The death of Medicaid expansion in Wyoming hits one portion of the state, the Wind River Indian Reservation, particularly hard, but an item on this year’s state budget could fix that.
Wyoming Representative Lloyd Larsen said many citizens of the reservation regularly go without care for addiction, cancer or diabetes.
“Many of them don’t. They just go without,” Larsen said. The item in this year’s state budget would authorize the Wyoming Department of Health to apply for a Medicaid waiver worth $16.9 million, and could bring health care to more than 3,500 Eastern Shoshone and Northern Arapaho tribal members, without costing Wyoming anything.
Health is a problem on the reservation. According to a 2012 report “Racial and Ethnic Disparities in Wyoming” from the Wyoming Office of Multicultural Health, Native Americans are more likely than white residents of Wyoming to die of unintentional injury, diabetes, liver disease or heart disease. Native Americans also have less access to medical care, with 28 percent reporting cost has stopped them from seeing a doctor. This is almost three times the figure for white Wyomingites.
Larsen said that tribal leaders estimate 3,700 eligible people on the Wind River Reservation are not receiving federal Indian Health Service (IHS) medical care. Last year, the Wind River Reservation IHS clinic saw 40,000 uncompensated visits. State Senator Cale Case (R-Lander) said the clinic typically “runs out of money early in the year, and is unable to help people in relatively dire situations.” Case said the waiver “could make a big difference.”
This program will not cost the state anything, both legislators said, and could save money for Riverton and Lander hospitals that would see fewer uncompensated emergency visits. Larsen explained that while most Medicaid money requires an equal amount of state matching funds, under the Affordable Care Act waivers like this do not, and the tribes have agreed to pay administrative costs. To be granted the waiver also has to be cost-neutral to the federal government; that is, savings must balance costs. It would last one year and could be renewed multiple times, with the money used to expand IHS services.
The waiver has not been a contentious issue in the legislative session, and is expected to pass easily, Larsen said. “Legislators and committees so far have been extremely supportive of this effort.” Case said that he supports the bill and views it as a way to assist Wind River residents.
“This is an important step the state of Wyoming can take to help people on the Wind River Indian Reservation,” Case said “I’m really pleased to be able to do this.”
