Wyoming to consider Medicaid expansion

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Wyoming???s Republican Governor Matt Mead has reluctantly endorsed a plan to expand the state???s Medicaid program through the Affordable Care Act???s provisions. The plan, called SHARE (Strategy for Health, Access, Responsibility and Employment) was developed by the Wyoming Health Department and would require many newly eligible participants to pay premiums and co-pays.

The SHARE plan comes after a year in which Wyoming has considered several plans to expand its Medicaid program under the Affordable Care Act, such as the ???premium assistance??? model that Arkansas embraced and another plan offering more limited health care benefits while requiring increased cost sharing. None have been able to pass.

Jonathan Ingram, Research Director at the Foundation for Government Accountability argues Medicaid expansion in any form distorts medical markets and drives up costs. ???Medicaid expansion by any name is inherently not pro-patient, nor is it pro-tax payer. So that alone is enough to safely say it’s a terrible idea for Wyoming and should not be considered viable under any circumstances,??? said Ingram.

Governor Mead???s comments to local media suggest he???s not fully on board with a Medicaid expansion either. According to the Casper Star-Tribune, Mead said during an early-December press conference that the SHARE proposal was not good legislation, but ??????we need to either go forward with this or if the Legislature wants to come up with a different plan, I certainly would be open to that.??? Mead explained “I don???t think we can say to those people in Wyoming who are working who cannot get insurance that we???re not going to do anything.”

SHARE Expands Faltering System

SHARE would create two tiers for Medicaid recipients. All participants would be required to make co-payments; recipients with higher incomes of between 100 and 138 percent of the federal poverty level would pay an additional monthly premium ranging from $25 to $50 based on household size and income. The new proposal also includes access to work assistance programs such as job search services and vocational rehabilitation programs.

All told, the SHARE plan would add around estimated 17,600 low-income Wyoming residents to the Medicaid system.

???Medicaid expansion, no matter how you want to brand it, is going to completely distort the local healthcare economy,??? explained Ingram.  One specific outcome predicted by Ingram was that expansion would drive up the cost of private healthcare insurance premiums, because healthcare providers have to begin to compensate for the low reimbursements offered by Medicaid.

This would come on top of an already-faltering Medicaid system. Patients now face long waits for limited services and many Wyoming counties are facing physician shortages. According to the Association of American Medical Colleges, 87 percent of Wyoming counties are currently facing provider shortages.

Matthew Glans ( is a senior policy analyst at The Heartland Institute.