Initial Medicaid Implementation: Wyoming first implemented their Medicaid program on July 1, 1967. When the program began, the state did not offer a program for the medically indigent. The state did provide transportation services for people who needed medical services because of their medically indigent status. Wyoming participated in the Kerr-Mills program that pre-dated Medicaid. A small number of people participated in the program and the program faced no major issues with payment or billing.
Key Medicaid Political Issues: Wyoming is a largely rural state with one of the smallest populations in the country. Unlike most states with large rural populations, the state has less of a problem with access since 99% of providers accept Medicaid. All of the state’s nursing facilities and hospitals are also enrolled in Medicaid. Nearly all of the state’s pharmacies and 79% of dentists also participate, much higher than the national average of 42%. Since 2011 Wyoming has had a matching rate of 50%, similar to states like California and New York. This is because the state has a high income ratio, due in part to the state’s energy resources. Since 2012, Wyoming has been working on reducing the number of people who are on their waiting lists for disabled populations. The state has also been focused on improved maternal care and improving care for people who use more services in the Medicaid program. Wyoming has the highest per-member spending rate for people over the age of 65 who use long-term care services. Their per-enrollee spending is higher for disabled beneficiaries and adults than the national average, but they have lower per-child spending than national averages. The state has looked to establishing buy-in options in existing programs. In 2018, Wyoming passed an unusual law that attempts to recoup the cost of maternal care covered under the Medicaid program from unwed fathers. The legislation does not apply to married fathers.
Medicaid Expansion Implementation: Wyoming has not expanded Medicaid as part of the Affordable Care Act. Governor Matt Mead had initially been opposed to Medicaid expansion in 2012 but by 2013 was exploring the possibility of Wyoming expanding to save the state money. In 2016 his budget included a proposal to expand Medicaid, but the plan was ultimately rejected by the legislature. Hospitals in the state have been supportive of the expansion. Wyoming saw a large increase in the number of people enrolled in the program following the implementation of the coverage expansion in the Affordable Care Act. Since then, the state has seen a decline in enrollment to levels that pre-date the Recession. This could be a result of the improved economy in the state, but the state also implemented a new eligibility system that may have led to reduced enrollment. 56% of Wyoming residents support Medicaid expansion. In 2018 the state proposed a work requirement on the population of adults who are eligible based on having children enrolled in Medicaid. The plan ultimately failed to pass the legislature. The legislature also considered Medicaid expansion along with work requirements and that legislation has also failed to pass.
General facts about Wyoming Medicaid:
Medicaid program name: Medicaid
CHIP Program name: KidCare CHIP
Separate or combined CHIP: Separate
Medicaid Enrollment:56,000 (2018 estimate)
Total Medicaid Spending: $600 million
Share of total population covered by Medicaid: 13%
Share of Children covered by Medicaid: 25% (estimate)
Share of Medicaid that is Children and Adults: 79%
Share of Spending on Elderly and people with disabilities: 68%
Share of Nursing Facility Residents covered by Medicaid: 62.5% (estimate)
Expansion state: No
Number of people in expansion: N/A
Work Requirement: No