Several attorneys and labor officials have raised alarm about an air ambulance bill that the Wyoming Legislature will consider, warning that it unravels the grand bargain of workers’ compensation and will leave injured workers with hefty medical bills.
“I just think it’s a breach of trust between industry and labor,” Cheyenne attorney George Santini said. “It’s breaking the promise that was made, and the promise that was made was that if you’re injured on the job, we’ll take care of you.”
What this bill would do, he said, is say: “If it’s too expensive, you’re on your own.”
The measure in question is House Bill 35, a product of the Joint Labor, Health and Social Services Committee. It would essentially offer air ambulance companies a choice in terms of receiving payment for transporting injured workers: Take roughly double the Medicare reimbursement rate, or go bill the worker directly for the rest, a process known as balanced billing.
It’s a product of a yearslong lawsuit between the state and four air ambulance companies, which challenged the state’s set fee schedule for transports. The companies successfully argued that the fee guidelines were preempted by the federal Airline Deregulation Act of 1978.
Last week, Rep. Eric Barlow, the committee’s co-chair, said the bill was an attempt to protect workers from the exorbitant bills that are common of air ambulances. One of the companies that flies in Wyoming and sued the state, Air Methods, was charging $49,800 for an average flight in America in 2016. The transports cost the company between $6,000 and $13,000 per trip, according to a federal report from 2017.
Barlow and officials with the state’s Department of Workforce Service said the bill would give air ambulance companies more money than they would have received under the fee schedule and that they would be incentivized to take the doubled Medicare rate, rather than going after the injured worker, because the state would pay promptly and with certainty.
But attorneys familiar with the issue disagreed.
“Air ambulances aren’t going to take that little amount of money,” Casper attorney Dallas Laird said with a scoff. Under the bill, the rate would be over $10,600 for a helicopter ride and roughly $9,100 for a plane ride, with additional per mileage rates.
Richard Mincer, a Cheyenne attorney who represents the air ambulance companies in the lawsuit against the state, said that the workers’ compensation program was based on the premise that workers would not be charged for medical costs for an injury incurred on the job. In exchange, the workers lost the ability to sue for negligence.
This bill, he said, would unravel that by allowing providers — in this case, the air ambulance companies — to go after the injured workers if they decided to decline the doubled Medicare reimbursement.
“So the idea that this bill is going to do anything to protect workers is completely, flat-out, factually wrong because the workers don’t face any exposure to medical bills as we sit here today,” he said last week. “This bill changes that.”
Labor advocates expressed similar alarm. Rep. Stan Blake, a Green River Democrat and union railroad conductor, said he was “real concerned” about the bill and said the state’s workers’ comp fund was flush.
“I would hate to see somebody lose their life because we’re squabbling over the price of an air ambulance,” he said.
Travis Deti, the executive director of the Wyoming Mining Association, said last week he was still studying the bill. But he said he had “some significant concerns” at first blush.
“We don’t want our miners, an injured miner, on the hook just because workers’ comp doesn’t want to pay the bill,” he said. “We’re going to see how the debate unfolds and visit a little bit with the legislators and see where this goes.”
Jason Wolfe, the interim deputy director of the Department of Workforce Services, said the bill was drafted with the sprawling litigation in mind. He said the 10th Circuit Court of Appeals had indicated that the part of the state statute that was preempted by the federal airline law was the balanced billing provision, not the fee schedule that capped payments to air ambulances.
In other words, the part of the law that was at issue was the prohibition on directly billing the injured worker, a crucial part of the grand bargain that is workers’ compensation.
“This is not where any of us want to be,” Wolfe said. “Unfortunately, the litigation has really pushed us to this point.”
The opinions of the courts suggest otherwise. In a filing from August 2017, the 10th Circuit wrote that they agreed with a lower federal court that the “rate schedule for ambulance services (is) preempted by the Airline Deregulation Act” as set by the state. The air ambulance cost capping was again deemed void.
The 10th Circuit did reverse the lower court’s decision to force the state to pay 100 percent of air ambulance costs. But it did not strike down the direct balanced billing prohibition; it said only that the issue was one for state lawmakers and judges, not a federal appellate court.
The Wyoming Supreme Court, meanwhile, ruled in November that “the statute required the (state) to pay (the four air ambulance companies) the full amount of their billing for air ambulance services.”
Stated another way: The federal appellate court said the issue of whether the state can prohibit balanced billing falls to a state court or the Legislature. The highest state court ruled that the Department of Workforce Services had to pay all air ambulance costs for injured workers, as required by law.
A follow-up email to a Workforce Services Department spokeswoman was not returned Monday. In an email, Barlow, the committee co-chairman, wrote, “Yes, there are legitimate concerns to be considered and we will be receptive to them.”
According to the fiscal note attached to the bill, the measure would save employers in Wyoming about $4 million a year in workers’ compensation premiums. The state spent about $19.6 million in air ambulance fees from 2014 to 2017. Had this bill been in place over that period, with the doubled Medicare rate and balanced billing in effect, the state would’ve saved $15.4 million.
Wolfe acknowledged that the workers’ compensation fund has just over $2 billion in it. But he said that figure is misleading because those funds are attached to existing claims.
He added that should the air ambulance companies reject the doubled Medicare rate and go after the worker, that injured person would receive the Medicare funds to help offset the cost.
Still, even with that amount provided, an injured worker would likely have a difficult time paying an air ambulance bill. According to court filings, injured worker-related life flights in Wyoming routinely topped $30,000.
“The basic problem is the average Wyoming person who gets injured somewhere has no insurance for (an air ambulance) and can’t afford it,” Laird, the Casper attorney, said. “Nobody can afford those kinds of bills. It leaves them with losing their house or getting their wages garnished or having to take bankruptcy.”
Laird said that if the Legislature wanted to allow balanced billing, then it should allow injured workers to sue their companies for negligence. That’s currently prohibited by the grand bargain of workers’ comp and would completely unravel the compromise, but Laird said that workers won’t be able to afford the bills otherwise.
He also floated requiring employers to have air ambulance insurance, even giving them the option of purchasing coverage for their employees or facing a negligence suit.
In a blog post, Michael C. Duff, a law professor at the University of Wyoming and workers’ comp expert, argued that the bill would violate the Wyoming Constitution and could also be challenged on the grounds that it fell afoul of the same federal law that it’s trying to avoid.
“It is not difficult to anticipate the grisly possibility of a worker adamantly refusing air ambulance services, because of a realization that he or she will be stuck with thousands of dollars of expense, and dying during lengthy ground transport,” he wrote. “I also imagine that counsel for air ambulance companies will be factoring in added expense occasioned by pursuit of destitute injured workers in Chapter 7 bankruptcy proceedings.”
Legislative leaders addressed both houses of the 65th Wyoming Legislature on Tuesday afternoon, outlining the goals they hope to achieve over the next 40 days: addressing the state’s volatile revenue picture, finding reasonable solutions for health care and education and building a stable workforce that can endure into the future.
However, the path to getting there, particularly in the House, was a large and looming question hanging over the pomp and circumstance of the general session’s opening day.
Newly-elected Senate President Drew Perkins, R-Casper, addressed the 30-person body with a general speech of where the Legislature was headed: finding a solution to the state’s seemingly endless cycle of booms and busts while improving the revenue side of the state budget, an area where he and second-term Speaker of the House Steve Harshman, R-Casper, are in agreement.
While following a similar narrative in the House, Harshman – presiding over a younger body with 10 new members – made sure to emphasize themes of bipartisanship and progress as the 60-person House of Representatives begins its work.
He did so by looking back to the history of the state and the intentions of its founding fathers. He noted past successes, from the 23rd House of Representatives implementing the first sales tax in the Great Depression to Harshman’s second session, in which a proposal to create a merit-based scholarship passed after weeks of effort.
“The process of getting a majority is tough, and it can knock you down,” he said. “And I think this process really favors those that get back up.”
The important thing, Harshman said, was to make sure the good ideas that rise to the top get their fair shake and to consider the long-term success of the state when lawmakers cast their votes.
“People elected us to come here and solve problems,” he said. “I think it’s easy to just sit there and vote ‘no’ on everything – I’m sure we can build some kind of machine to do that. But the idea is to analyze, solve, debate and accomplish things. This whole solving and fixing, building and accomplishing is only possible with this type of selfless service for the people back home and following the golden rule. If we do that, and treat each other the right way, we’re going to be in great shape.”
That attitude, he hoped, would extend itself to the most pressing and challenging issues currently facing the Legislature. While he lauded the House for its work whittling down a roughly $1 billion shortfall facing the schools in the not-so-distant past, he noted that the system is still highly dependent – about 65 percent for grades K-12 – on the price of oil and minerals.
“It is repeatable if we don’t work to fix it, and there are things we can do to bring balance and more stability,” he said.
Harshman also outlined a number of other priorities – job creation and training, a Wyoming-based solution to fix health care and determining how to best utilize the state’s rainy day fund in the future. But addressing those challenges, he hinted, may come with some difficulties.
“At some point, we’re not going to cut our way to prosperity,” he said. “We need to be cognizant of that. We don’t have $20 billion sitting around in coffee cans – we have a billion-and-a-half in the LSRA, and a few small savings accounts for projects. There’s $20 billion from the mineral trust fund, that goes to worker’s comp, to common schools, the permanent land fund … Those are all constitutionally protected funds that are generating revenue for the state. Those aren’t things you can dip into.”
Speaking for the Democratic minority, Rep. Cathy Connolly, R-Laramie, spoke of the Legislature taking risks this session with the possibility of great reward.
Those risks included several progressive policy priorities such as the funding of early childhood education statewide, an improved tax structure, solving the state’s earnings gap, passing corrections reform and setting a benchmark for literacy by the third grade.
The biggest fight for the Democrats and Connolly in particular, however, will likely be in the passage of an anti-discrimination statute, which the state GOP has expressed it would be working to oppose vehemently this session.
“Make no mistake about it, our state and the homophobic violence associated with that violence are inexorably linked,” said Connolly.
In television interviews reflecting on the murder of Matthew Shepard, a gay University of Wyoming student whose murder inspired a wave of anti-discrimination legislation across the country, she reflected on the state’s need to do more.
This year, she emphasized in her speech, could be the year to make that happen.
“We’re losing our youth – not just our gay ones, but their friends and family who do not want to stay in a place where their loved ones live in fear. Here in this body, we need to take the risk to go home and tell our constituents proudly that Wyoming now joins the majority of the nation in doing something. And you know what? I’m pretty sure you will be rewarded for that action. Not by everyone, that’s for sure. But we’re not here for the easy votes.”
Secretary of State Ed Buchanan gave the first speech in the House on Tuesday, laying out a number of legislative priorities he had hoped to accomplish, as well as updates on his priorities entering his first elected term as secretary.
Among them, Buchanan called for legislative support to purchase new voting machines and updating the election code to incorporate changes in the political landscape stemming, in part, from social media and the “creative” use of political action committees.
He also expressed a priority by his office to maintain local control in statewide elections, in response to Democratic members of Congress pushing legislation for automatic voter registration nationwide.
“In Wyoming, we do elections right,” he said.
WASHINGTON — President Donald Trump made a somber televised plea for border wall funding Tuesday night, seeking an edge in his shutdown battle with congressional Democrats as he declared there is “a humanitarian crisis, a crisis of the heart and a crisis of the soul.”
Addressing the nation from the Oval Office for the first time, Trump argued for funding on security and humanitarian grounds as he sought to put pressure on newly empowered Democrats amid an extended partial government shutdown.
Trump called on Democrats to return to the White House to meet with him, saying it was “immoral” for “politicians to do nothing.” Previous meetings have led to no agreement.
Responding in their own televised remarks, Democratic House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer accused Trump of misrepresenting the situation on the border as they urged him to reopen closed government departments and turn loose paychecks for hundreds of thousands of workers.
Schumer said Trump “just used the backdrop of the Oval Office to manufacture a crisis, stoke fear and divert attention from the turmoil in his administration.”
Trump, who has long railed against illegal immigration at the border, has recently seized on humanitarian concerns to argue there is a broader crisis that can only be solved with a wall. But critics say the security risks are overblown and the administration is at least partly to blame for the humanitarian situation.
Trump used emotional language, referring to Americans who were killed by people in the country illegally, saying: “I’ve met with dozens of families whose loved ones were stolen by illegal immigration. I’ve held the hands of the weeping mothers and embraced the grief-stricken fathers. So sad. So terrible.”
The president often highlights such incidents, though studies over several years have found immigrants are less likely to commit crimes than people born in the United States.
Trump has been discussing the idea of declaring a national emergency to allow him to move forward with the wall without getting congressional approval for the $5.7 billion he’s requested. But he did not mention that Tuesday night.
With his use of a formal White House speech instead of his favored Twitter blasts, Trump embraced the ceremonial trappings of his office as he tries to exit a political quagmire of his own making. For weeks he has dug in on a signature campaign promise to his base voters, the pledge to build an impregnable “beautiful” wall along the U.S.-Mexico border.
The partial government shutdown reached its 18th day, making the closure the second-longest in history. Hundreds of thousands of federal workers are going without pay, and government disruptions are hitting home with everyday Americans.
The Casper City Council bid farewell to three members at Tuesday’s meeting, including longtime Councilwoman Kenyne Humphrey, who was elected to her Ward 3 seat in 2006 and served four terms as mayor.
“Rather than give everybody a boring speech, for those of you who know me, I have to shake things up a little bit,” said Humphrey, who is leaving alongside council members Jesse Morgan and Dallas Laird.
Humphrey, who has changed her hair color many times while serving, then placed a towering cotton-candy colored wig on her head and played a photo montage showcasing her many different hues.
“You guys are going to have an amazing new era,” she said.
Outgoing Casper City Councilwoman Kenyne Humphrey made a memorable exit Tuesday. Humphrey, who often changes up her hair, put on a huge wig and shared pics of her various different hair styles throughout the years. pic.twitter.com/xzEzsGUCVU— Katie King (@KatieKingCST) January 9, 2019
Humphrey, who works at Mountain Plaza Assisted Living, announced more than a year ago that she would not be seeking re-election. She cited stress as the primary reason for her departure.
“(Serving on the Council) kind of takes a toll on your health. ... I work 50 hours a week, and then I’m running to meetings and I don’t sleep,” she said.
Morgan and Laird also made brief remarks.
Morgan, who represented Ward 1, explained that the city had undergone significant changes during the last two years, including hiring a new city manager and attorney, as well as new fire and police chiefs.
“All of these positive changes will hopefully set up our new City Council members in a much better position than I faced in the first six months that I took my term,” he said.
Morgan urged the new council members to ask questions and find out as much information as possible about the issue at hand.
Laird also encouraged new council members to ask questions and research issues as thoroughly as possible.
“It’s the lowest paying job I ever had, but it was the most fun,” said Laird, adding that he was honored to serve.
Laird and Morgan both opted not to run for re-election last year.
Although Laird said he enjoys representing his constituents, he said this summer that he believes it’s important to step down and give others an opportunity to serve.
“People stay on there too long and it just slows the city down — I think new perspectives are needed,” said Laird, who represented Ward 2.
Morgan, who represented Ward 1, previously explained that he decided not to run because he intends to sell his home and will likely be relocating outside of the district.
After the departing remarks, new council members Kenneth Bates and Steven Freel were sworn in. Incoming councilwoman Khrystyn Lutz was unable to attend due to a family emergency.
After taking his new seat, Bates shared a quote he credited to Henry Ford.
“He said coming together is good. Staying together is progress. Working together is success,” said Bates, adding that he would aim for success.
Freel thanked his supporters and said he was looking forward to serving.
“I’m very happy to be here, and I will give it my all,” he said.
Freel currently works as a real estate agent. He retired about two years ago as the assistant police chief for the Casper Police Department.
Lutz is the vice president of operations at Pathfinder Federal Credit Union. Bates recently left his position as a supervisor at the Youth Crisis Center.