Guest editorial: Failure to expand Medicaid costs us all

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At over $880 per month, Wyoming’s average health-care premiums are the highest in the nation, according to Value Penguin, a subsidiary of Lending Tree. And, Wyoming’s premiums are expected to rise by 15 percent this year, the third largest in the nation.

Part of the explanation for such high premiums is certainly Wyoming’s rural population spread over great distances. That means rural medical facilities don’t experience economies of scale that facilities in larger communities benefit from, and that drives up the cost of care.  

However, Wyoming’s refusal to expand Medicaid only exacerbates the problem. Wyoming is one of 12 states that has not expanded Medicaid. When expanding Medicaid was first introduced, Wyoming declined for fears that the federal government would not continue to pay the lion’s share of the premiums. Fourteen years on, the United States government still pays 90 percent of the premiums.

Statewide, hospitals have taken on more than $100 million in uncompensated care annually, according to the Wyoming Hospital Association. Johnson County Healthcare Center writes off millions of dollars a year.  

The hospital association acknowledged that expanding Medicaid would not solve every cost issue, but reducing write-offs would be a good start to improving the financial outlook for small, rural hospitals.

It would also be a step in the right direction for ultimately slowing down rising private and employer-sponsored health insurance premiums. That’s because when people receive treatment in Wyoming hospitals that they cannot afford, the rest of us end up paying for it.

Like any business, a hospital needs to balance its books. So, if a hospital loses millions of dollars in uncompensated care, it must somehow make up for that loss. Wyoming hospitals often offset uncompensated care losses by charging higher prices for things like tests, surgeries and other services they provide.  

Since insurance companies pay for most medical treatment, they are the ones who pay these higher prices. Likewise, those insurance companies pass the higher costs on to their own customers by charging higher insurance premiums.

That is why uncompensated care is a big reason Wyoming has some of the highest healthcare costs and insurance premiums in the nation.

Expanding health insurance to those who earn under 138 percent of the federal poverty level would not only improve the health care for those of our friends and neighbors who would qualify, it would also reduce the financial strain on rural hospitals like ours.

It may even allow hospitals to charge less for the rest of us, thus lowering health insurance costs for everyone. Several other Republican states have already expanded access to federal health insurance including Idaho, Texas, South Carolina, Oklahoma and Utah.
All of these states enjoy lower health insurance premiums than Wyoming.

The average monthly cost for health insurance in Idaho is 44 percent less than Wyoming at $483. In Montana the average monthly premium is $519.

When will Wyoming finally look at the economics of expanding federal health benefits to hardworking people who cannot afford it? When will the state consider what is best for our health-care system and indeed our citizens?  

We hope it is soon.