Matt Mead is at it again. The governor of some of the people says he’s not inclined to allow the federal government to provide health insurance for thousands of Wyoming citizens who cannot otherwise afford health insurance.
The governor is putting GOP politics above the needs of Wyoming families who go without health care. To be fair, Mead hasn’t rushed to the front of the line of Republican governors who have already said they’ll not accept the offer of the Obama administration to insure their uninsured. But he’s headed there and wants to ease us into the decision.
Mead says it doesn’t make sense to take federal dollars to insure the uninsured. He is ignoring his responsibility to rise above partisanship and represent all of us, especially uninsured families. He’s also ignoring what it costs to walk away from Medicaid expansion under the Affordable Care Act (ACA).
Here’s how the law works. Either Wyoming or the dreaded feds (Mead’s choice) will create a health insurance exchange. When uninsured persons go to the exchange they’ll qualify or not, based on income, for either Medicaid or a subsidy (available to those making between 100 and 400% of the federal poverty level, i.e. FPL) to help purchase insurance on the private market. Because of the ACA, low-income families will find health insurance affordable. Note: It costs the federal government more to provide subsidies than to provide Medicaid.
Governor Mead admits 30,000 Wyoming people are currently uninsured. Many will be eligible for either Medicaid or subsidized insurance. For the most part, these are hard-working people. Some work more than one job. Their low-wage jobs don’t often provide health insurance. Under Medicaid or the subsidies, these families will have insurance at little expense to state taxpayers.
The federal government will pick up the entire cost of Medicaid expansion for the first 3 years. After that, the federal match will gradually drop to 90%, where it will be remain. The Wyoming Department of Health acknowledges the expansion of Medicaid to all citizens below 138 % of FPL will save the money we are now spending. Savings to the state budget will be achieved because many of the programs previously created to provide services for the uninsured, such as the nearly 100 million spent on state funded mental health and substance abuse treatment, can go away as uninsured families obtain coverage.
Governor Mead may have the authority to reject Medicaid but he cannot reject either the health insurance exchange or the subsidies. To justify his plans to reject Medicaid coverage, Mead says we can’t count on the feds, they might pay initially and then quit paying later. But why would the fed’s stop paying for Medicaid when that would actually cost even more. One non-partisan study concluded, “The federal government would see significant savings by not having to pay for the Medicaid expansion in states that choose not to participate. But it would end up spending even more covering private insurance subsidies for some of those no longer eligible for the entitlement program.”
Nonetheless, he says we shouldn’t insure these people now only to tell them later they have no insurance. “That’s just not the right thing to do,” he told the press. To the contrary, rejecting federal funding of health insurance for these people is “just not the right thing to do.”
Understandably Mead is a Republican who hopes Romney will be elected on his promise to reduce the number of people with health insurance. But if the federal government pays nearly all the cost because it can save money doing so, and as many as 30,000 uninsured Wyoming families would then be covered, we have to ask, “Why, governor, do you think uninsured people are better off with no insurance at all than with coverage that, at the very worst, might last only a few years.
If you are the governor of only some of the people, that may make sense. It doesn’t make sense to anyone else, especially the uninsured.