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Wyoming legislative committee takes up bill to expand Medicaid benefits to about 17,600 adults

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CHEYENNE, Wyoming — The Wyoming Legislature this week will start what promise to be contentious hearings about whether to expand the federal Medicaid program in the state.

Meanwhile, the Legislature's Joint Appropriations Committee this week will continue budget meetings as lawmakers work to review new revenue figures that predict a decline in the face of sagging energy markets.

The Senate Labor, Health and Social Services Committee has set a hearing for Monday morning to listen to comments from the public about the Medicaid expansion issue. The committee is not set to vote on the bill.

Pressure is mounting in Wyoming to accept federal money to expand Medicaid. The expansion, aimed at offering health insurance to an estimated 17,600 adults who make up to 138 percent of the federal poverty level, is a critical element of the federal Affordable Care Act. It's also an element Wyoming has resisted for years.

Wyoming Health Department Director Tom Forslund has said expanding the Medicaid program would save the state money by getting people off other programs. The state's Medicaid program would likely need an infusion of nearly $80 million in state general funds in coming years without the expansion, while expanding the program promises the state nearly $50 million in savings, Forslund said.

Gov. Matt Mead, a Republican elected last fall to his second term, had joined other states early in his first term in an ultimately unsuccessful federal legal challenge to the Affordable Care Act. Over the last year, however, Mead increasingly has come around to the idea of expanding Medicaid.

"The fact is, many of us don't like the ACA, including me," Mead said Wednesday in his state of the state address. "But here's another fact: Our federal tax dollars pay for ACA. Wyoming federal tax dollars help pay for the ACA. Do we choose to have that support, that Wyoming money, return to Colorado, to California, or to Wyoming? I say Wyoming."

The Wyoming Department of Health proposed an expansion plan going into this legislative session that didn't include the health savings plan component.

PHOTO: ADVANCE FOR SUNDAY JAN. 18 - FILE - In this Feb. 1, 2013 file photo, Wyoming state Rep. Kermit Brown, R-Laramie, looks over paperwork during the morning session of the 62nd Wyoming Legislature at the capitol in Cheyenne. Wyoming legislative leaders say lawmakers will spend the week of Jan. 19, 2015, the second week of the ongoing legislative session, digesting recent revenue projections that show the poised to receive over $200 million less in revenue than had been projected a year ago as a result of lower oil prices. (AP Photo/The Wyoming Tribune Eagle, Miranda Grubbs, File)
ADVANCE FOR SUNDAY JAN. 18 - FILE - In this Feb. 1, 2013 file photo, Wyoming state Rep. Kermit Brown, R-Laramie, looks over paperwork during the morning session of the 62nd Wyoming Legislature at the capitol in Cheyenne. Wyoming legislative leaders say lawmakers will spend the week of Jan. 19, 2015, the second week of the ongoing legislative session, digesting recent revenue projections that show the poised to receive over $200 million less in revenue than had been projected a year ago as a result of lower oil prices. (AP Photo/The Wyoming Tribune Eagle, Miranda Grubbs, File)

The Wyoming Hospital Association also has been a vocal proponent of expansion, saying hospitals subsidize hundreds of millions of dollars in uncompensated care each year — much of which could be covered by the federal program.

The Wyoming Business Alliance issued a position paper this month concluding the state needs to support Medicaid expansion. "Ignoring the economic reality and hardship of some 17,600 citizens does not advantage Wyoming today, or for the future," it stated.

The chief architect of Legislature's repeated rejection of Medicaid expansion in the past few years has been Sen. Charles Scott, R-Casper. He's chairman of the Senate Labor, Health and Social Services Committee holding Monday's hearing.

In December, Scott's committee and its House counterpart voted to amend the Medicaid expansion bill drafted by Mead's administration to insert the health savings account language. It's still uncertain whether federal officials would accept that requirement and still provide money for the program.

Rep. Elaine Harvey, R-Big Horn, chairman of the House Labor, Health and Social Services Committee, said Friday that she believes the savings account proposal would make the program more similar to how people pay for insurance on the open market. "We're trying to teach management of medical dollars," she said.

Harvey also said she believes the committee bill would have a better chance of getting through the Legislature than the version proposed by the Health Department. She said the committee still doesn't have estimates yet of how much it would cost to administer the savings account program.

In other action this week, top lawmakers said they expect legislators will take time this week to absorb new revenue projections that were released on Friday. The state's Consensus Revenue Estimating Group on Friday announced that it was reducing its general revenue estimates for the current two-year fiscal cycle by about $220 million as a result of falling energy prices. The state's school system is in line for additional losses.

Senate President Phil Nicholas, R-Laramie, and House Speaker Kermit Brown, R-Laramie, said Friday that lawmakers will call for a longer-term fiscal profile to assess where the state stands.

Nicholas said he expects the Legislature's Joint Appropriations Committee this week will finish its hearings on the state's supplemental budget.

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