State officials say Medicaid program served over 77,000 people in Wyoming last year at a cost of over $500 million, split evenly between the state and federal governments. Expanding the program could add another 30,000 people to the rolls.
The federal government has pledged to pick up the bulk of the Medicaid expansion costs. Mead, however, has expressed concern that the state ultimately could get stuck with increased expenses if the federal government fails to live up to its promises, noting Washington's perilous financial condition.
Mead noted in his letter that Wyoming was among the states that challenged the law before the U.S. Supreme Court this year. The court ruled this summer that although the law is constitutional, states have the right to opt out of the proposal to expand Medicaid eligibility.
"I was one of the governors who joined the lawsuit challenging the Affordable Care Act. We lost," Mead wrote to Sebelius. "The Wyoming legislature and my office want to move forward. In order to do so, we need HHS to engage with us to provide answers to questions that affect patients, providers, hospitals and taxpayers. Without meaningful discussion and answers, we cannot move forward."