Medicaid: The Facts vs The Politics

Name the last Wyoming governor elected by Democrats. Dave Freudenthal? Nope. It was Republican Matt Mead. Hundreds, some say thousands of progressives, many of them Democrats who switched parties in the primary, gave Mead the nomination assuring him the governorship. He won by 703 votes, a fraction of the Democratic crossovers.

Mead wasn’t elected by Tea Partiers or other conservatives, but by Wyoming progressives. Most Republicans wanted someone else. Like the Democratic-switchovers, they thought Mead was a moderate. As governor he’s worked hard to prove both wrong. Once elected, he calculated his political future is best secured by appealing to those who didn’t trust him in the beginning.

When the Supreme Court ruled Obamacare constitutional, it regrettably created one last playground for playing the politics of Obamacare with the lives of people who have no health insurance, limited access to healthcare and even less access to decision makers.

Mead insists the decision on whether to expand Medicaid shouldn’t be political. Yet there’s no other, genuine explanation for his decision to kick the can upstairs to legislators who have already demonstrated a penchant for playing politics with the issue. To be fair, let’s take his claim not to be playing politics at face value. Here, Mr. Mead, are the facts

Meet the uninsured who could be covered under Medicaid expansion. “I am one of the 30K,” one emailed. “I am the director of a non-profit agency that creates hope, saves lives and builds Wyoming communities. Most non-profits cannot afford health care for their employees, but we do the work because we believe that making a difference is more important.”

One-fourth of all veterans of Iraq and Afghanistan don’t have health insurance (WTE November 20, 2012). Governor Mead talks loftily at Veteran’s Day ceremonies about their service but is quite willing to allow the legislature to leave them behind and uninsured.

Most of the remaining are among the working poor, working hard at multiple jobs earning so little they cannot afford health insurance or healthcare. Many work in the food service and construction industries, home healthcare and childcare, each critical to Wyoming’s economy.

The federal government covers 100% of the costs for newly eligible citizens in the first three years, gradually dropping to 90% after 10 years. Mead’s response, “What if they don’t?” Notice that although his budget recommends accepting tens of millions of federal dollars for other programs, he doesn’t ask the “what if” question about any other dollar coming from Washington on which Wyoming routinely relies for everything from roads to education and a myriad of other healthcare programs.

The governor has long claimed expanding Medicaid will cost a great deal of money. He knows better but only yesterday did his administration announce that Medicaid expansion is “a better budgetary choice for the State General Fund. Pursuant to the Department of Health’s analysis, expanding Medicaid to cover optional expansion adults would result in a net savings to the General Fund of $47.4 million from FY 2014-2020."

How is that? Wyoming spends millions funding health programs serving the uninsured, from substance abuse treatment to prescription drugs. Today hospitals write off or shift costs of uninsured patients who can’t pay their bills. That could end. Nearly all of those dollars could be saved if Medicaid is expanded.

The infusion of federal dollars resulting from expansion would be an economic opportunity, increasing revenue to Wyoming providers, hospitals, clinics, nursing homes and pharmacies while offering good jobs to Wyoming people.  The Department of Workforce Services projects 10,000 new jobs in the healthcare sector over the next 10 years.

Earlier in the week the Governor visited with a crowd at a Circles meeting. Many were low income, hard working folks. He graciously stopped to talk to each family though I know he was behind schedule. I’ve been told he and his wife quietly, with no fanfare, serve meals at COMEA, the homeless shelter. Governor…these are some of the 30,000 people who depend on your decision. You have their lives and healthcare in your hands. The facts are not standing in your way.