Wyoming's Senate defeated a bill Friday to expand the federal Medicaid program — apparently killing any chance the state will find a way this year to extend health insurance to thousands of low-income adults.
Medicaid expansion is a key element of the federal Affordable Care Act and has come under fire for years from Republicans in Congress. The state Senate voted 19-11 against the bill.
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Gov. Matt Mead, a Republican, opposed expansion in Wyoming for most of his first term. But this year he urged lawmakers to approve an expansion bill, saying Wyoming can no longer afford to forego federal funds.
Washington pledges to cover 100 percent of expansion costs through 2016, dropping to 90 percent after that.
The bill's main sponsor, Sen. Michael Von Flatern, R-Gillette, said expansion would provide health care coverage to 17,600 people in Wyoming, bring more than $100 million a year in new federal funds and create about 800 jobs.
Several senators said Friday they don't trust federal promises to keep paying. Some said they don't want to contribute to the national debt by accepting more federal dollars in any case.
"Make no doubt about it, this saddles more debt upon your children and your grandchildren," said Sen. Larry Hicks, R-Baggs, who voted against the bill.
Von Flatern said that Friday's vote could make it harder to get expansion in the future because the bill to the state will be higher.
After the vote, Rep. Elaine Harvey, R-Lovell, chairman of the House Labor, Health and Social Services Committee, said her committee wouldn't consider a parallel Medicaid expansion bill.
"We still have those people who are uninsured, and we still have those medical facilities that are not financially healthy. We need to take care of them," Harvey said. "But I saw it as an exercise in futility to move forward."
The Wyoming Hospital Association has pushed expansion. It says hospitals around the state are stuck with hundreds of millions of dollars in uncompensated costs annually as uninsured people are treated at emergency rooms.
Tom Forslund, director of the Wyoming Department of Health, had told lawmakers that expansion wouldn't affect the state's general fund because it would relieve pressure on other state health programs.
Chesie Lee, lobbyist for the Wyoming Association of Churches, had supported Medicaid expansion.
"We've worked on this for three years now, and to think that they've not been able to come up with a way to cover the people who are in that coverage gap is extremely disappointing," Lee said. "It's not like the money's not there. It is there. It's a matter of the political will to do it."
A similar proposal in Tennessee died Wednesday when that state's Senate Health Committee defeated Republican Gov. Bill Haslam's proposal to extend health coverage to 280,000 low-income residents.