Gov. Matt Mead told state lawmakers that Wyoming can no longer afford to wait to pass a Medicaid expansion bill.
"We have fought the fight against the (Affordable Care Act)," he said. "We've done our best to find a fit for Wyoming. We are out of timeouts, and we need to address Medicaid expansion this session."
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Mead made the case for the optional expansion during his State of the State address that was held Wednesday before a joint session of the 63rd Wyoming Legislature.
The expansion, which would extend health benefits to about 17,600 low-income residents, is a key part of the federal Affordable Care Act, also known as Obamacare.
Mead was among the governors who sued to overturn the federal health-care law, and he has been skeptical of the expansion plans during the past few years.
But in November, Mead said he would support an expansion plan that was developed out of negotiations between the Wyoming Department of Health and the federal government.
That proposal, which is called Wyoming's Strategy for Health, Access, Responsibility and Employment, or the SHARE plan, would require the expansion group to complete health assessments and pay small co-payments for certain health services.
Those making between 101 and 138 percent of the federal poverty level also would need to pay premiums that would range from $20 to $50 per month.
An alternative plan, which would require enrollees to pay a percentage of their income into personal health and wellness accounts, is being sponsored by the Joint Labor, House and Social Services Interim Committee.
Mead told the Legislature that he doesn't care which plan they ultimately select. But he said something is needed to create jobs, to help the state's hospitals with their uncompensated care, and to support the "working men and women who don't have insurance."
"The fact is many of us don't like the ACA, including me," he said. "But here's another fact: Our federal tax dollars help pay for the ACA, and Wyoming tax dollars pay for the ACA.v "Do we choose to have that Wyoming money be returned to Colorado, California or Wyoming? I say Wyoming."
After the governor's speech, Senate Minority Floor Leader Sen. Chris Rothfuss, D-Laramie, applauded Mead's call for action on Medicaid.
"There are 17,600 folks in Wyoming who are either underserved for health care or don't have health care," he said. "We need a solution for those people, and we need it right now."
Rothfuss added that he prefers the SHARE plan, but he said he is open to any approach that is "viable."
But any Medicaid expansion proposal that goes before the Legislature will face some resistance from conservative lawmakers.
"I think Medicaid expansion, in the House side, is going to be difficult and acrimonious," said House Speaker Kermit Brown, R-Laramie. "But I can't predict how it is going to come out."
Mead additionally called on legislators to pass his $156 million supplemental budget request.
His spending proposal includes adding more than $56 million for University of Wyoming programs and construction projects; $25 million for cities, towns and counties; and $21 million to add passing lanes on some state highways.
"It is a conservative supplement to the biennial budget," Mead said. "I think it positions Wyoming well for the years to come. It strengthens UW and the community college system, it makes investments in strategic areas, and, the fact is, the state has these funds."
Mead is proposing to pay for his requests through reversions -- money from past appropriations that were never used -- and the Strategic Investment Project Account.
But low oil prices have raised concerns about the state's revenue outlook. A state revenue report due out Friday will tell lawmakers just how much of a hit on the budget the dropping energy prices will create. Mead acknowledged that the falling oil prices are a concern to the whole state. But he said it is not a reason to panic.
"We are in a better position now than we were in the past," he said while noting that the state has the $2 billion rainy-day fund and other money in state savings. "We will be able to work through this, and we will be able to continue to build Wyoming."
Legislative leaders said after the speech that there is broad support for most of the governor's budget requests. But they said they will have to give close scrutiny to the budget and the state's revenue projections in the coming days and weeks.
"These are programs we want to get off the ground and move forward," said Senate President Phil Nicholas, R-Laramie. "So we'll be studying the budget and its impact when (the revenue report) comes out."
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