CHEYENNE, Wyo. (AP) — Wyoming will reject federal money for an expansion of Medicaid intended to cover tens of thousands of low-income residents if the state Senate follows the advice of a legislative committee.
The Senate Labor Health and Social Services Committee voted 4-to-1 Wednesday to recommend the full Senate kill a bill that would add nearly 18,000 people to the Medicaid rolls in the state.
Since the committee didn't hold the bill, however, it's still possible it could come to the Senate floor for a vote from all 30 lawmakers in the chamber.
Committee Chairman Sen. Charles Scott, R-Casper, led opposition to the bill, saying he doesn't believe federal officials will pay for the expansion in the long term.
"I don't trust the federal government to keep its promises here," he said.
Scott added he expected the cost of the program to increase in "fairly short order — two years, four years, I don't know — the teaser rate will go away."
Expanding Medicaid, a joint state-federal health program for low-income people, is a cornerstone of the federal Affordable Care Act.
The act itself, meanwhile, has served as a lightning rod for Republican criticism since President Barack Obama signed it in 2010. Wyoming Gov. Matt Mead had steered the state into the multi-state legal challenge that led to last year's ruling by the U.S. Supreme Court upholding most of the law as constitutional. Republican presidential candidate Mitt Romney had pledged to overturn the act if elected.
The Medicaid program currently serves over 77,000 people in Wyoming at an annual cost of over $500 million, split evenly between the state and federal governments.
Without any state action, the Wyoming Department of Health says the state will still add roughly 10,600 new people to the Medicaid rolls starting next year. Those new enrollees will be newly eligible children plus an estimated 3,700 people now eligible for the program but who are expected to sign up only after a provision of the federal law requiring everyone to have health insurance takes effect.
The optional expansion would add another 17,600 low-income adults to the Medicaid rolls, which would bring total expansion of the state's Medicaid program to roughly 28,200.
The federal government is offering to pay 100 percent of the cost of expanding Medicaid coverage in the state for the first three years, starting next year. It has said it will pay 90 percent after that.
Mead has called on legislators to reject roughly $50 million in this legislative session for Medicaid expansion. He has said that, given the continual turmoil over the federal budget, he doesn't trust federal promises to continue to fund the program. However, he has asked lawmakers to evaluate the issue.
Expansion proponents, however, emphasized at Wednesday's committee hearing that even if the federal government eventually reneges on its promises, Wyoming citizens who otherwise wouldn't have insurance would benefit from whatever increased coverage they could get until that happens. No one in the audience spoke against the bill.
Sponsor Sen. John Hastert, D-Green River, and other supporters emphasized that an analysis by the Wyoming Department of Health concluded that expanding Medicaid would save the state money by relieving pressure on existing programs. He said the agency concluded the state would see $47 million in savings over seven years because of offsets.
"For people who have no coverage today, three years could certainly make a huge difference in their health and their ability to get health care coverage, and their ability to have health care issues taken care of," Hastert said.
Co-sponsor Sen. John Schiffer, R-Kaycee, told the committee the benefits of accepting the federal expansion are readily apparent. He said the Legislature would be remiss in its duty to state citizens not to take the federal government up on its offer. He said the federal government is likely to continue funding the program due to demand from predominantly Democratic states.
A coalition of medical groups, including the Wyoming Hospital Association, has been pushing to accept the optional expansion. Dan Perdue, lobbyist for the association, told the committee that member hospitals saw more than $200 million in uncompensated care in 2011 and said the figure would probably decrease if more people had coverage.
Allison Sage, with the Northern Arapaho Tribe's health department, urged the committee to pass the bill. "We have a great need on the Wind River Indian Reservation, Fremont County, of getting Medicaid expansion," he said, adding that if the program isn't expanded more people will be forced to use emergency room care.
Sen. Bernadine Craft, D-Rock Springs, cast the lone vote for the bill in committee. Sens. Scott; Leslie Nutting, R-Cheyenne; James L. Anderson, R-Casper; and Ray Peterson, R-Cowley, voted no. The committee then voted 4-to-1 to give the bill a "do not pass" recommendation with Craft casting the lone vote in favor of the expansion.
Hastert said after the vote that the bill will head to the Senate Appropriations Committee before it could proceed to the floor. He said he believes there's a pretty good chance the bill will still come to the Senate floor.