WHAT DOES MONTANA KNOW ABOUT EXPANDING MEDICAID?

GO BROKE AND DIE WAITING IN LINE

In Montana, Medicaid spending grew from 17% to 26% of the overall budget (2015 to 2018, after expansion). These cost increases are consistent in every expansion state with available data, along with dramatically higher enrollment and cost than initial projections.

Perhaps the former Montana speaker doesn't see that as a problem when he spoke with our Representative Harshman, but less money for education, infrastructure, and safety does not seem like a great idea. During the first full year of expansion, Montana's hospitals saw a collective 40 percent decline in their profit margin. The head of the Montana Hospital Association directly attributed this to "cost shifting" as more Medicaid reimbursements fell below the cost to provide care.

The Montana Hospital Association's own data confirms these plummeting profits were due to a massive shift in the payer mix from private insurance to Medicaid. Bottom line: The effect of Medicaid expansion on hospitals is one of lower profit margin and lower quality care access. When able-bodied adults crowd the Medicaid platform, the truly needy get pushed to the back of the waiting line.

MEDICAID FRAUD IS A REAL PROBLEM

Another aspect of Medicaid expansion is fraud. Unfortunately, fraud was rampant in Medicaid during 2020, with improper spending accounting for one out of every five dollars spent on Medicaid. Opening the door to expansion opens the door to waste, fraud, and abuse. Scarce dollars need to go to the truly needy, not to fraudsters. The Federal Medical Assistance Percentage (FMAP) bump is temporary. Expansion is permanent. Costs may be covered by "free money" for two years, but in year three, FMAP goes back to the current rate in Wyoming, which is 50-50. Additionally, since states that already expanded do not qualify for the five percent FMAP boost, a renewal of this boost is extremely unlikely.

By not expanding, Wyoming can avoid footing the bill and still provide an option for those who need it. Another provision in the federal stimulus bill provides two years of private insurance coverage entirely paid for by the federal government for those between 100% and 138% Federal Poverty Level (FPL). Basically, let the federal government provide private coverage (at higher reimbursement rates for providers) to these populations or force them onto Medicaid and make the state pick up part of the tab (at lower reimbursement rates).

• This represents more than 1.9 million expansion enrollees
• Unlike the FMAP bump, these subsidies will be politically easy to renew in two years
• Medicaid expansion would kick these folks off of private insurance, and place them onto Medicaid, taking away this option for Wyoming residents

Non-expansion states such as Wyoming made the best choice—avoiding spikes in enrollment and preserving budgets during a strong economy. Take advantage of that wise decision and stay out of the Medicaid expansion trap.

Don't give in to liberal talking points about not caring for your neighbor or being on the right side of history. This is common sense and runs counter to everything Wyoming stands for. We always know when logic runs short in these arguments, because the heated emotional appeals begin. Stand your ground. Fight for the future of our state. Please don't bankrupt us to give free health insurance to able-bodied, childless adults under a socialist system that only leads to single-payor health services that remove health "care" from the conversation completely.