The only piece of legislation in 2023 to increase Medicaid coverage for Wyoming residents to make it to the House floor of the Wyoming Legislature passed its first reading after a close vote after passionate debate Monday afternoon.
“There’s strong feelings on both sides of the issue and I think it really comes to, are we expanding the role of government in an appropriate way?” said state Rep. Lloyd Larsen, R-Lander.
House Bill 4 would extend postpartum Medicaid coverage from 60 days to a year in Wyoming.
If the measure passes this session, Wyoming would join 35 other states that already have approved postpartum Medicaid extensions for poor and disabled people.
In response to the COVID-19 pandemic, the 2020 Families First Coronavirus Response Act temporarily extended postpartum medical benefits to mothers for one year. In Wyoming, mothers were previously only covered for 60 days.
More Than Tripled Enrollment
Enrollment increased from 1,200 to 4,200 members in Wyoming after the extension.
Rep. Dan Zwonitzer, R-Cheyenne, said although there are signs that the extension has had a positive impact for Wyoming and their newborn children, he said it has been far too short of a time to determine accurate conclusions.
With the federal COVID-19 emergency set to expire in May, the program also will end in Wyoming unless the Legislature votes to extend it. Without HB 4, postpartum Medicaid coverage in Wyoming would return to 60 days.
Rep. Sarah Penn, R-Riverton, described the extension as an expansion, as it has a higher ceiling for eligible enrollees at 154% of the federal poverty level, or around $16,000 per year, slightly higher than the ceiling for a standard Medicaid expansion in Wyoming.
Extending the postpartum coverage would come at a 50/50 match with the federal government, available through 2027.
Duplicating Services
Rep. Tamara Trujillo, R-Cheyenne, claimed many of the services provided in the legislation are already offered through a variety of programs in Wyoming, but Larsen said in most cases this is not true, or at the very least requires extensive paperwork by the applicant to qualify.
“If they were providing all those services then the government could clearly step out,” he said.
Rep. Jeanette Ward, R-Casper, said the “medical cartel” is to be blamed for America’s high rate of infant mortality, treating “pregnancy as a disease rather than a healthy event.”
“It has nothing to do with this bill,” she said.
Abortion Comparisons
Earlier in the day, the “Life is a Human Right Act,” which would make all forms of abortion illegal in Wyoming, passed a House vote.
Reps. Cody Wylie, R-Rock Springs, and Martha Lawley, R-Worland, who both said they are pro-life, drew a comparison between the two bills in their support for postpartum coverage.
“We also need to be damn sure we’re prepared and willing to roll up our sleeves and be able to fund programs for mothers and children,” Wylie said.
Lawley said she wants to create an environment where mothers feel no desire to receive an abortion in the future.
Rep. J.T. Larson, R-Rock Springs, said he is pro-life and feels the same way.
“In my opinion you can’t have it both ways,” responded Larson.
House Bill 4 passed out of the Legislature’s House Labor, Health and Social Services Committee on a 5-4 vote in mid-January to advance to the full House for debate.
Harshman and Zwonitzer said there has been a substantial decrease in Medicaid children in the last few decades, down to 31% from the nearly 50% it sat at about 20 years ago.
“We live in probably the most charitable state in the United States,” said Rep. Steve Harshman, R-Casper. “There is no one group that can take over the severest Medicaid case of a disabled person.
“We pay a little bit of taxes to help out.”
Costs
The original bill requested $3.8 million in state money annually, but this was halved to $1.9 million, matched dollar-for-dollar by federal money.
Legislators would have to determine whether they want to continue funding the program by 2024.
Rep. Ben Hornok, R-Cheyenne, said the anticipated costs of the program are way too low at about $250 per mother per month.
“The $250 will barely cover a prescription drug,” he said.
Zwonitzer said 1,200 mothers a year would benefit with the extension. He said there are some state officials who believe the extension would actually save money.
More Government
A number of those who spoke against the bill said approving the expansion would be government overreach and increase government entitlements.
“Personal responsibility has to come back into this,” said Rep. Jeremy Haroldson, R-Wheatland.
HB 4 will have to pass two more House votes before it can move on to the Senate.
