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.