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You are here: Home / Anderson On Health Insurance / And another one (perhaps)

And another one (perhaps)

by David Anderson|  December 2, 20159:53 am| 9 Comments

This post is in: Anderson On Health Insurance

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WY Gov. Matt Mead calls for expanding Medicaid when legislature meets for budget session on Feb 8 – https://t.co/jEPgC67raa

— Reid Wilson (@ConsultReid) December 2, 2015

Wyoming has been struggling with Medicaid Expansion for the past fifteen months.  The state prepared a waiver application in December 2014 and I thought it was a fairly decent one for a red state:

Overall, this is a fairly straightforward and simple Medicaid waiver.  There will be a significant conversation about benefit restrictions but everything else should go through quickly.  The major stopping point now is approval through the legislature.

The legislature was the show stopper last year. However Wyoming needs to save money.  Medicaid expansion saves states money in a couple of ways.  The biggest short term savings is cost shifting.  States can shift some people and services that they cover with either traditional Medicaid funds (which states pay 40% to 60% of the cost) or state-only funds to paying for those services with 100% Federal money this year and eventually 90% federal money over the long run.  Secondly, state subsidies for charity care and bad debts will decline as more people can pay for care.  Finally, over the long run, the optimistic argument is that Medicaid Expansion can help people who otherwise would have been uninsured avoid medical crisis that would in the future qualify them for disability and Legacy Medicaid.  That argument is the least supported argument.

It looks like the offer of Medicaid expansion is still a one way ratchet and that the number of Republicans who can count to eleven with their shoes on are willing to form coalitions with Democrats to get this passed Tea Partiers in Red States.  That is good news for the long term Medicaid expansion.

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Reader Interactions

9Comments

  1. 1.

    BGinCHI

    December 2, 2015 at 10:04 am

    Drip, drip, drip…..

  2. 2.

    Cermet

    December 2, 2015 at 10:05 am

    Wow – have to fight people to take free money while also, they get to provide sick people with medical care. What a country – not.

  3. 3.

    Punchy

    December 2, 2015 at 10:39 am

    The major stopping point now is approval through the legislature.

    That’s like saying the only thing stopping me from traveling back in time is a time machine. Soooo close, but lacking the Delorean and 1.21 gigawatts.

  4. 4.

    benw

    December 2, 2015 at 10:56 am

    @Punchy: Great Scott!

  5. 5.

    Another Holocene Human

    December 2, 2015 at 11:01 am

    @Punchy: You mean you have the flux capacitor? I’m sure all those gigawatts could be rustled up if necessary.

  6. 6.

    dedc79

    December 2, 2015 at 11:07 am

    McCain, shedding crocodile tears on voting to nix Medicaid expansion in the process of repealing the ACA:

    “It’s going to trouble me in the vote,” McCain said. “It does provide me with discomfort. I am very reluctant to take positions counter to the decision made by the governor.”

    So what troubles him is going against the governor of his state, not all the poor people who would lose coverage if repeal actually passed.

  7. 7.

    RaflW

    December 2, 2015 at 12:01 pm

    All this of course flies in the face of Mitch McConnell who is planning to advance a bill to wipe out the Medicaid expansion.

    Obama will of course veto the bill should it ooze its way up Pennsylvania Ave.

    But the fissures between the performance art that has replaced governance in D.C., and states where direct lines can be drawn between elected officials and public suffering continues to grow (particularly low population states where a governor is often pretty accessible).

    I don’t know if the state/national dissonance can be leveraged. But it is interesting to watch.

  8. 8.

    The Gray Adder

    December 2, 2015 at 12:33 pm

    Apparently they hate losing elections more than they hate Barack Obama.

  9. 9.

    Fake Irishman

    December 2, 2015 at 11:37 pm

    Is Haslam going to try again in Tennessee? I also heard Bentley making noises recently in Alabama, of all places.

    The one-way rachet analogy seems to be a good one so far.

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