State senators are backing a bill that would update Medicaid eligibility to include a new federal work requirement, as well as increase reimbursement rates for EMS services. Meanwhile, House representatives declined to increase those rates for nursing homes and maternal services, despite staffing shortages in both fields.
Medicaid provides health insurance to people with low incomes, including children, pregnant women and parents. In Wyoming, the federal government covers a match rate of 50%. But it’s up to the state Legislature on how much the state matches for certain services.
Eligibility for the program differs by state. One bill that the Senate Labor, Health, and Social Services Committee forwarded to the Senate codifies current requirements for Wyomingites, in addition to adopting new federal regulations. The One Big Beautiful Bill Act signed into law last July requires many Medicaid recipients to work or participate in qualifying activities for 80 hours per month unless they meet exemptions for disability, pregnancy, caregiving or other circumstances.
The Wyoming-specific requirements outlined in the bill include that the individual applying must be a U.S. citizen with proof of identity and a Wyoming resident. In addition, an individual must also be eligible for one of the additional outlined criteria, including: being disabled according to Social Security guidelines, receiving Supplemental Security Income or being entitled to hospice services, among others.
During the committee’s discussion, Sen. Charles Scott (R-Casper) said defining eligibility is very important.
“We tried a number of years ago to do something like this and we were unable to get it done. [We] couldn't define the eligibility for the program well enough,” Scott said. “I think this is a responsible effort to try to preserve the Legislature's ability to control the eligibility in the program. But this means that if you are going to have a major change. It will have major budgetary implications and that is something the Legislature needs to deal with as a whole.”
The bill also requires prior authorization from the state Legislature if the federal government expands eligibility requirements after July 1, 2026.
If passed, those changes would apply to Medicaid applications submitted or renewed on or after July 1, 2027.
A fiscal note for the bill said it would have “no fiscal or personnel impact.”
But another bill the committee also forwarded would.
Senate File 4 would increase the state’s portion of Medicaid reimbursement for EMS services to 100% using a $1.3 million appropriation from the state’s general fund with an equal federal match.
EMS services have struggled in the rural Cowboy State, as ambulances need to cover a lot of ground. There are currently 44 organizations that provide these services but 16 have closed in the last 10 years, according to Tom Lacock, associate state director with Wyoming AARP.
“It’s not the silver bullet, but it certainly helps,” Lacock told committee members.
By increasing the state reimbursement rate, EMS services will get paid more money to recoup their costs for the next two years. All five committee members agreed and referred the bill to the Senate Appropriations Committee.
But representatives were not so optimistic about the value of increasing Medicaid reimbursements.
The House killed two bills upon introduction that would’ve increased the state reimbursement rates for nursing homes and maternal services.
HB 63 would’ve increased the reimbursement rate by 5% for skilled nursing homes under the Wyoming Medical Assistance and Services Act. Rep. John Bear (R-Gilette) said the Rural Health Transformation fund will make a big impact on the state.
“It's because we did not accept Medicaid expansion. And when we go to increase the amount of money that we're going to put into Medicaid, that's exactly what we're doing,” Bear told the chamber, urging a no vote.
HB 64 would’ve allowed the Wyoming Department of Health to apply for enhanced Medicaid reimbursement for maternal services. This means an extra $1 million from the state and feds each would be available for providers in the maternal health area.
Rep. Abby Angelos (R-Gillette) spoke against the bill, saying the OB-GYN shortage is because malpractice rates are so high in the state.
“One of the maternity wards in the center of the state had nine babies born in one year, and it was $4 million for the malpractice insurance,” Angelos said. “Until we address that issue, throwing money at this is not going to fix it.”
Angelos did not offer more specific details. But Wyoming has relatively high average payouts, according to North American Community Hub Statistics.
Both of these bills were meant to address healthcare shortages in the state, including nursing homes and OB-GYN providers.
