I am writing to strongly disagree with the Medicaid editorial in the Sunday, February 16, 2020, paper. The numbers you cite are misleading and current programs meet most of the need.
The editorial stated 19,000 Wyomingites would join Medicaid if it were expanded. What is left out is many of those people already have good health coverage and most could get it if they chose. The official Wyoming Department of Health estimate is 38 percent of those eligible already have coverage. I believe reality is closer to one-half. The reason is coverage through the Obamacare exchange is better in Wyoming than many other states. Our Insurance Department and our monopoly insurance carrier have carefully worked together to structure the subsidized private offerings through the exchange to take advantage of what’s available under federal law. Last year about half of the Bronze and Gold plan offerings through the exchange were free. There is a trade-off. Free coverage requires some deductible for care. Also, studies done on the Oregon Medicaid expansion show private coverage is better for health than Medicaid.
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Someone who is unable to work due to disability or long-term illness is eligible for the federal/state Supplemental Security Income program with Medicaid coverage. For everyone else, subsidized Obamacare exchange coverage requires income of at least the federal poverty level. A minimum wage job, 40 hours a week, reaches the federal poverty level for an individual. In our economy these jobs are available.
Medicaid expansion would cause a problem for Wyoming hospitals and doctors. Wyoming Medicaid pays poorly because our revenue is down. The legislature, I included, has chosen to spend less on Medicaid and more on education.
A tax increase would be needed to expand Medicaid. The $9 million annual cost estimate is too low. The official estimate is $12 million for following years. Experience in other states shows official estimates are too low. My judgement is Medicaid expansion does too little good to justify a tax increase.
CHARLES SCOTT, Wyoming Senator, Casper
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