Sen. Ray Peterson (R-Cowley) said he was returning home after last year’s budget session feeling pretty good about helping to defeat Medicaid expansion. Then he went to see the director of his local hospital.
“He thanked me for my conservatism, then showed me how much the facility was losing in bad debt and charity care,” Peterson recalled. Some of those funds could have been made up by Medicaid expansion.
Peterson said he still couldn’t bring himself to vote for Medicaid expansion this year, and he was on the prevailing side of a 19-11 vote to reject the plan. Expansion of the program would have brought in $125 million a year to the state in federal funds and provided health insurance to an estimated $17,600 low-income childless adults.
But he told the House Labor, Health and Social Services Committee on Monday that the state has to do something to help hospitals reduce their uncompensated costs.
Peterson acknowledged Gov. Matt Mead, who favored passage of the SHARE Medicaid expansion plan that was shot down in both chambers, isn’t a big fan of the approach to help hospitals in SF 145.
Combined, the 27 members of the Wyoming Hospital Association (WHA) have losses of more than $100 million annually from uncompensated care.
Peterson said the bill he worked on with Sen. Bill Landen (R-Casper) that was being considered by the committee was merely a temporary “Band-Aid” that could provide Wyoming hospitals some relief — particularly the three small hospitals the WHA said are in danger of shutting their doors unless they get a quick influx of cash.
Originally, Peterson related, SF 145 contained an appropriation of $10 million to be divided between the state’s hospitals, but he and Landen voluntarily lowered it to $5 million. The bill survived a third reading attempt by Senate Appropriations Committee Chairman Tony Ross (R-Cheyenne) to pare it down to $2.5 million, and SF 145 passed the Senate 19-11 at the $5 million level.
Landen said $5 million “is an appropriate target to shoot at” to help stabilize the hospitals’ situation. He compared Medicaid expansion to “firing a shotgun from 100 yards away” to try to fix the problem.
WHA President Eric Boley told the panel one hospital has only a paltry 19 days worth of cash reserves on hand, which is enough to cover it through one payroll cycle. He said the WHA still firmly backs Medicaid expansion, but it supports SF 145 “because some of our hospitals could really use the money.”
The problem is “gut-wrenching,” Boley said, adding the most at-risk hospital — which he didn’t identify because of privacy concerns — has to do whatever it can to delay paying bills while it tries to collect more money. Sometimes that includes management personnel not cashing their paychecks right away, he noted.
Under SF 145, the $5 million would be distributed through a formula that would give small hospitals two-thirds of the funds, with the other one-third directed at the state’s largest hospitals.
Boley said the funds that would go to the hospital with only 19 days of cash reserves would help it cover about a month’s worth of expenses.
A spokeswoman for the Wyoming Medical Center in Casper said while the national average in uncompensated care makes up about 6 percent of a hospital’s budget, at WMC it is 12.7 percent of the hospital’s total expenses.
Chairwoman Elaine Harvey (R-Lovell) said she wished the House could add another $100 million appropriation to the bill.
The House committee passed SF 145 unanimously, 9-0. The bill will move on to the full House and will likely be heard within a few days.