Some key Wyoming lawmakers say they see little chance the Legislature will expand the Medicaid program in coming months now that Gov. Matt Mead has recommended against doing so.
Mead rolled out his budget recommendations on Friday, advocating against accepting $50 million in federal funds to expand the low-income health care program. The expansion proposal is a cornerstone of the federal Affordable Care Act.
Wyoming has about 77,000 people on Medicaid, and the proposed expansion could add another 30,000 by raising eligibility limits. The Wyoming program currently costs about $500 million a year, split evenly between the state and federal governments.
Despite the federal government's promise to pick up the bulk of expansion costs for the first few years, Mead said he doubts it can be trusted to stick with any long-term commitment. He said the ultimate decision on whether to accept the federal funds lies with the Legislature, which convenes in January.
Mead, a Republican, had pressed U.S. Health and Human Services Secretary Kathleen Sebelius repeatedly for information about how Wyoming would implement the new federal programs. He said a lack of any response was a factor in his announcement that Wyoming wouldn't meet a recent federal deadline to specify whether it would operate a health insurance exchange program under the health care law.
Rep. Keith Gingery, R-Jackson, serves on the House Labor, Health and Social Services Committee. He said Tuesday he believes Wyoming has no choice but to reject Medicaid expansion because of the federal government's refusal to answer Mead's questions.
"I believe the governor has taken the right course of action in asking many of the questions Wyoming has to the Department of Health and Human Services," Gingery said. "He hasn't gotten back those answers, and until we do, I don't think we can make a sound decision."
Sen. Tony Ross, R-Cheyenne, will serve as Senate president next year. "Medicaid expansion is a tough pill to swallow in many respects," he said, also citing Mead's objections.
Ross said he believes the Legislature needs to discuss the prospect of expanding the program but that "it's awfully premature, in my opinion, to jump onto that bandwagon right now."
Sen. Phil Nicholas, R-Laramie, is outgoing chairman of the Senate Appropriations Committee. He said he believes Mead's recommendation against the expansion likely settles the issue for state lawmakers.
Wyoming was among the states that launched a constitutional challenge to the Affordable Care Act. The Supreme Court upheld the law this summer.
Nicholas said he doesn't believe the overwhelmingly Republican Wyoming Legislature is likely to oppose Medicaid expansion merely because of friction between the political parties.
"I think you have a large group of people saying, 'Enough on the entitlement programs, and any expansion is dangerous,'" he said.
House Minority Floor Leader Rep. Patrick Goggles, D-Ethete, said he believes most Wyoming Republicans believed they should wait until after the presidential election before deciding on how to proceed. Republican presidential nominee Mitt Romney had pledged to repeal the law if elected.
"And having not done an analysis prior to this, I would see them as hard-pressed to run any kind of a successful program at this point," Goggles said.
He said taking a year to analyze the situation is probably a cautious but necessary step for the state.