Polls show Medicaid expansion is a nonpartisan issue; lawmakers think otherwise

May 3—CHEYENNE — Wyoming Freedom Caucus lawmakers argue Medicaid expansion will eat up the state's budget and entice people to work less for free health care. Other Republican lawmakers say that isn't true.

Medicaid expansion has long been a point of political contention in the Wyoming Legislature.

Yet a poll by the American Cancer Society showed a majority of Wyomingites support Medicaid expansion. These supporters consist of 98% of Wyoming's Democrats, 58% of the state's Republicans and 68% of independents.

The closest attempt at passing Medicaid expansion was during the 2021 general session, when a bill passed the House of Representatives, but failed in the Senate.

Sen. Cale Case, R-Lander, told the Wyoming Tribune Eagle that senators said to him in private they would vote to pass Medicaid expansion, but feared being caught "on the wrong side of the election." Future conversations on the topic, he added, will largely depend on the outcome of this year's voting.

"I'm kind of excited to get the election part over this year, and then see where the hell this goes," he said.

Both the Legislature's Joint Revenue Committee and Joint Labor, Health and Social Services Committee have visited the topic of Medicaid expansion numerous times in the last decade.

Rep. Dan Zwonitzer, R-Cheyenne, who chairs the Labor Committee, said it's all boiled down to political ideology.

"We're just kind of acknowledging we're killing people and charging everybody too much money for it," Zwonitzer said.

Wyoming taxpayers already make contributions to Medicaid in their paychecks, he added. Meanwhile, uncompensated care by hospitals for patients who don't have health insurance continues to jack up rates for private insurance companies.

"In Wyoming, we're paying a lot of money, but none of it is coming back to us," Zwonitzer said. "Insurance for all of our individuals and our businesses is higher than it needs to be."

Rural hospitals in Wyoming lose a combined $120 million a year in uncompensated care. Individuals with no health insurance often wait until they have a life-threatening emergency to seek medical care, and hospitals end up eating the cost of treatment.

These costs are typically covered through mill levies or commercial insurance agreements, resulting in higher insurance rates.

"There's a reason why there's only one insurer in Wyoming," said Sen. Stephan Pappas, R-Cheyenne. "Health care in Wyoming is too doggone expensive."

Several Freedom Caucus members told the WTE they oppose Medicaid expansion because of the "financial burden" it would put on Wyoming.

"I don't think it's smart societally to extend benefits to able-bodied persons where, right now, they can get health insurance on the (federal) exchange," said Rep. John Bear, R-Gillette, who chairs the Wyoming Freedom Caucus. "Why would we want to take able-bodied people who can work and put them on a substandard insurance plan?"

Reps. Ben Hornock, R-Cheyenne, and Sarah Penn, R-Lander, both members of the Freedom Caucus, said there are private avenues available to offer health insurance without government involvement, such as the expansion of health savings accounts or using direct primary care as an alternative payment model.

"They're wanting to dangle this 90/10 carrot in front of us," said Rep. Chip Neiman, R-Hulett, referring to the 90% of the cost that the federal government pays for Medicaid expansion. "That, to me, is very disingenuous."

However, several other lawmakers who spoke to the WTE said the results of Medicaid expansion in other states speak for themselves. Zwonitzer said it's "frustrating when all the information is out there," but lawmakers refuse to see it.

"We need rational people who can look at the financials and say, 'Wow, this saves us money,' instead of promoting ideological briefs that aren't grounded in factual reality," he said.

Hannah Shields is the Wyoming Tribune Eagle's state government reporter. She can be reached at 307-633-3167 or hshields@wyomingnews.com. You can follow her on X @happyfeet004.