Medicaid expansion bill approved in House committee

CHEYENNE — A bill to authorize Medicaid expansion to low-income residents in Wyoming gained approval from a House committee Thursday evening, as some lawmakers push for the state to take the federal government up on its offer of new incentives to the 12 states that have declined to extend coverage over the past decade.

While expanding Medicaid to uninsured people whose income is at or below 138 percent of the federal poverty level has been a frequent topic of debate in the Wyoming Legislature in recent years, some lawmakers hope this year could be different than past failed attempts.

Under Medicaid expansion, the federal government covers 90 percent of the costs, while states pick up 10 percent of the tab. If authorized by state legislators, Medicaid expansion would cover approximately 24,000 residents in its first two years of implementation, according to recent estimates from the Wyoming Department of Health.

In Wyoming, Medicaid expansion has been projected to cost the state roughly $20 million in the initial biennium of implementation, a figure that has repeatedly given lawmakers hesitations during past consideration of the proposal.

But the landscape has shifted slightly at the federal level. Under the latest federal stimulus bill that was signed into law earlier this month, the 12 states that have not expanded Medicaid would gain a 5-percent boost to their traditional Medicaid matching program, which is done at a 50-50 split and includes a far wider population than the expansion-eligible one, if they decide to opt into the program. That boost would bring an estimated $120 million per biennium to Wyoming.

The legislation advanced by the House Revenue Committee on Thursday would authorize Gov. Mark Gordon and the Wyoming Department of Health to begin pursuing a plan to expand Medicaid in the state, with an amendment that would allow the state to back out if the federal government reneged on its incentives.

The bill’s main sponsor, Rep. John Romero-Martinez, R-Cheyenne, told the committee of his own struggles as an uninsured person that helped guide him to sponsor the bill.

“I’m probably the poorest person in both chambers, so I got a bone to pick, but it’s not about me picking a bone,” Romero-Martinez said. “It’s about there’s thousands of people – they’re saying approximately 24,000 residents – that are not currently covered under an expansion that we have failed to produce.”

Lawmakers heard from a handful of people who testified during the meeting, with some opposed to expansion due to the possibility of state costs being greater than anticipated, while others supported the measure as a way to provide a much-needed “hand-up” to some of Wyoming’s most disadvantaged residents.

The legislation is also similar to a bill in the Senate that won committee approval last week. Sponsored by Senate Minority Leader Chris Rothfuss, D-Laramie, that proposal would essentially authorize Medicaid expansion to the same population included in Romero-Martinez’s bill. That bill, Senate File 154, awaits an initial vote in the Senate.

The committee ultimately advanced House Bill 162 by a 5-3 vote, with one member excused. The legislation will now head to the House floor for further debate, though it will need to be considered by next Monday, the last day for bills to gain an initial vote in their house of origin, for it to have any chance of final passage.

Also during the meeting, Rep. Bill Henderson, R-Cheyenne, tabled his bill that would have gradually increased Wyoming’s residential and industrial property tax rates, instead asking the committee to consider the topic as a part of a broader revenue discussion during the interim period between sessions.