Wyoming Liberty Group

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Wyoming Is Safe from Medicaid Expansion – But Could it Rise Again?

     If you think health care is expensive now, wait until you see what it costs when it’s free.
             PJ O’Rourke

Choosing to expand Medicaid is like deciding to marry for the sake of a dream honeymoon when disillusionment is the likely outcome. Fortunately, seven members of the Joint Appropriations Committee rescued Wyoming from a looming and ill-conceived entitlement marriage by voting to strip Medicaid Expansion from the 2017-18 budget appropriations bill.

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Testimony: Direct Primary Care-Insurance Exemption

Testimony of Charlie Katebi, Healthcare Policy Analyst, Wyoming Liberty Group

Before the Labor, Health, and Social Services Committee
August 24, 2015

Direct Primary Care-Insurance Exemption

Introduction:

My name is Charlie Katebi. I am a Policy Analyst at The Wyoming Liberty Group. I would like to express my thanks to the Joint Labor, Health and Social Services Committee for the opportunity to speak here this morning.

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Disinfecting Healthcare Prices with Sunlight

When we walk into a hospital, we have access to a cornucopia of different tests, procedures, and specialists. What we will hardly ever see is how much all of this costs. When insurers pay most of the bill, patients have no incentive to find the best deal, and hospitals are more than happy to keep their cost hidden. Now a revolution is underway to pull back the veil on what hospitals are charging.

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Wyoming Welcomes Out-of-State Doctors

Governor Mead is by no stretch of the imagination a visionary government reformer. However, he took a big step towards expanding healthcare access in Wyoming by signing the Interstate Medical Licensure Compact into law. This will allow out-of-state physicians to practice medicine in Wyoming and lower healthcare costs for patients.

Physicians that wish to practice in Wyoming must receive a license from the Wyoming Board of Medicine. However, every state has virtually identical requirements for a doctor to receive a license. Prospective physicians must graduate from a medical school approved by the American Medical Association and they must pass the US Medical License Exam. If every state requires doctors to have the same basic credentials, why not let out-of-state doctors practice in Wyoming?

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The Supreme Court Upholds Obamacare in Wyoming

After months of anticipation, the Supreme Court ruled in favor of the Obama Administration in King v. Burwell and upheld the IRS’s authority to issue insurance subsidies on the federal insurance exchange as part of Obamacare. This decision gives cover to the abuses of an out-of-control agency and allows it to continue punishing Wyoming through the individual and employer mandate.

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Direct Primary Care’s Promise

Progressives constantly frame the debate over healthcare reform as a false choice: should healthcare be financed through insurance companies or the government?  Both options leave patients at the mercy of third parties.

Now an alternative known as Direct Primary Care promises to put the patient back in the driver’s seat.  The patient pays a flat monthly fee or retainer, and in exchange, physicians provide primary care services.  These services include checkups, urgent care, and chronic care management.

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Is Medicaid Expansion Still Voluntary?

Throughout the debate to expand Medicaid during the 2015 Legislative Session, opponents repeatedly claimed that the federal government couldn’t be trusted to keep its promise to cover 90 percent of Medicaid Expansion’s costs. So it should come as no surprise that the Obama Administration has now broached the idea of reneging on its existing financial promises. In a letter to the Deputy Secretary of Medicaid in Florida, the head of the federal Center for Medicare and Medicaid Services (or CMS) threatened to withhold funding to a Medicaid pilot program in the Sunshine State unless it expanded Medicaid. If successful, the federal government would have found a way to undermine the Supreme Court’s 2012 decision on Medicaid Expansion and foist a federal program that delivers woefully inferior healthcare onto millions more patients.

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