Wyoming Education Association

Fall 2021

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Page 21 of 31

By: Tate Mullen Medicaid Expansion Why it Would Benefit Wyoming's Students, Families, and Communities 22 Last year, the Wyoming Education Association joined the Healthy Wyoming Coalition to support efforts to pass Medicaid expansion in Wyoming. Many Education Support Professionals are ineligible for employer-provided health insurance. Medicaid expansion would cover many Wyoming ESPs and their families. Medicaid expansion would also provide access to health insurance and medical care for thousands of working-class families across the state. There's a well-documented relationship between access to affordable, quality healthcare and positive educational outcomes. Healthy education staff, healthy students, and healthy families are a priority for the Wyoming Education Association. Enacted under the 1965 Medicaid law, Medicaid is a national public health insurance program that provides health insurance for low-income Americans. Medicaid covers 1 in 5 Americans, many of whom have complex and costly needs for care. Most Medicaid enrollees lack access to private insurance. Medicaid coverage has evolved over time. Now, under a provision of the Affordable Care Act (ACA), states can elect to expand eligibility for Medicaid coverage. When states opt to expand Medicaid, coverage eligibility extends to adults up to age 64 with incomes up to 138 percent of the federal poverty level. In Wyoming, Medicaid expansion would cover approximately 25,000 more citizens. Currently, for states choosing to expand Medicaid, the federal government covers 90 percent of the costs while the state is required to cover the remaining 10 percent. A report from the Wyoming Department of Health states, "an initial biennial appropriation of $18 million in State Funds" would be required to expand Medicaid in Wyoming. The state would need to generate enough revenue to cover this increase in appropriations. However, upon expanding Medicaid, other states have found that expansion reduces state and local government costs for uncompensated care. This cost reduction offsets some—and in some states all—of the cost increase of expanding Medicaid. Among the potential benefits of expanding Medicaid in Wyoming is an increase in access to care, improved health outcomes, bolstered financial security, and a substantial reduction in uncompensated care costs. In states that have expanded Medicaid, significant impacts on a reduction in the number of "low-income adults screening positive for depression, improved diabetes and hypertension control, increase in early- stage cancer diagnoses, and decreases in the share of patients receiving surgical care inconsistent with medical guidelines" have been observed. A 2019 study titled Medicaid and Mortality, showed that from 2014-2017 more than 19,000 lives were saved in states that expanded Medicaid while conversely, over 15,000 lives were lost in states opting out of expansion. In rural states such as Wyoming, expanding Medicaid may be vital to maintaining access to health care practitioners and facilities in rural areas of the state. A study conducted by the University of North Carolina's Rural Health Research Program tracked rural hospital closures across the U.S. from 2010 to 2018. Among those states with the highest rates of rural hospital closures, the common characteristic of those groups is that none of them have expanded Medicaid. In fact, a recent publication in the Health Affairs Journal titled Understanding the Relationship Between Medicaid Expansion and Hospital Closures, notes that "The ACA's (Affordable Care Act's) Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of uninsured adults." States opting out of Medicaid expansion are finding that when local rural health care access diminishes, schools and businesses close, and families leave these rural areas because they lack essential services and amenities. The health of our Wyoming schools, those that work in them, and the students and communities we serve would benefit greatly from Medicaid expansion. Learn more about the benefits of Medicaid expansion and how you can help at healthywyoming.org.

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