Medicaid expansion to get another crack in Wyoming after two defeats in 2021

MM Curator summary

[MM Curator Summary]: About 25,000 people would be added to the rolls if the measure is passed this time.


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CASPER, Wyo. — Another attempt at Medicaid expansion in Wyoming has been proposed for the legislature’s consideration during its upcoming budget session. The Wyoming Legislature’s Joint Revenue Committee is sponsoring House Bill 20, known as the Medical Treatment Opportunity Act.

Medicaid expansion was previously proposed for the legislature’s consideration during its fall 2021 special session. That special session was primarily focused on responding to COVID-19 vaccine-related mandates and the Wyoming Senate voted 8-21 against introducing the Medicaid expansion bill during that session. Medicaid expansion was also proposed for consideration during the 2021 general session and passed in the House of Representatives on a vote of 32-28 but stalled out on a 2-3 vote in the Senate Labor, Health and Social Services Committee

Sen. Cale Case (Fremont County), who is Chair of the Senate Revenue Committee, argued in favor of Medicaid expansion during the October 2021 special session, saying that expanding Medicaid could benefit about 25,000 people in the state.

“They are people that serve you breakfast, clean your hotel rooms,” Case said. “They have children and this would be a great thing for them.”

A poll conducted by New Bridge Strategy in 2021 found that 66% of Wyoming’s registered voters support expanding Medicaid. That included 98% of Democrats in the state, 64% of Independents and 58% of Republicans.

The Medical Treatment Opportunity Act would direct the Wyoming Department of Health, the state’s insurance commissioner and the governor to negotiate with the Centers for Medicare and Medicaid Services (CMS) to amend the state’s Medicaid plan and expand eligibility.

Under the 2010 Affordable Care Act, 90% of the cost of expansion would be paid for by the federal government and Wyoming would pay 10%. The Wyoming Department of Health estimates expanding coverage would cover an estimated 24,000 (between 13,000 and 38,000) residents and net the state $34 million in General Fund savings over the next biennium.

The group Healthy Wyoming held vigils across the state in September 2021 to raise awareness about projected savings for the state under expansion and to share stories of people who have suffered and died without health care.

The Casper contingent met at the Nicolaysen Art Museum on September 17 to hear from health care providers, legislators, and people directly affected by the issue. 

“This issue is a matter of life or death,” said Healthy Wyoming advocate Andrew Schneider in his remarks. He said people who can’t afford to go to the doctor allow chronic conditions, including mental illness, to “linger and worsen.” They also skip cancer screenings and other preventative measures and can’t budget for both prescriptions and food.

Linda Jones spoke about her friend and neighbor Earl, who died three years ago. She said Earl worked a steady job at Walmart until he slipped on the ice and injured his knee, and lost his job while recovering.

Without insurance, he was unable to achieve a full recovery, became afflicted with gout, and sold a cherished Camero to pay bills. His health declined rapidly and he was eventually found dead in his home.

“It was a difficult thing to watch another person be in so much pain and not know how to help,” Jones said. “At the time, we didn’t think there was anything that could be done about Earl not being able to see a doctor. … Now I know that if our state had expanded Medicaid, Earl could have gotten the health care he needed.”

“He wanted to get better; he wanted to work to provide for himself.”

Critics have cited concerns that expansion has led to significant cost overruns and decreased profit margins for hospitals in other states. They also worry that the federal government could change its match rates, leaving Wyoming “on the hook” for a greater percentage of costs.


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