CHEYENNE -- The Wyoming Legislature will consider at least one Medicaid expansion bill after the Senate voted Friday to introduce a compromise offered by Sen. Chris Rothfuss, D-Laramie.
Senate File 118 will give the state time to explore the best options available in providing health care to more than 17,000 uninsured, low-income residents.
The Senate voted 21-9 to consider the proposal, or one more vote than needed to be introduced in the budget session.
The bill was referred to the Senate Committee on Labor, Health and Social Services.
The Legislature rejected four other Medicaid-related bills earlier this week, the first of the four-week budget session.
The House on Friday rejected a fifth Medicaid-related bill on a 33-27 vote -- House Bill 161, a Medicaid expansion compromise sponsored by Rep. Eric Barlow, R-Gillette.
Friday was the last day for bill introduction in the session.
Rothfuss said his bill brings all of the options "to the table."
"I'm trying to bring forward a compromise solution that we can discuss and debate on the floor," Rothfuss told fellow senators.
He said the bill includes the best ideas from other sources, including other states.
The bill calls for traditional Medicaid expansion only for the first year.
This would allow the state quick access to resources available from the federal government.
During that year, the governor, insurance commissioner and the director of the Wyoming Department of Health would negotiate the waiver to find the best option for the state.
In addition to the first-year expiration, the waiver sunsets after three years and would require action by the Legislature to continue.
"We have to opt to stay in and hope that will allow people some confidence in the future," Rothfuss said.
The bill also has a "kick-out option" that can end the state's participation if the federal government fails to keep its promise of a 90 percent match of funds.
Additionally, it puts the expected net savings of $40 million per two-year biennium into a savings account to bridge the gap if the state moves to a different policy.
Sen. Charles Scott, R-Casper, chairman of the Senate Labor, Health and Social Services Committee, said SF188 is one of the bad Medicaid expansion bills offered this session.
"It removes our bargaining leverage with (Centers for Medicare and Medicaid Services) to get a decent Medicaid expansion," he said in an interview Friday.
Scott believes that once the state gets on the regular Medicaid expansion, it won't get off.
"But it is a vehicle. We could do all kinds of things to it," he said of the bill.
Scott said he will consult with the four other committee members to see if there is enthusiasm for the bill.
"Because, if we turn this loose on the floor, it will kill a bunch of other bills," he said in reference to the time it would take to debate the bill in the limited time available during the budget session.
Rothfuss doesn't understand Scott's concern.
"We're locked into expansion for the first year but then we negotiate in that year for subsequent years," he said.
Gov. Matt Mead has opposed Medicaid expansion but offered no alternates for the Legislature this year.
"I'm comfortable with the governor," Rothfuss said. "I'm less comfortable with the committee."
If the Legislature passes his optional expansion bill, Rothfuss said he expects the the governor will support it "with reluctance."
"Based on discussion with him, even if he doesn't support it, he has all along expressed openness to options and a legislative solution," Rothfuss said.