An uninsured patient visited Dr. Gregory McCue’s practice in Cody, Wyoming, this week and explained that she can’t afford insulin to treat her diabetes. McCue fears that the next time she returns to Cody Regional Health, it could be costly and life-threatening.
“That patient,” McCue said, ”will end up in the hospital and it will cost us $5,000 for a two-day stay instead of $200 to $300 a month it would have cost for her insulin. And because you can’t get blood out of a turnip, that’s uncompensated care that gets passed onto the hospital and the state.”
That’s a weekly occurrence for him in Wyoming, he said, because the state hasn’t expanded Medicaid, an option that could provide health care to thousands of working people in the state.
That could soon change, however.
On Wednesday, Republicans who long opposed the measure and Democrats who long supported it in the Wyoming House joined together to pass Medicaid expansion, potentially signaling the beginning of a change nationwide that could bring health care to those within the coverage gap.
Expanding Medicaid is an option available to states since 2014 through the Affordable Care Act, commonly known as Obamacare, yet Wyoming and 11 other states have refused to take up the federal government’s offer. Approximately 2.2 million people, who earn too much for Medicaid and too little for Obamacare subsidies, fall in that coverage gap nationwide, according to the Kaiser Family Foundation.
In those that have refused to expand Medicaid, Republicans in power have maintained that their states cannot afford to pursue the measure and their opposition has become more ideological over time. Their positions have ignored much evidence that states that have expanded did not take on additional cost burdens and increased coverage saved American lives.
The conversation around Medicaid expansion appears to be undergoing a new and dramatic shift in some of the holdout states, however. Central to that change is the Biden administration’s offer, via its Covid-19 relief bill, of increased federal dollars over two years to states that adopt expansion for the first time. It’s expected that funding could cover the states’ Medicaid costs for that period.
“It’s the stimulus funds that are really the motivation,” said Sen. Chris Rothfuss, the Wyoming Senate minority leader who helped write the bill moving its way through the Legislature. “I think it has really changed some hearts and minds in the Legislature.”
The window is small for the bill to pass in Wyoming. The state Senate has a week to approve it before the session ends, and Republican leadership in the Senate quashed an effort in the chamber earlier this month. The fact it’s a conversation with Republican support is significant, and the aid to the state could be massive.
In Wyoming, Medicaid expansion combined with the boost from the American Rescue Plan means $120 million over the next two years and, according to the state’s own estimate, it would provide more than 24,000 people health care coverage. The state has 67,900 uninsured residents, according to data released by the Department of Health and Human Services.
“I voted ‘no’ multiple times on this same issue,” Wyoming Republican House Speaker Eric Barlow said Wednesday on the floor of the Legislature, “and I’m going to vote ‘yes’ this time, because I haven’t seen any other solution. Nobody’s brought anything forward, and I’ve looked myself.”
It’s not just Wyoming where advocates and state leaders have begun to see the ground shift. Many have noted Alabama Gov. Kay Ivey’s office said she is “open to the discussion” after she and state GOP leaders have long opposed expansion, but there is also fresh movement among some Republicans in North Carolina, Texas and in other states — something many once thought impossible.
On Friday, North Carolina Republican state Sen. Kevin Corbin announced on Facebook that he was working with Sen. Jim Burgin, the chairman of the state’s Senate health care committee, “to introduce a bill in the next two weeks that looks at how to expand healthcare coverage for working families in North Carolina.” It’s one of the first public announcement by North Carolina Senate…