Dear Editor:

Medicaid is a state-administered program that currently supports the medical needs of Wyoming citizens who are both low income AND blind, disabled, pregnant or elderly. Low income is defined as under 100% of the federal poverty level (FPL), which is currently $12,880 for an individual and $21,960 for a family of three.

The Affordable Care Act (ACA) provides subsidies for private health insurance to anyone who earns 138% or more of the federal poverty level, which in 2021 was $17,774 for an individual or $30,305 for a family of three, etc. 

Anyone who earns more than the poverty level but less than 138% of the poverty level falls into the “coverage gap.” This describes the 25,000 people expected to benefit from Medicaid expansion in Wyoming.

Who falls into this coverage gap? Documented Wyoming residents who are currently uninsured; who are ineligible for Medicaid, Medicare or another public health care program; who do not have access to private health care through their employment; and who cannot prove the requisite income for the Health Care Exchange. These are people who work long hours and multiple jobs. This could include some small business owners, including some farmers and ranchers who can’t afford insurance for themselves or their employees.

Who pays for Medicaid expansion? In Wyoming the federal government currently covers 50%, with the state covering the remaining 50%. The federal government pays 90% of the cost for those covered under Medicaid expansion. With new incentives again being offered to the 12 states that have not expanded Medicaid, Wyoming will see an additional $54 million to the state in the biennium. The cost to expand Medicaid is expected to be $20 million, resulting in an additional $34 million to the state in the biennium.

How will this affect me? Uncompensated health care costs would decrease as a result of increased health care coverage. Wyoming has some of the highest private health insurance costs in the nation. The Wyoming Department of Health predicts a 5-15% drop in health insurance costs if Medicaid Expansion is passed because more people would have access to health care coverage and would not rely on the high cost of emergency care they cannot afford.

Wyoming hospitals are absorbing $110 million in unreimbursed care annually which results in higher costs and premiums to those privately insured. This means Wyoming citizens are already paying the full costs of health care for those people in the coverage gap, instead of letting them be covered under Medicaid expansion and lowering the costs for everyone. We have learned from other states’ experiences. The Wyoming Department of Health has updated and recalculated early estimates based on real data from other states to ensure their models and estimates are as accurate as possible.

Can Wyoming withdraw from Medicaid Expansion? States can voluntarily withdraw from Medicaid Expansion at any time. Not one state has withdrawn from the program since its inception.

What is the alternative to Medicaid expansion? Continued burdens borne by our health care industry, and increased insurance costs for the privately insured? Friends, family and neighbors who cannot access routine checkups necessary to prevent costly catastrophic illnesses?

Studies have found that expanding Medicaid helps a state’s economy and expands a state’s tax base. A healthy Wyoming is an economically strong Wyoming.

Valerie Lengfelder, MD

Jilaena Freitas, BSN

Powell