- Associated Press - Thursday, February 27, 2014

CHEYENNE, Wyo. (AP) - Gov. Matt Mead and other Wyoming officials could get the green light from the Legislature to investigate over the coming year whether they can reach an agreement with the federal government to expand Medicaid on the state’s terms.

A conference committee of Wyoming legislators on Thursday endorsed a measure that specifies Mead - as well as the Wyoming Department of Health and the state insurance commissioner - may negotiate with federal officials on a plan called a demonstration waiver that differs from conventional Medicaid expansion.

The full House and Senate would still have to endorse the language before it would become part of the general government appropriation bill for the two-year period that starts July 1.

Both the Wyoming House and Senate earlier in the current legislative session rejected proposals to accept full federal funding to expand Medicaid to add 17,600 low-income adults. The Legislature last year also rejected $50 million in federal funds for the expansion.

The proposed expansion that the state rejected would have covered adults making up to 138 percent of the federal poverty level, or $15,856 a year. The federal government has offered to cover 100 percent of the expansion costs for 2014, 2015 and 2016.

Mead and Republican legislative leaders say they don’t trust federal promises to pay for expanding Medicaid. Expansion of the program is central to the federal Affordable Care Act.

Renny MacKay, spokesman for Mead, said Thursday the governor has made it known from the beginning that he didn’t think the Affordable Care Act was good policy and believes the way it’s been implemented hasn’t inspired confidence.

“For those who support the ACA and those who oppose it, this allows us to find out what we’re saying yes to and what we’re saying no to,” MacKay said of the conference committee action. “It allows us to present more information to the Legislature, and allows us to have more information to make a decision going forward.”

Rep. Eric Barlow, R-Gillette, was the original sponsor of the Medicaid amendment that passed the House.

“Now the governor has some guidance on how he can proceed,” Barlow said after the committee vote. “And I think the Legislature has provided that, and I hope the governor will be receptive to proceeding.”

Sen. Curt Meier, R-LaGrange, served on the budget conference committee. He said after Thursday’s vote that he doesn’t know whether the measure will pass in the Senate.

“It really doesn’t do that much from the standpoint of that it tells the governor he can do what he already can do,” Meier said. “So the value of it, I think, is probably limited.”

The conference committee amendment specifies that any Medicaid expansion proposal would have to be submitted to a legislative committee by Nov. 1 or as soon after as possible. It specifies that any expansion may not draw down the state’s general fund or generally harm Wyoming businesses.

Sen. Eli Bebout, R-Riverton, is chairman of the Senate Appropriations Committee and led the Senate conference committee. Speaking after the committee vote, he said he’s concerned that expanding Medicaid could harm private insurance carriers in the state as well as small employers.

“But it’s an amendment that says we’re going to go ahead and see what a waiver might look like,” Bebout said.

Rep. Steve Harshman, R-Casper, is chairman of the House Appropriations Committee and led the House team. Harshman said after the committee vote that Wyoming lawmakers are leery of expanding Medicaid on the basis of federal promises.

Harshman said the federal government has reneged on a series of funding promises it’s made to Wyoming, including changing the original Medicaid funding formula, cutting federal mineral royalties and eliminating state payments for abandoned mine lands.

“So when you take something on like that, what’s the best predictor of future actions? It is past actions, really,” Harshman said. “So I think folks are rightfully nervous and want to make sure we have all the answers on how this is going to roll out.”

The Wyoming Hospital Association and other groups, calling themselves the Wyoming Coalition for Medicaid Solutions, had pushed for full Medicaid expansion. They have pointed to a study commissioned by the state health department that concluded expanding Medicaid would save the state millions by relieving pressure on other health programs.

Dan Perdue, executive director of the hospital association, also serves as chairman of the coalition.

“This is a start,” Perdue said in a prepared statement after the conference committee vote. “This ensures will go into the 2015 session with some plan to insure very low-income working adults without children through Medicaid. Currently they have no options for health insurance.”

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