Medicaid expansion is still alive

Feb. 28--CHEYENNE -- The door has been opened for Medicaid expansion in Wyoming, as early as next year, if Gov. Matt Mead is able to work out a waiver that he and other state officials find acceptable.

A conference committee of senators and representatives on Thursday finalized an amendment to the state's budget bill.

It permits the governor, the director of the Wyoming Department of Health and the state insurance commissioner to begin talks with the Center for Medicaid Services to craft a waiver for the state.

That waiver could let the state expand Medicaid services to the 17,600 Wyomingites who make too little money to qualify for insurance through the federal Affordable Care Act exchange.

But rather than a standard Medicaid expansion, the waiver would allow Wyoming to specify certain conditions for how federal dollars could be spent to expand health-care offerings here.

The 10-member conference committee made a few changes to the initial amendment.

Most notably, it was altered to say the governor "may" negotiate for a waiver, rather than "shall" enter into talks.

It now also specifies that whatever waiver the governor might agree to, it may not negatively impact the state's general fund or Wyoming's small business owners, employers and insurance providers.

It further states that any proposed waiver must be given to the Joint Labor, Health and Social Services Interim Committee by Nov. 1, or "as soon as practicable," so lawmakers may consider it in the 2015 session.

This is not what proponents of Medicaid expansion wanted out of this year's legislative session: Four proposed expansion bills all failed.

But the mere fact that the door is now open for a potential expansion next year was seen as a cause for celebration.

"It's a compromise," said Dan Neal, director of the Equality State Policy Center. "We're disappointed the state's left millions of dollars on the table in 2014 and did not provide any insurance for more than 17,000 state residents this year when they could have done so.

"That won't happen, but at least we have a chance in 2015. We think the federal government has a big incentive to get as many states as possible to enroll."

In a statement, Dan Perdue, executive director of the Wyoming Hospital Association, called the amendment "a start."

"This ensures we will go into the 2015 session with some plan to insure very low-income working adults without children through Medicaid," Perdue said. "Currently, they have no options for health insurance."

Marguerite Herman with the League of Women Voters credited the amendment's passage to pressure put on legislators by their constituents across the state.

"Everyone needs insurance," Herman said. "As people became aware of this opportunity, they telephoned, emailed and met with lawmakers to call for their action."

Mead's communication director, Renny MacKay, said the governor still doesn't believe the Affordable Health Care Act n the source of the proposed expansion n is good policy.

But, MacKay added, the amendment gives Mead the chance to find out what options are available and what may work to Wyoming's benefit.

"For those who support and those who oppose the (act), this allows us to find out what the state would be saying 'yes' to or what we're saying 'no' to," MacKay said.

"It allows us to present more information to the Legislature as they make a decision on this and revisit it. And we can see if there's any potential program that we think is legitimate for Wyoming."

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