Wyoming Governor Endorses Medicaid Expansion

Published December 10, 2014

Wyoming Gov. Matt Mead has endorsed a plan to expand the state’s Medicaid program under the Affordable Care Act. The plan, called SHARE (Strategy for Health, Access, Responsibility, and Employment) was developed by the Wyoming Health Department and would require many newly eligible participants to pay premiums and co-pays.

The SHARE plan comes after a year in which Wyoming lawmakers considered several plans to expand Medicaid under ACA, such as the “premium assistance” model Arkansas embraced and another plan offering more limited health care benefits while requiring increased cost sharing. None passed.

Jonathan Ingram, research director at the Foundation for Government Accountability, says any form of Medicaid expansion distorts the health care market and drives up costs. “Medicaid expansion by any name is inherently not pro-patient, nor is it pro-taxpayer. So that alone is enough to safely say it’s a terrible idea for Wyoming and should not be considered viable under any circumstances,” said Ingram.

The Republican Mead’s comments to local media suggest he’s not fully on board with a Medicaid expansion, either. According to the Casper Star-Tribune, Mead said during an early-December press conference the SHARE proposal was not good legislation, but “we need to either go forward with this or if the legislature wants to come up with a different plan, I certainly would be open to that.” Mead explained, “I don’t think we can say to those people in Wyoming who are working who cannot get insurance that we’re not going to do anything.”

SHARE Expands Faltering System

SHARE would create two tiers of Medicaid recipients. All participants would have to make copayments, but recipients with incomes between 100 and 138 percent of the federal poverty level would pay an additional monthly premium ranging from $25 to $50 based on household size and income. The new proposal also includes participation in optional work assistance programs such as job search services and vocational rehabilitation programs.

All told, the SHARE plan would add an estimated 17,600 low-income Wyoming residents to the Medicaid system.

“Medicaid expansion, no matter how you want to brand it, is going to completely distort the local healthcare economy,” Ingram said. ¬†Ingram specifically stated expansion will drive up the cost of private health insurance premiums because healthcare providers will have to compensate for the low reimbursements offered by Medicaid.

This expansion will put even more pressure on an already-faltering Medicaid system. Patients now face long waits for limited services, and many Wyoming counties are facing physician shortages. According to the Association of American Medical Colleges, 87 percent of Wyoming counties currently have provider shortages.

Matthew Glans ([email protected]) is a senior policy analyst at The Heartland Institute.