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Wyoming Becomes Latest GOP-Led State to Push Medicaid Expansion

Nina Liss-Schultz

Health officials in Wyoming last week released a report urging the state to expand Medicaid coverage, adding to the list of Republican-led states advocating for the program's expansion under the Affordable Care Act.

Health officials in Wyoming last week released a report urging the state to expand Medicaid coverage, adding to the list of Republican-led states advocating for the program’s expansion under the Affordable Care Act.

The Wyoming Department of Health last week published a plan for Medicaid expansion, called the Strategy for Health, Access, Responsibility, and Employment (SHARE) Plan, which it says will provide health coverage to 17,600 low-income people in the state.

Low-income Wyoming residents must meet both financial and other eligibility criteriafor example, a person must also be pregnant or disabled—to qualify for Medicaid. These restrictive eligibility criteria create a “coverage gap,” a section of the population that is too poor to afford private insurance but not poor enough to qualify for the public insurance program.

The new state rules would open Medicaid eligibility to any Wyoming resident who earns less than 138 percent of the federal poverty level.

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“We have done the work and we have a plan,” Republican Gov. Matt Mead, a backer of the SHARE Plan, said in a statement. “I believe it is the most favorable plan for Wyoming, and it addresses the need of those who fall in the gap.”

The plan must also be approved by both the state legislature and the Obama administration before it can take effect, which would likely be in 2016.

Wyoming’s plan differs from the rules set up under the ACA, which guarantees coverage without cost-sharing for most people eligible for the low-income insurance, since Wyoming’s Medicaid would include co-payment and premiums for some recipients.

If approved, Wyoming would join the 27 states that have already opted to expand Medicaid coverage under the ACA, which provides federal funding of expanded programs.

Wyoming would also become one of only a few states controlled by Republican governors to expand the public health insurance. Though Republican-led states have by and large been opposed to the adoption and implementation of Obamacare, an increasing number of conservatives have changed their stance on Medicaid, pushing to expand the program even in the face of political opposition, including the Republican governors of Arizona, Michigan, Ohio, and Pennsylvania, which have all implemented expansion.

Tepid Republican acceptance of Medicaid expansion could be the result of political expediency, as expansion of the program has proven popular across the country—even in the South, where Republican governors and GOP-controlled legislatures have long fought the ACA’s assistance for low-income residents.

Several other GOP governors have voiced an interest in expansion but haven’t moved forward with plans, including state leaders in Florida, Indiana, and Utah.

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