Letter to the Editor

Dear Editor,

Senator Driskill’s opinion essay (Sundance Times, October 14) on the topic of Medicaid expansion stated that we should base our opinions on the facts. I could not agree with him more, so I undertook a search of facts.

On the issue of the financial impact on hospitals, I found an American Hospital Association study that showed hospitals in Medicaid expansion states are doing better than they were before. Mr. Driskill is right that Medicaid reimbursement rates are lower than private health insurance rates (although there is no reason they have to be), but since 2000 American hospitals have provided $702 billion worth of care for which they were not paid.

This rate of uncompensated care is reduced with Medicaid expansion. Simply put, Medicaid expansion is good for hospitals.

Other facts are necessarily based on estimates: population, percent of population in poverty, number of persons who would become eligible for coverage under expanded Medicaid, cost to the state of expansion – these estimates vary depending on who is making the estimates. For example, the Wyoming Health Department has raised its estimates of enrollees and cost after looking at the experience of other states. (Mr. Driskill does point out that original cost estimates have proven to be too low.)

Here are some things that we know for sure: federal minimum wage is $7.25 an hour. If we look at a family of two children and two adults each working full time for minimum wage, their monthly household income would be $2417. If the children in this family are under the age of 6, the children would currently qualify for Medicaid, but the parents would not. If the children in this family are over the age of 5, neither the parents nor the children would qualify for Medicaid even though this family is only $209 above the federal poverty level.

An organization called 24/7 Wall St. studies the cost of living across America. They estimate that rent, health care, child care (remember, both parents are working full time), food and transportation cost a Wyoming family $5600 per month.

Compare this to the income of $2417 for two full time, minimum wage earners: they would have a monthly shortfall of $3183. If one of the wage earners stays home to care for the children (he/she is earning $1280 a month, but child care is costing $1620) and the state/federal governments pay for the family’s health care, the shortfall each month is $1312. (Note that the much-ballyhooed minimum wage of $15 per hour would almost cover cost of living, if one adult does the child care and if health care is provided by the government.)

The new estimates from the Wyoming Department of Health suggest that Medicaid expansion could cost the state government between $7 and $13.5 million a year for the first two years, raise the third year, then stabilize. Wyoming has 444,000 working age adults. That’s $30.41 cents per worker per year to fund health care for our hard working, poorly paid neighbors, while improving the financial stability of our hospitals.

Now we leave the realm of facts and come to personal opinions: Is it a good thing to tax each worker $30.41 a year to help our neighbors and our hospitals, or should people earning minimum wage look for better jobs?

Since 1950, the federal unemployment rate has fluctuated between 2.5% and 10.8% (not counting 2020). This is among people actively seeking jobs.

In 2020 in the US, 1.1 million workers were earning the federal minimum wage or less. My opinion is that low wages and unemployment are problems with our society, not problems of individual lack of gumption.

Maybe the minimum wage should be raised, or maybe health care should be paid by the government, or maybe both, but it is unacceptable – in my opinion – that so many of our neighbors should be so poor through no fault of their own, and it is unacceptable that our legislators, none of whom are wondering whether they will be able to pay their medical bills, continue to vote against Medicaid expansion.

Mr. Driskill characterized the members of the House of Representatives as “caving to the pressure” when they passed Medicaid expansion last year. No, Senator, they did not cave; they found their moral compass.

Ernest Reinhold