Medicaid expansion is on Legislature's docket, again, but with $120M incentive

JACKSON — Medicaid expansion is again before the Wyoming Legislature, but this time it comes with an incentive of $120 million.

President Biden’s latest COVID-19 relief package includes about $6 billion in direct payments to states that expand Medicaid, including $120 million that could go to Wyoming to offset state costs of expanding the federal health insurance program. States also could use the money to shore up flagging revenues.

“This is money we can use to invest in our essential workers, teachers and other infrastructure projects,” Jan Cartwright, executive director of the Wyoming Primary Care Association, said in a statement. “At a time when the state is making difficult budget decisions, accepting these funds and covering 25,000 more hardworking Wyomingites is a win-win.”

Proponents like Cartwright’s organization and Equality Wyoming cite a Kaiser Family Foundation review of studies that looked into the effects of Medicaid expansion. The foundation found that, in addition to the health benefits gained by residents of states that accept the deal, expansion has economic benefits, including budget savings for state governments.

The number of individual beneficiaries Cartwright referenced — 25,000 — represents those Wyoming residents who would be eligible for Medicaid under the expanded guidelines. Though the state participates in the health insurance marketplaces created by the Affordable Care Act, it has so far resisted Medicaid expansion.

The ACA created a system in which the federal government pays about 90% of the costs of expanding Medicaid; states pay the balance. States that have not opened Medicaid to more people have cited concerns that the federal contribution will diminish in the future, and state governments would not be able to cover the balance.

Those worries have not stopped some Wyoming legislators — Rep. Andy Schwartz, D-Teton, among them — from introducing bills on a yearly basis that would expand the program. Previous efforts have failed, but some around the state see this year as the perfect moment to find success.

“Wyoming’s refusal to update its Medicaid program has long been an obvious mistake, whatever lawmakers’ corny excuses,” Better Wyoming Director Nate Martin wrote in a column for WyoFile. “If Congress offers us $120 million to update it, at least state legislators will no longer be able to claim that Wyoming can’t afford it.”

According to Wyoming Department of Health estimates, expansion would cost the state around $9 million annually, and the federal government would contribute about $68 million per year.

With Wyoming facing a massive budget shortfall, $120 million in federal funding could be tempting, since that would cover more than a decade of expansion costs to the state.

Architects of Senate File 154 — including three Teton County Democratic lawmakers: Schwartz, Rep. Mike Yin and Sen. Mike Gierau — stipulated that Wyoming’s share of the costs will never exceed 10%, giving the state an off-ramp should federal funding decline.

The bill has been referred to the Senate Labor Committee, which has not scheduled a discussion.