Charlie Scott does not trust the federal government to keep up their end of the bargain in healthcare, and his distrust will be felt throughout Wyoming as the State Senate shot down a bill last week that would have expanded Medicaid coverage.
According to U.S. Department of Health and Human Services, Wyoming is the most expensive state in the U.S. to buy health insurance, where more than 15 percent of the Wyoming population remains uninsured. Medicaid expansion advocates say approximately 17,600 Wyoming residents would have been insured by Medicaid expansion.
Medicaid is the nation’s largest government-funded health insurance program, designed to help pay for health care services for the disabled and those with low income. The failed Medicaid expansion bill is part of the Patient Protection and Affordable Care Act, also referred to as Obamacare, in which the federal government is responsible for paying all costs of the newly expanded program until 2017. Beginning in 2017, Wyoming would have to begin picking up the tab, but the federal government is still responsible for paying at least 90 percent of Wyoming’s Medicaid costs.
Chairman of the Senate Labor, Health and Social Services Committee, Sen. Charlie Scott, R-Casper, was not convinced that the federal government would keep their word.
“That’s a concern that many members have, and the federal government has a long history of that,” Scott said.
Scott cited the failure of the federal government to uphold its agreements with Wyoming going all the way back to the Fort Laramie Treaty, when the government denied Native American tribes agreed land settlements.
“It’s fairly clear to me that they are not going to cover the costs and that they will revert back to the standard 50/50 settlement,” Scott said.
Jan Cartwright of the Wyoming Primary Care Association, which is a part of a coalition of 25 organizations statewide in favor of Medicaid expansion, said she saw an absence of logic in Scott’s reasoning.
“Why would we use very precious state dollars when there are federal dollars waiting to come to Wyoming for expanding Medicaid, but instead we are going to turn our back on that and only use state funds?” Cartwright said. “It does not seem fiscally responsible to do that. I know that the legislators are very concerned that the money won’t stay here, but our argument is that if we are able to even give people just three years of care with the federal Medicaid match, wouldn’t that be better than just giving them zero care?”
Sen. Chris Rothfuss, D-Laramie, the architect of the Medicaid expansion bill, included a clause in his proposal that Wyoming would end participation in the newly expanded Medicaid if the federal government failed to pay at least 90 percent of Medicaid costs in Wyoming beginning in 2017.
There was no vote on this bill, however, as Scott opted not to allow a vote with his powers as Committee Chairman. Committee Chairpersons have the authority to determine if the proposal should go forward in the legislature. Scott said there were not enough votes for the bill to pass.
“On the floor there weren’t enough votes to pass the bill, and we had a debate that it would kill a lot of other bills, and that’s why I didn’t bother,” Scott said.
Scott said he is not a believer in the theory of Medicaid expansion, as he believed it would lead to overutilization of health care.
After citing the findings of a Dartmouth University study, Scott said, “The Medicaid program seems to be designed to encourage excessive utilization of healthcare.”
Scott said he favored reforms to Medicaid that would control consumer health care spending through premiums for Medicaid users and Health Savings Accounts which are tax-free accounts that individuals may save money in to pay for future health care expenses.
