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Governor still says 'no' to Medicaid expansion

Dec 2, 2013 - By Ben Neary, The Associated Press

Gov. Matt Mead is recommending that the Wyoming Legislature not accept federal money to expand Medicaid coverage to more than 16,000 low-income adults who lack health insurance.

Mead, a Republican, said Friday he can't see plunging Wyoming deeper into working with the federal government on implementation of the new federal health care law given the serious problems with its rollout so far.

Expansion of Medicaid to cover the uninsured is a cornerstone of President Barack Obama's Affordable Care Act.

Mead has long been a critic of President Obama's administration, and some critics said the decision on Medicaid is intended to help ensure that Obama's signature legislation, the Affordable Care Act, will not succeed.

Some Wyoming Democrats, however, said they're hopeful they can work out an agreement in the legislative session that starts in February that would allow the state to accept federal money to expand Medicaid. They argue the state can't afford to turn its back on potentially hundreds of millions in federal subsidies over coming years.

Implementation of Obama's signature health care reform law has been plagued by problems in recent weeks.

The federal registration website was supposed to provide a place for people to shop for approved insurance programs and apply for federal assistance to help cover the cost. Technical problems became apparent as soon as it went online in early October, and many people have not been able to register.

The Obama administration has been forced to postpone key elements of the new law even as deadlines loom for getting approved insurance coverage by early next year.

Insurance companies notified customers that coverage that didn't meet new federal requirements would be canceled, but problems with the new system have forced the federal government to reverse itself and say companies can continue offering the old policies for a time.

Mead addressed reporters Friday by telephone from Dubai. He and first lady Carol Mead spent Thanksgiving in the Middle East visiting with troops deployed there from Wyoming.

"The problem that I see with the ACA is that in large part it presumes that the exchange is going to work," Mead said.

"We were going to get people into the exchange, a lot of young, healthy people into the exchange, and in doing that you're going to ultimately cut costs for everyone," Mead said. "And when you see the exchange, in my view, doing more to kick people off of insurance instead of putting them on, sort of the whole notion, the whole pretext of how this is going to work is in doubt."

Mead is a longtime opponent of the Affordable Care Act. He steered the state into joining a multi-state challenge of the constitutionality of the law. The U.S. Supreme Court ultimately ruled that the law passed muster.

The Legislature last year voted against accepting $50 million in federal money to expand Medicaid despite federal promises to foot most of the future cost.

As of early this year, the Medicaid program was serving over 77,000 people in Wyoming at an annual cost of over $500 million, split evenly between the state and federal governments. Tom Forslund, director of the Wyoming Department of Health, has said expanding the Medicaid program in Wyoming would save money by getting people off of other programs.

Rep. Ken Esquibel, D-Cheyenne, said Friday he believes accepting the optional Medicaid expansion would save Wyoming money.

He said uncompensated trauma care costs hospitals in the state roughly $200 million a year.

"It makes sense financially to cover that population of citizens who are not going to be available to be covered under any other type of health care coverage," Esquibel said.

"It seems to be more a political move on the part of the governor, than a common sense move on the part of the governor," Esquibel said.

Senate Minority Floor Leader Chris Rothfuss, D-Laramie, said Friday he's hopeful the Legislature can reach a compromise to expand the program.

"We are going to pay for that health care, it's just a question of how we go about it," Rothfuss said.