Rep. Coleman: Medicaid expansion would grow already broken system
Date posted: January 28, 2014
SHERIDAN — Over the 2013 interim session for the Wyoming Legislature, the Joint Labor, Health and Social Services Committee tackled several issues including Medicaid expansion and how to define what constitutes misconduct in order to disqualify workers for unemployment insurance.
It was hoped by many state residents that the committee would propose a bill to address a Wyoming Department of Health redesign of developmental disability waivers, but Rep. Kathy Coleman, R-Sheridan, said as of the final committee meeting in January, no bill was proposed. Coleman serves on the Labor, Health and Social Services Committee.
In the waiver redesign, passed in 2013, the department of health said it will create two separate waiver programs that will optimize services for current clients and extend services to people currently on a waiting list.
However, many service providers have expressed outrage at the redesign, saying it will disrupt the lives of clients who receive services at places like Easter Seals and Rehabilitation Enterprises of North East Wyoming, as well as home-based clients.
The Labor, Health and Social Services Joint Interim Committee did draft bills for consideration in the 2014 session dealing with Medicaid expansion, an optional part of the Affordable Care Act that would provide health insurance for approximately 17,000 uninsured Wyoming residents. Medicaid expansion was voted down in the 2013 legislative session.
Two out of three proposed versions of Medicaid expansion will be on the docket of bills.
“Medicaid Fit” is similar to the optional expansion that was proposed last year with more limitations than the federally recommended program, Coleman said. It includes higher co-pays for services as a way to put more responsibility on the new Medicaid recipients.
The “Medicaid Expansion Insurance Pool” is more convoluted, Coleman said. It would allow people who are eligible for Medicaid expansion to use expansion money to purchase insurance through the federal health insurance exchange. It would set up health savings accounts and be monitored by the department of health to ensure personal responsibility. Coleman thinks the insurance pool option is too messy.
“I think you really start to muddy the waters when you’re adding words like ‘personally responsible’ and ‘opportunity driven.’ You’re going to put that in statute? A court of law somewhere is going to have to uphold the language you put into a bill. To me — I get where they’re going with it — but we’re going to hang ourselves trying to be grammatically inventive,” Coleman said.
Coleman said while she would like to see people who truly need health care to receive it, she is against expansion because she thinks it is growing a broken system. She doubts either expansion option will pass in the Legislature but that it may be a close vote.
Dealing with labor issues, the committee has proposed a bill for consideration that will define what constitutes misconduct by an employee in order to disqualify them for unemployment benefits. A similar bill was vetoed by Gov. Matt Mead in 2013 because it was too vague and gave too much power to employers who could use it to avoid paying unemployment benefits even when they should be given, Coleman said.
The bill will require that employees show deliberate disregard for job duties in order to be disqualified for benefits, while saying that being fired for good faith errors or incompetence should not disqualify a person from receiving unemployment.
“This changed the definition of misconduct. Specifically, the definition of misconduct has everything to do with whether you’re eligible for unemployment benefits. That’s why it was a big deal. It was too broad before. We played with the language just a little bit,” Coleman said.
Three hospital licensure bills failed in committee.
One bill would have required all hospitals in the state to accept Medicare and Medicaid payments for services. While Coleman was against the bills because she felt they were an overreach of the government, she said she would have felt compelled to support them because Sheridan Memorial Hospital CEO Mike McCafferty was passionately in support of them.
McCafferty said that allowing hospitals to not accept Medicare and Medicaid would enable those hospitals to charge less, potentially endangering the viability of SMH and other hospitals that do accept Medicare and Medicaid.
A “charity care equalization” bill that would have required hospitals that don’t accept Medicare or Medicaid to contribute a percentage of their profits to hospitals that do also died in committee, Coleman said. And a third bill that would have put a moratorium on licensing any new hospitals in the state until the Medicare and Medicaid issue was worked out also died by a vote of 6-6 in committee.
The Labor, Health and Social Services Committee will present a bill for consideration that will provide options for the management of public health nursing responsibilities at the local county level.