten bound up in politics,” said White House press secretary Josh Earnest. “That’s what the real problem is. We can’t have a legitimate discussion about priorities and the fiscally responsible way to handle this.”
Senate majority floor leader Phil Nicholas, R-Laramie, said Republicans in the Legislature are concerned with the lack of a requirement to maintain federal funding for the program over the long term.
“A majority of legislators are very concerned that there is no federal obligation to pay for what is becoming a federal mandate and that by joining the Obama plan prematurely we will commit the state to an unfunded obligation at a price that can’t be identified,” Nicholas said.
Medicaid expansion will continue to be a topic of discussion among Wyoming legislators in the 2015 session after the Centers for Medicare and Medicaid Services waiver proposal is received, Nicholas said.
In the last session, the Wyoming Legislature rejected proposals to expand Medicaid in the state. Lawmakers did adopt a budget footnote that would allow the state to negotiate a new Medicaid waiver with the Centers for Medicare and Medicaid Services that would provide coverage to the state’s uninsured.
Kim Deti, Wyoming Department of Health spokeswoman, said preliminary negotiations have begun, but no definitive proposal has been drafted.
“Everything we do will go through the governor and the Legislature,” Deti said. “We provide the best information that we can, but policymakers will ultimately make that decision.”
The Wyoming Department of Health will report its progress to the Legislature by Nov. 1, providing an opportunity for more consideration in the next session.
Sen. Chris Rothfuss, D-Laramie, said the state’s move to allow negotiations is only a beginning for expansion discussions in Wyoming.
“It was a disappointment in the last legislative budget session that we weren’t more proactive with Medicaid expansion,” Rothfuss said. “We had the opportunity to bring a quarter of a billion dollars to the State of Wyoming to provide medical care to the state’s uninsured.”
Rothfuss said the move to turn down federal expansion funding without providing an alternative for the uninsured was poor leadership on the part of the body. He said he will continue to look for alternatives to expand the program in Wyoming.
“They need to come up with a good solution for Wyoming that works for us and our population,” Rothfuss said. “Then, we need to have a good discussion on ‘if not this, then what?’ We’ve been asking the question, those of us supporting the expansion for two years, and we haven’t heard an answer.”
Earnest said the Obama administration is dedicated to working with state agencies to craft flexible proposals for Medicaid expansion that best fit the states involved.
“(The) report is yet another reminder that access to affordable health care makes a real difference to families, hospitals and state economies across the country,” President Barack Obama said in a statement. “I applaud the governors and state legislatures of both parties who have done the right thing and expanded Medicaid in their states, and I urge the governors and state legislatures who have not yet expanded Medicaid to put their constituents’ health over partisan politics and give millions more Americans the access to affordable health care they deserve.”