Medicaid cost disputed
By Benjamin Graham, Jackson Hole, Wyo.
Date: December 8, 2012
Expanding Medicaid coverage to poor, single adults could save Wyoming $47 million over the next six years, according to a Wyoming Department of Health report released Friday.
Increasing coverage to include that population would allow the state to spend less money on other health care programs aimed at helping the vulnerable.
The health department estimates Wyoming would have to pay $151 million from 2014 to 2020 to cover newly eligible people under an expanded program. But the savings for the state could reach $198.5 million.
Under the Patient Protection and Affordable Care Act, also known as Obamacare, states have the option of expanding Medicaid to adults within 138 percent of the poverty line.
The federal government has said it will cover all of the additional costs for the first three years, beginning in 2014. After that, states would have to contribute no more than 10 percent of the additional cost.
The study makes a financial case for why Wyoming should take the federal expansion money, said Lou Hochheiser, chief executive at St. John’s Medical Center.
But the primary reason for increasing coverage should not be the savings, he said.
“Most importantly, it would allow us to engage that population that is falling through the cracks,” Hochheiser said.
Wyoming’s current Medicaid program serves four primary groups of low-income or medically needy individuals: pregnant women, children, adults with children, and people who are elderly or disabled.
An estimated 17,600 poor, single adults would gain coverage if the state chooses to expand.
The report projects the state could save money on several state programs if more of Wyoming’s most vulnerable residents were to receive Medicaid coverage. Those programs include mental health and substance abuse outpatient services, the Prescription Drug Assistance Program, breast and cervical cancer coverage, the Pregnant by Choice waiver, and the Employed Individuals with Disabilities Program, among others.
“The study makes sense, because the people who are currently uninsured that could be insured are using the most expensive care or delaying care,” Hochheiser said.
News of the potential savings comes only a week after Gov. Matt Mead announced he wouldn’t endorse expanding Medicaid.
Mead has said the federal government has not given the state enough information on many particulars of the new health care reform law, including Medicaid expansion.
Mead spokesman Renny MacKay said the governor was aware of the health department’s report when he made his decision.
MacKay cited another report released by the Kaiser Family Foundation in November that estimates an expansion could cost Wyoming $204 million over eight years.
“There seems to be ambiguity among people who are well-versed on this topic,” MacKay said of Mead’s stance.
The fact that there are differences between the Kaiser Family Foundation report and the department of health report illustrates the need for more information, MacKay said.
The decision to expand now rests with state legislators.