Of all the eloquent words used on the House floor Thursday to make a rock-solid case for Medicaid expansion in Wyoming, the most succinct argument was spoken by a Democratic leader from Cheyenne.
“It’s a no-brainer,” said Minority Floor Leader Mary Throne.
It is indeed, but that fact didn’t faze the 41 House Republicans who voted the same way 19 senators did last week when they killed Medicaid expansion for the next year. That makes 60 dolts — that’s the nicest word we can think of — who proudly voted against the best interests of the working poor, hospitals, businesses, churches, city and county officials, insurance companies and economic development groups.
If a coalition with these members came to the Legislature supporting any other bill, Throne noted, lawmakers “would jump to get on that bandwagon.” But in their refusal to pass Medicaid expansion, the opponents made certain that poor people cannot get affordable health care; some hospitals will close; city and county coffers will be drained trying to bail out health-care facilities, and no new jobs in the health-care industry will be created.
And even though opponents have callously ignored the figure, let’s not forget the Wyoming Department of Health — the states own experts — estimated 111 people will die every year because we have not expanded Medicaid to include impoverished, childless adults. A considerable number of this vulnerable population will get sick, get worse, suffer and perish because 60 Republican legislators couldn’t bring themselves to support a federal program that is tied in any way to “Obamacare.”
Rep. Mark Baker (R-Rock Springs) apparently spoke for many of his GOP colleagues about 80 minutes into the debate when he strolled to the microphone and said the discussion should end because “we want to have lunch.” Yes, we certainly wouldn’t want to interrupt the dining plans of legislators, when they’re just wasting time talking about how people eligible for Medicaid expansion now have to choose between going to the doctor or eating.
Rep. Ken Esquibel (D-Cheyenne) noted the Legislature is a pretty elite bunch of people, most of whom probably make more than $100,000 a year. He said if they had to rely on what they made as legislators, they would qualify for Medicaid.
“Could you live on your legislative salary?” he asked. Esquibel didn’t get any response, but everyone on the floor and in the gallery knew the true answer would be a resounding “no.”
Rep. Sue Wilson (R-Cheyenne) patiently explained to her colleagues something most have never seemed to grasp, even though they’ve been talking about the issue for three years. People who make 100 percent or less of the federal poverty level — the poorest of the poor — do not qualify for the expanded Medicaid program solely because state officials foolishly won’t agree to take hundreds of millions in federal dollars. And unbelievably, they don’t qualify for federal subsidies under Obamacare because the 17,600 people who need help don’t make enough money under the program’s guidelines.
To anyone who thinks this population can just go out and buy health insurance like everyone else, Wilson said the average private insurance plan available to them in Wyoming costs $640 a month. That’s amounts to about half of their average total monthly income; the other 50 percent has to be used for shelter, food, transportation and many other necessities.
There is one thing to be grateful for about Thursday’s debate, thanks to Rep. Dan Zwonitzer (R-Cheyenne), who tried to amend the state budget bill to include Medicaid expansion. Because of his efforts, the public knows exactly which House members are intelligent, caring human beings, and which ones are thick as a brick and don’t give a damn about poor people.
We thank the six House Republicans who joined the chamber’s nine Democrats in voting for Zwonitzer’s amendment. Chief among them was Wilson, who gave a brilliant explanation about why expansion makes perfect sense for both health and economic reasons.
Wilson was the right GOP legislator to make this pitch, because like the majority of her party, she would like to see Obamacare repealed. Nevertheless, she researched Medicaid expansion and wisely concluded “it would spend public money in the most efficient way possible.”
Even though it failed to sway many representatives, Wilson’s words should be used the rest of this year and in 2016 to convince opponents to put the partisan fear-mongering away and examine what Medicaid expansion actually means for the state. It would:
— Provide about $125 million per year in federal funds that would boost Wyoming’s economy.
— Create about 800 new jobs, mostly in the health-care industry.
— Reduce hospitals’ massive debt of more than $100 million annually due to uncompensated care.
As a side benefit for those legislators who are always asking how Medicaid expansion would help hard-working citizens like themselves, passage would likely stabilize health insurance rates or cause them to decrease.
For every ideological point opponents tried to make, expansion supporters had an answer that could be backed up with facts. When they piped up that Medicaid recipients need to be forced to work so they have “some skin in the game” (could someone please retire that phrase?), expansion backers said the majority do work, sometimes two minimum-wage, part-time jobs with no benefits, because that’s the only employment they can get.
Rep. Catherine Connolly (D-Laramie) said most of the rest of those who would be new Medicaid recipients can’t work; they’re too sick because they don’t have adequate health care.
Stupidity ran rampant out of the mouths of the amendment’s opponents.
Rep. Matt Winters (R-Cody) said he was concerned because it’s “an ethical issue.” It is, but not in the way he considers it.
In the traditional Medicaid program, costs are split 50-50 between the federal and state governments. Winters said instead of adding more people to Medicaid, the feds need to fix the program.
His comments ignored the fact the new recipients represent our most vulnerable population. If the federal government is willing to initially pay all of the cost, then at least 90 percent after 2020, significantly reducing state spending while actually helping people who desperately need it, how on earth is it unethical to anyone?
What isn’t ethical is to effectively tell the working and/or sick poor to drop dead, because they don’t deserve the state’s help.
Winters soon explained what’s really behind his opposition. It’s the “destruction” of the 10th Amendment — which is constantly cited by conservatives as a major reason to get rid of most of the federal government, because it gives states the powers to do what isn’t explicitly given to the feds in the Constitution.
Of course, strict constructionists like Winters don’t mind holding out their hands and taking the $2 billion the federal government sends to Wyoming every year. But if a small portion of those dollars would go to Medicaid expansion, it gets their blood boiling. The representative should ask himself how the state government is going to replace that $2 billion if his dream comes true and the feds say “Adios, you’re on your own.”
We’re going to quote freshman Rep. Harlan Edmonds (R-Cheyenne) at length, because of all the Medicaid expansion opponents, he’s the most unhinged about the issue:
“I’d like to remind the body that from the conservative point of view, I think we’re on the cusp of victory, and this is no time to go wobbly and embrace socialized medicine,” he said.
“We’ve fought this battle for years now, and I’m sorry if I offend anyone, but the way leftism works is to create a problem and then offer a solution and reap the benefits of power, bureaucracy and control. … We’re seeing ‘Oh. We have this problem now, and this was created by socialist ideas. And now the solution is more socialism.”
Edmonds said Wyoming is in an excellent position to resist Obamacare and “to stand tough and provide some leadership to the other states.” He wrapped up his lecture on conservatism by saying once Obamacare is gone, “We can begin rebuilding the private sector solutions that will address the health-care crisis, if that’s what we want to call it.”
Please, give us a break. The private sector is largely responsible for the health-care crisis — and it is a crisis — we find ourselves in today because the “free market” approach led to soaring costs and a steady decline in the quality of American health care.
Zwonitzer’s amendment addressed all of the concerns expansion opponents have cited for years. It called for a suspension of the program if at any time the federal government’s contribution fell below 90 percent. It limited it to four years without further legislative action, and it spelled out how the state would pay for administrative costs by setting up a $1.5 million health-care reserve account without spending any new state dollars.
Throne related a story about a Campbell County man who has diabetes, would qualify for expanded Medicaid and has no health insurance. He was forced to choose between eating and buying insulin. He picked food.
On the same day the Senate voted 19-11 against Medicaid expansion, the man was rushed to the hospital with insulin shock, Throne said.
“That’s what happens to real people while we argue about taking or not taking the federal government’s money because we don’t trust them,” she said. “Real people have real crises easily preventable if we took the Medicaid money. It’s the right thing to do.”