This is a guest post by Phyllis Sherard, a former hospital executive. I’ll be inviting guests with extensive subject matter expertise to offer their take on current events and other important policy decisions facing Wyoming. I understand no single person has all the right answers, and I believe the best answers for Wyoming’s circumstances will come only if we listen to many voices, not just mine. – Amy
The best time for Wyoming Medicaid expansion was ten years ago. Or eight. Or even earlier this year had Wyoming lawmakers acted. But, again, they did not.
For years supporters of Medicaid expansion have fought misunderstanding, and outright lies by my opponent and others in the Wyoming Legislature. Here are some of the facts:
- Many adults do not have health insurance through work. They fall in a gap where they make too much to qualify for Medicaid, but not enough for financial help on the Affordable Care Act exchange..
- Medicaid expansion fills that gap. Most people covered by Medicaid expansion work but remain poor. They do not make enough to qualify for subsidies on the insurance exchange, and in non-expansion states like ours, they are left without real health coverage.
- A decade of studies demonstrated Medicaid expansion saves lives, improves health, creates jobs, protects hospitals, supports doctors, benefits veterans, saves state funding on inmate healthcare, stimulates economies, and reduces state budgets. Federal funds cover 90% of expansion.
- It will also protect our hospitals, which faced $114 million a year in costs from treating the uninsured before the pandemic.
- Wyoming is facing unprecedented budget shortfalls with anticipated cuts to senior services, mental health and substance abuse services, health care and hospital reimbursement cuts, making health care access even more important.Expansion states experience greater improvements in access to mental health than do non-expansion states. Expansion states saw a 6% reduction in opioid-related drug deaths.Medicaid expansion states improved the health of women of childbearing age, increasing access to preventive care, reducing adverse health outcomes before, during and after pregnancies, and reducing maternal mortality rates. Better health for women of childbearing age means better health for their infants.
Only a blend of incremental, fair, common sense new revenues and likely painful cuts will see Wyoming through to a brighter future. Now is the best time to expand Medicaid.
The job losses in the energy and transportation industries was just the beginning. Before the COVID-19 crisis and the unprecedented job loss, expanding Medicaid would have provided critical health care coverage to over 19,000 Wyomingites living in the coverage gap. What is the number now?
Unemployment insurance and workers compensation benefits will end. The loss of healthcare insurance through work means an individual likely won’t catch illnesses early, but in a public health emergency, a delayed visit to a health care provider can allow an undiagnosed person to spread the virus throughout the community.
Supporters of Medicaid expansion have argued it is the moral thing – the right thing – to do for people. I agree.
But I believe Medicaid expansion has now become the necessary thing to do for Wyoming’s recovery. Not only will increased access to Medicaid make it possible to expand access to care, it will also provide a reliable stream of federal revenue that could allow the state to redirect funds to other important areas like education and supporting our cities, towns, and counties. Rural frontier states like Wyoming have benefitted economically from Medicaid expansion. Montana saw $185M (through 2020) in increased spending on goods and services (not health care related). Colorado created more than 30,000 jobs thanks to the infusion of hundreds of millions of dollars into the state through Medicaid expansion.
Because Wyoming can have these same economic and community benefits and 19,000+ of our friends and neighbors can access life-saving health care, the right time to expand Medicaid is now.