Without Medicaid Expansion Lawmakers Will Consider Some Alternative Reforms

Feb 5, 2016

Lobbyists and others listen as the Legislature’s Labor and Health Committee considers legislation.
Credit Bob Beck


Legislators have been talking about reforming health care in the state for at least 25 years. Access to health care providers is difficult, finding affordable health care is a challenge, and so after another Medicaid Expansion defeat the legislature’s Health and Labor committee spent the summer trying to find ways to improve health care in the state without spending much money. 

Gillette Representative Eric Barlow said the committee crafted 17 bills that will address a wide range of issues in health care. One bill involves nurses.

“Getting more nurses, more availability to nursing professionals in the state, that does improve access and quality of care…etc. Direct primary care, that’s a bill that’s going to allow a particular kind of practice…a model where you pay in advance to have certain health care needs met.”

Barlow added that they even crafted a couple of bills that will help local hospitals and nursing homes leverage more federal money.

“Now is it the same or as good as Medicaid expansion or overall improved reimbursement rates for Medicare or Medicaid…etc? No it’s not, but it certainly does improve the potential that nursing homes or hospitals and providers are getting closer to what they need for a viable operation.”

Cheyenne Representative Sue Wilson who is also a member of the Health and Labor Committee said the legislation they are bringing will help a little, but she admits it’s going to be a work in progress. 

“We are still trying to maybe give localities some tools and to try to maybe look at it in a broader perspective. It’s maybe not what everybody would have wanted, but given the situation…we haven’t given up we’ll just say that.”

Wilson said they do have some legislation that might help get people with limited health insurance better access to health care. But she still sees a need for more creativity.

“Opportunities for people who are in more rural areas to go to the Senior Center, the EMS office, you know some place where you can put a telehealth kiosk and have people check in to a provider from there.”

Noting that health and mental health needs vary from county to county, Wilson is in the midst of crafting an additional piece of legislation that deals with grants.

“To try to give localities the opportunity to look at their specific situations and design it, rather than designing a one size fits all program.”

The question is how to pay for it. That question both amuses and frustrates Democratic Senator Bernadine Craft of Rock Springs. She notes that if the legislature would just expand Medicaid it would get federal money to address a number of needs. 

“I think that’s our only hope to really have the kinds of resources…especially now in this economic downturn…that we need to have, is to take that Medicaid Expansion. I’ve always supported it, but I think it’s even more critical now. And I don’t think we can do have of what we want unless we do that.”

House Health and Labor Committee Chairman Elaine Harvey said it does not appear as if the legislature is anywhere near moving in that direction. The most recent blow came last month when the Appropriations Committee removed Medicaid Expansion from the governor’s budget. But Harvey added that under the circumstances, she thinks the committee did do a good job.The legislature begins work next week.