MEDICAID EXPANSION - April 11, 2016

I have consistently voted NO to expand Medicaid in Wyoming.  Four main reasons:

1.  Enrollments have exceeded projections in every state that has expanded Medicaid, sometimes by almost 300%.  (Colorado)
2.  The five-year study, by the state of Oregon, of the health outcomes of Medicaid enrollees and individuals with no health insurance at all showed no difference.
3.  Emergency Room use has not declined – it has risen in every state that expanded Medicaid.
4.  Due to the strain of drastically higher enrollments, provider payments to doctors and hospitals are being reduced.  Fewer doctors accept Medicaid patients because they are compensated below the cost of care, and actually lose money.

When we sought assurances that the laws of economics and human nature, clearly at work in every expansion state, would not apply to Wyoming, we got none.

We had volumes of testimony on the subject of Medicaid expansion.  The evidence was overwhelming that it would not financially suit Wyoming.

The Wyoming Department of Health was recently told to cut its budget.  First on the chopping block – provider payments.  Wyoming’s provider payments have been among the most generous in the country.  That will not be the case for very much longer.

I do not dispute the need for Medicaid – it was originally intended for poor pregnant women and their infants, the impoverished elderly and the disabled.  They are the truly needful and deserving among us.

Expanding taxpayer-paid health care to single, working-age, able-bodied adults, and increasing the “poverty” threshold for their eligibility, would serve only to harm the population for whom the program was originally intended.

The dubious promise of federal money is no reason, in my opinion, to start any new program.  As we learned in this last session, federal money often goes away, leaving states to either pick up the program itself or eliminate the program.  What is the state to do when these “new Medicaid” enrollees are folded into the “old Medicaid” population?  When the federal government begins to cut back its participation in Medicaid, as it has cut back on many other programs?