David Northrup

Dan Laursen

R.J. Kost

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Concerned with how the state would pay for its share of the program, Powell’s representatives were among 39 lawmakers who voted not to consider a bill regarding a Wyoming Medicaid expansion.

Had House Bill 75 passed, it would have created a collaboration between the insurance commissioner and Department of Health, overseen by the governor, to pursue Medicaid expansion if it was determined to be viable and fiscally advantageous.

Under the Affordable Care Act, Medicaid expansion provides coverage to residents who are at 138% of the poverty line. That would mean a family with two kids making about $24,000 a year would be eligible for coverage under the plan.

The Wyoming Department of Health estimated the state’s cost of the expansion would have been somewhere between $11 million and $26 million, while covering approximately 19,000 people over the next biennium. The federal government would have matched the state’s money with $135 million.

Rep. David Northrup, R-Powell, said his main objection to the expansion was that it lacked any solid plan to pay for the state’s share; with budgets so tight, he didn’t want to commit money the state doesn’t have.

Northrup also wasn’t comfortable with tapping into the state’s Legislative Stabilization Reserve Account (LSRA) — the so-called “rainy day fund” — to cover it.

“We have enough demands on the LSRA with the [$200 million] education shortfall,” he said.

Northrup said he would have considered the bill if a tax, such as one on tobacco products, would have been proposed to raise the money for the state’s share, but nothing like that was put forth.

“A tobacco tax would have at least been something,” he said.

Rep. Dan Laursen, R-Powell, was likewise concerned about placing more demands on the state at a time it’s looking to cut costs. He said some states that have expanded Medicaid find it an ever-increasing drain on their budgets. He also said that since Medicaid reimbursements don’t always cover the full cost of care, it shifts greater burdens onto those who are privately insured.

“It’s just not good for the state,” Laursen said.

He also didn’t see the federal match as a particularly good selling point for a nation deeply in debt.

“The national debt is $23 trillion. That’s 23 million-million,” he stressed.

While the bill never made it to the Senate, Sen. R.J. Kost, R-Powell, had discussed the bill prior to the session at a town hall meeting. Kost — who is also a member of the Powell Valley Hospital Board of Trustees — pointed out that critical care hospitals like Powell’s have to write off a lot of bad debt, since they’re required by law to treat everyone regardless of coverage, on top of charitable care requirements. Expansion, he said, might have helped ease their financial struggles.

Speaking after the bill failed introduction, Kost said he understood some of the concerns about the bill, and its defeat was “not something to lose sleep over.”

However, he pointed to Montana’s experience with its Medicaid expansion, which he said was largely positive.

Hoping to revive the issue, Rep. Pat Sweeney, R-Casper, sponsored a resolution that would have asked voters to amend the Wyoming Constitution to implement a Medicaid expansion program. However, House Joint Resolution 7 failed on a similar 16-40 vote on Friday; local Reps. Northrup, Laursen, Sandy Newsome, R-Cody, Jamie Flitner, R-Greybull all reiterated their previous no votes.