Neither proposal follows the standard Medicaid expansion adopted by Democratic-led states. One proposal, backed by Gov. Matt Mead and the Wyoming Health Department, would set up two tiers for Medicaid recipients: All participants would make co-payments, and those with higher incomes would pay monthly premiums of $25 to $50. Participants would have access to employment assistance programs like job search services and vocational rehabilitation programs.
The other, backed by state Sen. Charles Scott (R), chairman of the Labor, Health and Social Services Committee, closely mirrors an alternative plan that will expand Medicaid coverage in Indiana. That plan would provide coverage through state-funded health savings accounts.
Critics of Scott’s plan have said it’s unlikely to pass muster with the federal Centers for Medicare and Medicaid Services. But on Tuesday, Indiana Gov. Mike Pence (R) announced CMS had approved his state’s plan, which he calls HIP 2.0, after the Healthy Indiana Plan.
Scott told the Casper Star-Tribune he plans to mesh the two competing plans together, using the Mead-backed plan, dubbed the Strategy for Health, Access, Responsibility and Employment — or SHARE — as its base.
Mead initially opposed Medicaid expansion under the Affordable Care Act, and the state joined a Republican-backed lawsuit aimed at overturning the health law. But, he said in a recent interview, now that the Supreme Court has upheld the law, Wyoming should take advantage of federal money that would cover uncompensated care that costs state hospitals more than $100 million a year.
“I thought it was both bad policy and I thought it was unconstitutional. The courts said I was wrong,” Mead said. “It’s not acceptable to me, even though I have serious disagreements with the law, this is the current law. How do we as a state make the best of it?”
Wyoming would become the 30th state to accept federal funds to expand Medicaid, and the 10th state to expand Medicaid under a Republican governor. Nevada, Arizona, New Mexico, North Dakota, Iowa, Indiana, Ohio, Michigan and Pennsylvania — all states run by GOP governors — have also accepted federal funds.
Tennessee lawmakers are debating whether and how to expand Medicaid as well. In Arkansas, where a Republican-led legislature passed a modified Medicaid expansion under Democratic Gov. Mike Beebe, lawmakers are considering ending the expansion, now that Republican Asa Hutchinson has moved into the governor’s mansion. Hutchinson has said he wants to maintain the expansion program through 2016 as he considers alternatives.