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Medicaid expansion bill not introduced; issue not dead

CHEYENNE —Lawmakers in the House failed to introduce a bill on the floor by Friday’s deadline that would have expanded Medicaid coverage for Wyoming residents. But that doesn’t mean the issue is dead for this session.

House Bill 20, “Medical treatment opportunity act,” would have needed 40 votes in the House to be introduced on the floor.

The legislation was sponsored by the Joint Revenue Interim Committee. Rep. Steve Harshman, R-Casper, who serves as the co-chairman of the Joint Revenue Interim Committee, told the Wyoming Tribune Eagle on Friday that the two-thirds vote to get the measure off the table for consideration during a budget session was simply not there.

“When you have this two-thirds introductory vote, it is hard to get two-thirds of any body to agree,” Harshman said. “I just don’t think we have a supermajority.”

Harshman previously said in committee meetings that he would support the bill, even after voting against similar measures in the past.

Wyoming is one of 12 states that have failed to expand Medicaid coverage to its citizens following the federal Affordable Care Act’s provision that allows for coverage to nearly all adults with incomes up to 138% of the federal poverty level, or $17,774 for an individual in 2021, according to the Kaiser Family Foundation.

Every state bordering Wyoming, with the exception of South Dakota, has expanded Medicaid. In November, voters there will vote on a ballot measure to expand Medicaid eligibility to its citizens. The South Dakota amendment would expand Medicaid to people between 18 and 65 who earn 133% or less of the federal poverty level, according to the Associated Press.

Although the bill to expand Medicaid in Wyoming was not introduced on the House floor Friday, Sen. Cale Case, R-Lander, said he intends to bring a budget amendment to the Senate next week to add Medicaid expansion to the 2023-24 biennium budget.

“There will be a budget amendment,” Case said in an interview.

Harshman said that he is unsure whether a budget amendment will come forward in the House.

“I don’t know. I haven’t gone too far down that road,” he said. “I think all those options are legitimate and important considerations.”

When asked why the bill was not brought to the floor Friday, House Speaker Eric Barlow, R-Gillette, said he has personally voted for a similar measure before, but also said that two-thirds majority vote is a high bar.

“The threshold is high. It only takes 31 votes to pass something out of the House. It takes 40 to even get it considered. You are actually not having a discussion about the policy of that first vote. You are just saying, ‘Am I willing to hear it?’” Barlow said.

Barlow said he is aware of the discussion about a budget amendment, but he is not involved in the process.

Jan Cartwright, executive director of the Wyoming Primary Care Association and Healthy Wyoming, said many people are working as a coalition in support of Medicaid expansion.

“The point for us is to get the governor talking (with the Centers for Medicare and Medicaid Services), so we can start the process of deciding what our Medicaid expansion would look like. People’s lives are hanging in the balance while these debates go on, and that has been the case for the last 10 years,” she said. “But we are excited that we are this far in the game, and we never will give up.”

Case, who spoke at a Monday rally in support of Medicaid expansion, said that for a budget amendment to work, there would have to be amendments with similar language proposed in both the House and Senate.

“Who knows how this will play out. It could go on in the House and not the Senate,” he said. “Certainly, I think the legislators are aware that a majority of Wyoming citizens want this, regardless of party,” Case said. “It is apparent that a minority, largely represented by the very conservative elements of the Republican Party now, are frustrating the majority.”

Case said he feels obligated to continue pushing for Medicaid expansion, even with a potentially difficult to achieve budget amendment, which would only have to secure a majority vote next week in each chamber.

“If it doesn’t happen, and the people feel strongly about it, they will have to change the makeup of the Legislature. And they will,” he said.

Delaying Medicaid expansion for another year, he said, would be a “travesty.”

“It is not anything we can do in good conscience. The reasons that have been offered against it, they really don’t hold up anymore,” Case said. “These are working people without insurance. It will be cheaper for everybody in the long run to get medical care, and it will be better for families and employers.”