CHEYENNE, Wyo. (AP) — The Wyoming Senate voted Wednesday for the second time to advance a bill to expand the federal Medicaid program in the state, but the bill sponsor says he must try to beat back amendments that could make the legislation untenable.
The bill would extend health care coverage to 17,600 low-income adults in Wyoming.
It will head to the House if it clears its third vote in the Senate, set for Thursday.
Sponsor Sen. Michael Von Flatern, R-Gillette, failed to persuade the Senate to remove an amendment that would require plan participants to work at least 32 hours a week if they're able.
Federal Medicaid regulators likely wouldn't approve the work requirement, Von Flatern said.
He said after the vote that he was also concerned that the Senate had stripped the bill of money for the Wyoming Department of Health to administer the expansion.
Von Flatern intends to bring more amendments to try to improve the bill on its third reading. However, he said he was a little less optimistic about the bill's ultimate chances of success.
Gov. Matt Mead, a Republican, has called on lawmakers to approve a Medicaid expansion bill. He has said Wyoming can't afford to ignore about $120 million annually in available federal funds to expand the program.
Mead said accepting the federal expansion would help hospitals in the state, which currently absorb millions of dollars in uncompensated care provided to low-income people. The federal government has offered to pay 100 percent of the expansion costs through 2016, tapering down to 90 percent in years after that.
Tom Forslund, director of the Wyoming State Health Department, has said his department could cover the state's portion of the matching cost if the Legislature gives him authority to transfer savings from the other programs.
However, the Senate voted not to allow the health department to make such a transfer.
Sen. Charles Scott, R-Casper, warned lawmakers that it's not safe to assume the state will realize savings. With the current energy downturn, he said its likely mental health programs will see increased demand.
Scott said he's hearing strong support for the work requirement.
"What I'm hearing from some of the members of the public is that they feel it's unfair that they've got to work to get their health care, and people who are perfectly able-bodied and are just freeloading on the system get a better benefit package than they do without having to work for it," Scott said.
Senate President Sen. Phil Nicholas, R-Laramie, said it's clear to him that many senators aren't interested in giving the executive branch the power to make cuts in existing health programs on the grounds that here may be cost savings as a result of Medicaid expansion.
Many senators don't trust federal promises to continue to pay program expansion costs.
"The people don't believe the promise that this is a cost-shifting issue, and we'll see savings in other programs," Nicholas said.