CHEYENNE, Wyoming — Democratic lawmakers questioned Gov. Matt Mead on Monday about his recommendation that Wyoming not expand Medicaid to offer health insurance to thousands of low-income adults.
Mead, a Republican, told members of the Legislature's Joint Appropriations Committee in Cheyenne that he has concerns about the implementation of the federal Affordable Care Act. He also questioned federal promises to pick up most future expansion costs.
"In my mind, it was not political — it was pragmatic," Mead said of his recommendation that the state shouldn't accept the federal government's offer to pick up the bulk of the cost of adding thousands more adults to Medicaid under the federal Affordable Care Act.
"Is this system going to work? Is this system a solution for Wyoming?" Mead said.
Democrats support Medicaid expansion, but the GOP leaders of the House and Senate say the Legislature will likely reject it when the issue is taken up as expected this session. On Monday, two Democrats raised their concerns with Mead about his proposal.
"There's a number of our veterans that are returning back from missions that would be covered under this expansion," Rep. Ken Esquibel, D-Cheyenne, told Mead.
And Sen. John Hastert, D-Green River, told Mead, "having some insurance for a period of time for some of these people would be better than having none at all."
Mead has opposed the federal health care law for years, and he told lawmakers on Monday that he's been concerned in recent weeks about problems with the federal health insurance exchange website, which has been plagued with problems since its unveiling in October. A majority of states including Wyoming opted to have the federal government operate their exchanges where citizens can shop for government-approved insurance coverage while also applying for federal tax-credits to help cover the cost.
More recently, the system has been working better, Wyoming Insurance Commissioner Tom Hirsig said last week.
Mead said he believes that Wyoming needs to see improvements to the federal health care law before it could commit to expanding the Medicaid program. "There's a lot to sort out, before we say 'this is a smoothly running system and we want to sign on,'" he said.
Expanding Medicaid is a centerpiece of the health care law, and the federal government has pledged to initially cover the cost of the optional expansion. As of early this year, Medicaid served over 77,000 people in Wyoming at an annual cost of over $500 million, split evenly between the state and federal governments.
The Wyoming Department of Health has projected that expanding Medicaid would save the state money by reducing pressure on other programs.
Kim Deti, spokeswoman for the Health Department, said recently that the optional expansion could add an estimated 17,600 childless adults to the Medicaid rolls in Wyoming. She said the cost of doing so between 2014 and 2020 would be $789 million, of which the state would have to pay just more than $51 million.
Deti said the full expansion would save the state nearly $200 million in other program costs through 2020. The full expansion would cost the state just over $151 million, leaving the state with a net savings for the full expansion of more than $47 million, she said.
Mead says lawmakers shouldn't blindly trust the federal government to follow its promises to cover costs of the Medicaid expansion. He noted that the federal government recently cut the amount of money it had promised to Wyoming under a program aimed at restoring abandoned mine lands.
"My disagreement isn't because it's federal dollars, my disagreement is because I'm not sure this system's going to work," Mead said.
The Joint Appropriations Committee will consider Mead's proposed budget for the two-year fiscal cycle that begins next July over several weeks of hearings before the Legislature convenes its budget session in February.