A local lawmaker is taking another swing at Medicaid expansion, which would grant health care to a swath of low-income Wyomingites. But the proposed bill is poised for an uphill battle, given that previous expansion efforts have fallen on deaf ears in the Wyoming Legislature.
Rep. Andy Schwartz’s flagship House Bill 244, introduced Thursday, would extend Medicaid eligibility to anyone earning up to 133 percent of the federal poverty level. The bill has since been assigned to the Labor Committee but hasn’t been debated yet.
“People should have insurance,” Schwartz said. “That’s the bottom line.”
In its current form the bill outlines a work or volunteer requirement (with exceptions) and the creation of a tailored mental health and substance abuse program.
Schwartz’s co-sponsors include fellow Teton County Rep. Jim Roscoe, an independent, Sen. Chris Rothfuss, D-Albany, and two Republicans, Sen. R.J. Kost, of Big Horn/Park, and Rep. Dan Zwonitzer, of Laramie.
Zwonitzer described himself as “one of the few Republican proponents for Medicaid expansion since the first attempt four years ago.”
“It’s a strong bill both on moral grounds and on fiscal grounds,” he said. “I know I’m not the most popular Republican by continuing to push it, but I just think it’s a good deal.”
Co-sponsor Rothfuss, who has “probably run a Medicaid expansion bill every year since Medicaid has been a topic,” said he’s tired of excuses.
“The Wyoming Legislature has failed utterly to provide any alternatives to Medicaid expansion despite several years to work on the problem,” he said. “With each passing year more and more states begin to participate, and the excuses not to participate keep falling one after another.”
He said fears often cited about expansion — that the Affordable Care Act will be repealed or the federal government will stop providing matching funds, for example — are “proving inaccurate.”
“We know that our hospitals and our medical associations continue to strongly advocate for expansion,” he said, “so we’re hopeful that this year the [Legislature] will revisit the concept and have a more favorable outlook.”
Wyoming is one of 14 states that haven’t expanded Medicaid, according to the Kaiser Family Foundation, and is now nearly surrounded by states that have expanded or are expanding Medicaid. The Wyoming Department of Health estimates roughly 20,000 to 30,000 people could qualify for care under expansion.
Previous estimates have indicated the amount of federal reimbursement for Medicaid expansion in Wyoming would be more than $100 million per year.
In November’s general election, voters in the traditionally conservative states of Idaho, Utah and Nebraska approved ballot initiatives to expand the health insurance program, affecting an estimated 363,000 low-income people.
Schwartz and co-sponsor Zwonitzer said they would like to see the Wyoming Legislature act before it comes to a ballot vote.
“In Idaho, obviously the citizens were strongly in favor of it, but they’ve tied the hands of their Legislature,” Zwonitzer said. “I believe if we put it to a vote in this state it would pass, and it’s better to have the flexibility of the Legislature to respond to emerging concerns and fiscal constraints as time goes on.”
Utah lawmakers are already attempting to modify or repeal the proposition that would expand Medicaid, citing costs.
Even if Schwartz’s bill manages to pass the House and Senate, Wyoming’s new governor, Mark Gordon, doesn’t support expansion.
“It’s unlikely to pass, but I think there’s more and more recognition that we have to do something,” Schwartz said. “If it doesn’t happen this year I’ll run it again next year.”
A version of this story first appeared in the Jackson Hole Daily.