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Wyoming Legislature could take another crack at expanding Medicaid during special session

Rep. Pat Sweeney (Natrona County) speaks at a Healthy Wyoming rally for Medicaid expansion at the Nicolaysen Art Museum. (Gregory Hirst, Oil City)

CASPER, Wyo. — While the Wyoming Legislature’s upcoming special session is expected to largely focus on the issue of vaccine mandates, the legislature could also take another crack at expanding Medicaid in the state.

The Joint Revenue Committee is sponsoring House Bill 1011 and its mirror legislation in the Senate, legislation that would expand Medicaid eligibility. The so-called “Medical Treatment Opportunity Act” could get a hearing during the special session that is scheduled to being on Tuesday, October 26.

A recent poll conducted by New Bridge Strategy found that 66% of Wyoming registered voters support expanding Medicaid. That includes 98% of Democrats in the state, 64% of Independents and 58% of Republicans.

The Medical Treatment Opportunity Act would direct the Wyoming Department of Health, the state’s insurance commissioner and the governor to negotiated with the Centers for Medicare and Medicaid Services (CMS) to amend the state’s Medicaid plan and expand eligibility.

Under the 2010 Affordable Care Act, 90% of the cost of expansion would be paid by the federal government and Wyoming would pay 10%. The Wyoming Department of Health estimates expanding coverage would cover an estimated 24,000 (between 13,000 and 38,000) residents, and net the state $34 million in General Fund savings over the next biennium. The WDH estimates that 60% who would benefit from expansion are currently employed.

Proponents of Medicaid expansion have been working to push the legislature to again consider expanding Medicaid after a similar effort failed during the 2021 General Session. During that session, the House of Representatives passed a measure to expand Medicaid on a vote of 32-28 but the bill stalled out on a 2-3 vote in the Senate Labor, Health and Social Services Committee.

The group Healthy Wyoming held vigils across the state in September to raise awareness about projected savings for the state under expansion and to share stories of people who have suffered and died without health care.

The Casper contingent met at the Nicolaysen Art Museum on September 17 to hear from health care providers, legislators, and people directly affected by the issue. 

“This issue is a matter of life or death,” said Healthy Wyoming advocate Andrew Schneider in his remarks. He said people who can’t afford to go to the doctor allow chronic conditions, including mental illness, to “linger and worsen.” They also skip cancer screenings and other preventative measures and can’t budget for both prescriptions and food.

Linda Jones spoke about her friend and neighbor Earl, who died three years ago. She said Earl worked a steady job at Walmart until he slipped on the ice and injured his knee, and lost his job while recovering.

Without insurance, he was unable to achieve a full recovery, became afflicted with gout, and sold a cherished Camero to pay bills. His health declined rapidly and he was eventually found dead in his home.

“It was a difficult thing to watch another person be in so much pain and not know how to help,” Jones said. “At the time, we didn’t think there was anything that could be done about Earl not being able to see a doctor. … Now I know if that if our state had expanded Medicaid, Earl could have gotten the health care he needed.”

“He wanted to get better; he wanted to work to provide for himself.”

Critics have cited concerns that expansion has led to significant cost overruns and decreased profit margins for hospitals in other states. They also worry that the federal government could change its match rates, leaving Wyoming “on the hook” for a greater percentage of costs.