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Medicaid and budget issues face Wyoming Legislature this week

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CHEYENNE, Wyoming — A key Wyoming Senate committee could decide by the end of this week on the general outlines of how the state may try to expand Medicaid to cover thousands of working poor.

Lawmakers will also work this week to craft a supplemental budget bill that could see the state put less money into its rainy day fund to cover sagging revenues in the face of lower oil prices.

Tensions are high between the Medicaid expansion plan proposed by Gov. Matt Mead's administration and an alternative plan supported by Sen. Charles Scott, R-Casper.

Scott, chairman of the Senate Labor, Health and Social Services Committee, supports requiring new Medicaid enrollees to pay into health savings accounts. He maintains that would make them more responsible about incurring costs.

Wyoming Health Department Director Tom Forslund told lawmakers last week that it's unclear whether the federal government would approve the savings-account proposal.

In any case, Forslund said, it certainly would take longer to get federal approval for Scott's plan than the simpler approach, called the SHARE plan, that Mead has proposed.

Forslund told lawmakers that Mead believes the SHARE plan is the most cost-effective way to move forward. But if lawmakers find a better way, Forslund said the governor would support it.

"What (Mead) doesn't want is to have competing plans and people attacking each plan," Forslund said.

The Affordable Care Act called for the federal government to pay 100 percent of the cost of expanding Medicaid for the first three years. After that, federal funding will taper down to 90 percent.

Wyoming left about $120 million in federal funds last year, the first year of the program expansion, by refusing to expand Medicaid, said Kim Deti, spokeswoman for the state health department.

Deti said 2015 is the second year of full federal funding but said the state likely won't be able to get an expansion program in place until next year at the earliest.

Mead, a Republican who was sworn in this month to start his second four-year term, has opposed expanding Medicaid, a fundamental element of the federal Affordable Care Act.

Yet Mead, in his recent state of the state address, said he's come around to believing that Wyoming can't afford to not to take the federal money. Hospitals in the state report they're absorbing over $100 million a year by treating the uninsured.

Scott said Friday that he expects his committee will consider the Medicaid expansion issue on Wednesday. "By the end of (this) week, I expect to have it out and on its way to the floor," he said.

House Speaker Rep. Kermit Brown, R-Laramie, said he senses many House members will have concerns about any effort to expand Medicaid.

"I think there's a lot of resistance to doing anything still," Brown said. "I can't predict how that will shake out, but it's going to be an issue (this) week."

Members of the Legislature's Joint Appropriations Committee are meeting Monday to continue to hash out a supplemental budget bill.

Mead had called for roughly $160 million in new spending on top of the two-year, $3.5-billion budget lawmakers approved last year.

Lawmakers are hustling to find ways to continue spending this session in response to recent state revenue estimates that cut projections by roughly $220 million in the face of falling oil prices and other concerns.

"Nobody's happy of course," Brown said of the budget negotiations. "And so there's a lot of discussion about who's going to get what. It's just got to be worked out, probably try to make everybody about equally unhappy."

Senate President Phil Nicholas, R-Laramie, said he expects the final markup on the budget to be finished Monday. It will then take legislative staff perhaps a week to put the agreement in final bill form, he said.

Nicholas said lawmakers are considering intercepting a $240-million payment that has been earmarked for deposit in the state's so-called rainy day fund this summer. The fund has been on track to reach nearly $2 billion, but transferring the money would cut into that growth.

"So there will be growth in there, but not as much as I'd like to see," Nicholas said. "But we do have to attend to these immediate issues."

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