Efforts in two Western states to accept hundreds of millions in federal funds to expand Medicaid are running into roadblocks with conservative lawmakers, in spite of Republican governors who back the expansions.
In Wyoming, the state Senate voted 19 to 11 against expanding health coverage to about 17,600 low-income, uninsured residents. Moments after the vote, a state House committee said it would no longer consider its own version of Medicaid expansion, effectively killing any hopes this year.
Utah lawmakers will begin considering their own Medicaid expansion proposal this week in Salt Lake City. Republicans will meet behind closed doors on Tuesday, the Salt Lake Tribune reported, while House GOP leaders say they still want to negotiate with Gov. Gary Herbert (R).
Both Herbert and Wyoming’s Matt Mead (R) participated in lawsuits challenging the constitutionality of the Affordable Care Act after the law passed in 2010. But after the Supreme Court largely upheld the law, and after winning their Republican primaries, Herbert and Mead both said their states should take advantage of the federal funds on offer.
“We have to deal with the real world,” Mead said of Medicaid expansion in a December interview. “I’m not open to the alternative, [that] we’re not going to do anything.”
That month, two leading Republican senators offered competing plans that would have extended coverage in slightly different ways. One would have modeled a Medicaid program on a version in Indiana, which requires newly eligible recipients to pay into a fund similar to a health savings account.
The other, which Mead backed, would have required participants to make co-payments, and those with higher incomes would have paid monthly premiums of $25 to $50. Participants would have access to employment assistance programs, such as job search services and vocational rehabilitation programs.
The federal Department of Health and Human Services approved Indiana’s plan, though not specifically for Wyoming, and Mead’s plan.
In Utah, where 90,000 people could gain coverage under an expansion, Herbert has proposed using federal money to help low-income residents get private insurance. HHS has given tentative approval to his plan, too.
Republicans said they would consider Herbert’s plan, which was formally introduced in legislative form on Friday, along with a scaled-back version that would cover fewer residents and a Democratic plan that would expand Medicaid in a way that more closely resembles what the ACA envisioned.
The roadblocks come a week after Tennessee Republicans killed a bill backed by Gov. Bill Haslam (R) that would have covered hundreds of thousands of uninsured state residents. Like Herbert and Mead, Haslam had campaigned around the state advocating his proposal, though conservatives in both chambers of the legislature blocked it by wide margins.