CHEYENNE, Wyoming — Both houses of the Wyoming Legislature on passed a budget bill Monday that calls on Gov. Matt Mead and other Wyoming officials to investigate whether they can reach an agreement with the federal government to expand Medicaid on the state's terms.
The Senate voted 20-10 to approve the general government appropriations bill including the Medicaid negotiation language. The provision wouldn't allow any expansion of the Medicaid program in the state without future legislative approval.
The approval came despite strong warnings from Sen. Charles Scott, R-Casper, that preparing the study would make it more difficult for the state to resist expanding the program next year.
"My conscience tells me, my experience tells me, we're looking at a considerable expansion of government," Scott said, adding that he fears expanding the program would do harm to the state. He said he believes that Medicaid encourages people to use medical services excessively.
As chairman of the Senate Health, Labor and Social Services Committee, Scott declined to allow his committee to vote on a bill earlier this legislative session to accept federal funding to expand Medicaid to add 17,600 low-income adults. The House likewise defeated accepting outright funding for the Medicaid expansion.
However, a House-Senate conference committee on the budget agreed to language that would call on state officials to work with the federal government to see if the state could negotiate with federal officials to reach agreement on a plan called a demonstration waiver that differs from conventional Medicaid expansion.
Expanding Medicaid is a fundamental element of the federal Affordable Care Act. The Wyoming Legislature last year rejected $50 million in federal funds for the Medicaid expansion.
Mead, in his State of the State address last month, urged lawmakers to continue to resist expanding the federal program. He has said the state can't trust federal promises to continue to fund the program in years to come.
Sen. John Schiffer, R-Kaycee, said studying the issue would at least allow Wyoming to determine what its options are.
"Up until now, because of legislative action, we have not been able to negotiate with the federal government," Schiffer said.
"This is the first time we've had an opportunity to go find out what chips are on the table and what are not," he said.
The Wyoming Democratic Party has attempted to rally around the Medicaid expansion issue. The party has held news conferences recently featuring uninsured people who would be covered by expanding the program.
The Wyoming Hospital Association and other groups, calling themselves the Wyoming Coalition for Medicaid Solutions, had pushed for full Medicaid expansion. They have pointed to a study commissioned by the state health department that concluded expanding Medicaid would save the state millions by relieving pressure on other health programs.
The Hospital Association has pointed out that people without health insurance costs everyone in the state by running up hospital bills they can't pay and forcing the medical establishment to raise fees to cover those costs.
The nonpartisan Equality State Policy Center is a member of the coalition. Director Dan Neal said after Monday's vote that the group is pleased to see the Medicaid language go through so the state can explore its options.
"It's important to remind people that we've given up the opportunity to insure 17,600 people in the state who otherwise will not have insurance this year," Neal said. "But, there's a chance that maybe insurance will be available next year if we can come up with a good program, so we're pleased to see it get through. We have to take what we can, this is a compromise."
The $3.3 billion general government appropriations that lawmakers sent to Mead will fund state government operations for two years beginning this July.
The budget bill includes a little less than $80 million for state employee salary increases. Executive branch employees and workers at the University of Wyoming would see raises averaging about 2.4 percent a year. Exact raises will depend on performance ratings.
Employees in Wyoming's K-12 schools would see a 1 percent pay raise for both years of the biennium under the bill. The proposal also calls for giving schools roughly $12 million more earmarked directly for employee salary increases. The budget bill also specifies that all K-12 employees would have to start contributing to the cost of their retirement benefits in the second year.
The budget bill calls for $175 million in state payments to local governments.