Wyoming Senate postpones Medicaid expansion vote after amending bill

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CHEYENNE, Wyoming — Members of the Wyoming State Senate say they want assurances the state won't get stuck with ballooning costs if they vote to support a bill to expand the federal Medicaid program in the state to offer health insurance coverage to 17,600 low-income adults.

Sponsor Sen. Michael Von Flatern, R-Gillette, said the bill to expand Medicaid would help "a portion of the population that's less fortunate than everyone in this room," while also bringing economic development to the state.

The Senate adjourned Friday afternoon after hours of questioning Von Flatern about the state's obligations if it opts to accept federal funds for the program expansion.

The Senate intends to resume discussion of the bill Monday. It would require three rounds of approval in the Senate before it could head to the House.

Medicaid expansion is a cornerstone of the federal Affordable Care Act. The expansion plan would extend coverage to single adults in Wyoming making from 100 percent to 138 percent of the federal poverty level.

According to figures from the Wyoming Department of Health, Wyoming missed out on roughly $120 million in federal funds last year by not accepting Medicaid expansion. The federal government has promised to pay 100 percent of the cost of expansion through 2016 and then taper off funding to 90 percent, leaving the state to cover 10 percent.

Pressure is rising in Wyoming to accept federal expansion dollars. Gov. Matt Mead, a Republican who initially opposed Medicaid expansion, called on lawmakers in his State of the State address early this month to send him an expansion bill.

Hospitals around the state have been covering over $100 million a year in uncompensated care from treating people lacking health insurance, according to an industry group. Supporters of expansion such as the Wyoming Business Alliance say accepting federal funds would be an important move toward making sure rural Wyoming hospitals can keep their doors open.

The Senate on Friday adopted an amendment presented by Cheyenne Republican Sen. Tony Ross, chairman of the Senate Appropriations Committee, to strip out a $1.5-million appropriation from the expansion bill that would have gone to administrative expenses.

Wyoming Health Department Director Tom Forslund testified this week to Ross's committee that expanding the program would free up enough money from other health department programs that the department could cover expansion costs with no drain on the state's general fund.

Senate President Sen. Phil Nicholas, R-Laramie, advised Von Flatern and other bill supporters to come in Monday ready to answer questions about whether the state participation in the expansion would stop permanently if the federal government ever breaks its promise to continue to pay 90 percent of costs. Nicholas said he wants more solid information about how expanding the program could help Wyoming hospitals and other details.

Speaking after Friday's Senate session, Von Flatern said he believes he has "an optimistic 50-50" to see the bill through final approval in the Senate. He said the amendment stripping out the state funding out of the bill helps its chances.

Early in its consideration of the bill on Friday, the Senate voted to reject an amendment sponsored by Sen. Charles Scott, R-Casper, that would have required participants to pay into savings accounts. He has argued that requiring participants to pay into the program would encourage them to keep medical costs down.

Scott, chairman of the Senate Labor, Health and Social Services Committee, said after the Senate voted to reject his amendment that he won't support Medicaid expansion without some similar type of cost control.

"I think anybody out there that votes for that has got to be prepared to say if they're going to vote for a tax increase, are they going to vote to cut education, or local government," Scott said. "What are they going to cut in two years or three years when we have to come up with somewhere between $50- and $70 million to pay for the thing?"

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