Don't push Medicaid expansion on Wyoming

Every session for the past several years, the Wyoming legislature has endured one push after another for Obamacare Medicaid expansion. For my part, I have held steady against expansion in every debate.

My position has brought no end of criticism from the media, certain special interests and many of my less conservative legislative colleagues.

Fortunately, a majority of senators have had the courage to stand up against those special interests that are pushing Medicaid expansion on Wyoming. It has not been easy, especially since last year the House of Representatives finally caved to the pressure. 

Both sides in this debate are certain that they are right and I think I know why – the two sides have very different definitions of what constitutes prudent, sustainable public policy.

Most states have already expanded Medicaid. What have we learned? As each state deliberated expansion, experts estimated probable enrollment and cost increases.

Reality has been very different. By their own measures, actual enrollment and costs usually end up right around double projections. But here’s the key: most of us look at those facts and see failure, pro-Medicaid boosters see that same data as a success.

Since Montana is our neighbor and comparable to Wyoming in many ways, we naturally look to their experience. Medicaid boosters in both states claim that Montana expansion has been a huge success.

Having your own opinion is fine, having your own facts is not. So what are the facts?

As their legislature debated expansion, state lawmakers were assured by experts that Medicaid enrollment would never exceed 59,000. How many Montanans are currently on Medicaid? Over 100,000.

And how much extra did it cost the state? In just the first two years, over $320 million more than projected. These are facts not debatable; numbers are numbers. 

But if they’ve overshot, they can just dial it back, right? Wrong. Montana cannot trim its Medicaid rolls without losing significant federal funding. They are stuck.

How about Montana hospitals? When Medicaid expands, employers save money by cutting insurance benefits and moving workers onto Medicaid, leaving hospitals with overall lower repayments than from private insurance.

Now Montana leads the nation in “high financial risk rural hospitals” (those deemed “essential” to their communities). After one year of expansion, Montana hospitals profit margins dropped by 40% and they now have fewer beds per capita than either of their non-expansion neighbors (Wyoming and South Dakota). 

If Wyoming expands Medicaid, our hospitals will lose over $16 million in annual revenues, meaning fewer hospital jobs and fewer beds available. And if we ever do expand, I believe a new hospital tax will be needed to cover Wyoming’s share of extra costs.

If Montana’s Medicaid expansion busted all estimates for enrollment and costs, left Montana’s hospitals less solvent and with fewer beds, and Montana has no way out, why does Wyoming keep debating the issue? Because there are elected officials, state employees and health care executives in both states who look at expansion and like what they see. They say Montana Medicaid expansion has been great – Wyoming should jump on board. 

Is that so hard to believe? Look at the Biden regime, proposing to spend over $5 trillion that we don’t have, on boondoggles we don’t need, that will bankrupt us and sink our next several generations in unpayable debt. Both of our U.S. Senators had the wisdom to vote against the first $1.5 trillion of Biden’s debacle, but 19 so-called “Republican” senators did not. The Democrats and those 19 declare a victory as they destroy our nation’s future. 

So, it is not really surprising that some call Medicaid expansion a success despite runaway costs and skyrocketing enrollments. The same people who look at $5.4 trillion of disastrous Federal deficit spending as sound public policy will view Medicaid expansion in that same light. They are as wrong as those 19 senators. 

But Wyoming voters now have a good a litmus test for next session. When we start debating Medicaid expansion again – and we will – voters can see whether their state senator or representative is a Mitt Romney, or a Cynthia Lummis.

Is runaway spending and government expansion your representative’s idea of success? I guess we’ll find out next January.