The WasteWatcher: The Staff Blog of Citizens Against Government Waste

Wyoming Legislature Continues to Reject Medicaid Expansion

The WasteWatcher is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.


On Friday, January 22, 2016, the Wyoming Joint Appropriations Committee struck out Governor Matt Mead’s budget proposal to expand Medicaid as provided for under the Affordable Care Act (ACA), better known as Obamacare.  This is good news for those who care about providing quality healthcare to low-income people, protecting taxpayers, and balancing Wyoming’s budget, now and long into the future. Even though the Governor offered a budget proposal that cuts spending by $18.7 million and taps into the state’s rainy day fund, he is determined to hang the Medicaid expansion albatross on Wyoming taxpayers, claiming that the federal government will provide an additional $268 million to the state.  It is very tempting to accept the Federal government’s faustian bargain and it is likely amendments to expand Medicaid could be proposed on the Senate or House floor during the budget debate.  This is why taxpayers must remain vigilant and oppose Medicaid expansion to avoid huge and costly troubles in the future. Under the ACA, states are allowed to expand Medicaid to all children and their parents, pregnant woman, and adults with no children that have a household income up to 133 percent of the federal poverty level.  Currently, that figure is approximately $15,654 for a single person, $32,252 for a family of four.  To entice states to expand Medicaid to newly eligible persons, ACA provided 100 percent federal funding for years 2014 through 2016, 95 percent funding in 2017, 94 percent funding in 2018, 93 percent funding in 2019, and 90 percent funding in 2020 and beyond. Expanding Medicaid is a bad idea for several reasons and governors and state legislatures should avoid the Siren call of “free” federal money to do so.  First, Medicaid is a terrible healthcare program as laid out in a Citizens Against Government Waste (CAGW) January 2014 Swine Line blog entitled, “Disturbing News on Medicaid from Oregon.” Expanding Medicaid also creates expensive problems for states, such as coping with additional Medicaid fraud, which is discussed in a CAGW January 2014 WasteWatcher entitled, “Medicaid Expansion – A Wolf in Sheep’s Clothing.”  Also, many doctors do not take Medicaid patients, especially specialists,  because they are often paid less than their costs to treat them.  Expansion allows able bodied, healthy individuals without children to gain access to the Medicaid program, crowding out poor children and the disabled. Another major issue of concern is when the federal government will renege on its generous funding of the program; after all, the current federal debt is fast approaching $19 trillion therefore, the feds are simply passing out borrowed money.  When Speaker of the House Paul Ryan (R-Wisc.) was chairman of the House Budget Committee, he said, “The fastest thing that’s going to go when we’re cutting spending in Washington is a 100 or 90 percent match rate for Medicaid. … It doesn’t matter if Republicans are running Congress or Democrats are running Congress.  There’s no way we’re going to keep those match rates like that.”  In fact, President Obama offered to cut the rate in the fiscal year 2012 budget negotiations. On top of the potential for a much lower matching federal subsidy, a January 21, 2016 National Review article found that states that have expanded Medicaid have seen staggering budget overruns.  In Ohio, the Medicaid program went over budget by $1.5 billion in the first 18 months; in Washington, the biennial budget increased by $2.3 billion; Illinois’ expansion ran over budget by $800 million in 2014; and in Kentucky, it is projected to be $1.8 billion over budget for fiscal years 2014 and 2015. CAGW will continue to track whether there are further attempts to implement Medicaid expansion in Wyoming and other states.  Meanwhile, the Wyoming state legislature should persuade the governor to work with them to help uninsured individuals gain access to healthcare through private plans and continue to reject a government-run program that will eventually bankrupt the state.

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