Sunday, September 15, 2013

The contortions of Wyoming politics

Contortionists! That’s it. Think of Governor Mead and the legislature’s leadership as contortionists and you can fathom what they’re doing by denying the benefits of Obamacare to Wyoming’s citizens.

Contortionists are performers displaying dramatic ability to bend and flex. Contortionists are circus acts. Contortionists have extraordinary flexibility, putting themselves through intense and painful gyrations.

Thinking of the Governor and some legislators as “contortionists,” explains why some believe contortionists apply snake oil to their joints to achieve flexibility.

What else explains the bending and flexing these politicians are engaged in with their partisan response to Obamacare? First the Governor abdicated his responsibility to the legislature. When the Wyoming Department of Health (WDH) advised legislators that expanding Medicaid to the uninsured would save the state tens-of-millions of tax dollars, these otherwise self-appointed fiscal conservatives displayed dramatic flexibility, rejecting the opportunity to save those dollars in order to make an anti-Obama statement.

The circus act continues. The Labor, Health and Social Services Committee is poised to send the uninsured into the private insurance market for coverage. What could possibly go wrong?

Calling it a “free-market solution,” instead of the “predatory solution” it is, the committee co-chairs, Senator Charlie Scott and Rep. Elaine Harvey, are twisting themselves into unusual positions. Before WDH experts finished a study evaluating alternatives, Scott and Harvey had a bill drafted to send the uninsured to private insurance companies for health coverage.

Senator Scott earlier blocked creation of an insurance exchange which consumers in other states find helpful in weighing the market’s confusing options. Exchanges have also achieved lower rates through transparency. But Wyoming legislators find Obamacare so radioactive they refused to create a Wyoming-specific exchange.

The Wyoming Insurance Department then refused to regulate private insurance companies to assure compliance with the consumer protections of the ACA. In that non-regulatory environment some legislators are willing to send their constituents into the shark-infested private insurance market to fend for themselves.

I lobbied for insurance companies for twenty-two years. Having continually defended their practices against legislators who believed the state should regulate and control the companies, these politicians are showing a dramatic ability to bend and flex their traditional views of insurance companies in order to avoid the documented benefits of Obamacare.

Private insurance companies had to be coerced by the Affordable Care Act to reduce their administrative costs to 20% or give rebates to consumers. The private companies have always had notoriously high administrative costs attached to them, which was one cause of escalating premiums.  Companies have rebated millions to consumers when they couldn’t control the overhead.

Senator Scott abhors Medicaid. He calls it “too expensive.” Medicaid’s administrative costs are a meager 4%.

After the Scott-Harvey bill was drafted, WDH issued a report studying the “free market solution” and three other options. The negatives included added costs of start-up and loss of control over rates and benefits among others.
Read the entire report at
Political considerations likely sidelined Option Four, managing the expansion group as the existing Medicaid eligibility groups. This is the soundest of all options but was the one rejected during the last session despite taxpayer savings of at least 47 million dollars, the one WDH says will “increase the number of individuals covered by the Medicaid program, without increasing its state general fund contribution to the program” while reducing the costs of uncompensated care and improving Wyoming’s health infrastructure.
It’s also the option WDH determined “would mean reduced complexity of operations” simplifying or eliminating “any administrative processes needed to manage this new group.”
WDH found, “This option allows the State to provide the most generous benefits package at a relatively low cost to State General Funds due to the enhanced federal match rate.”
Legislators know, the governor knows expanding Medicaid through the ACA provides the best healthcare while saving the most money. How are we to understand the Governor and legislature rejecting this option? It’s neither their interest in social justice, nor fiscal responsibility. Contortionism is the only explanation, well, other than partisanship.

No comments:

Post a Comment