By BEN NEARY, ASSOCIATED PRESS
CHEYENNE, Wyo. (AP) — Gov. Matt Mead announced Thursday that Wyoming won't meet a pending deadline under the federal health care reform law to specify whether the state intends to establish a health insurance exchange — an online marketplace that would offer the public one-stop shopping for health insurance.
Mead told reporters at his regularly scheduled press conference that Wyoming can't decide the issue because he has yet to hear any response to a series of questions about the law he submitted to U.S. Health and Human Services Secretary Kathleen Sebelius in mid-July.
Among the questions Mead asked Sebelius was how long the federal government was committed to provide funding for the exchange. "If the federally facilitated exchange is not financially self-sustaining, what happens then?" he wrote.
"There are questions to be answered," Mead said Thursday. "And we haven't got answers to those questions. So if and until we get answers to those questions, I don't think it's reasonable for the federal government to say we've got to make very big decisions that can impact our state budget and impact the quality of our health delivery system in Wyoming."
The Affordable Care Act gives Wyoming and other states three possible choices on the insurance exchange issue: set up their own exchange, partner with other states, or let the federal government set up an exchange.
While the federal law gives states until January to specify how they will address the exchange issue, Mead said Wyoming likely won't make a decision until after the Legislature adjourns next year, likely in early March.
Mead, a longtime opponent of the Affordable Care Act, has said he's worried about the cost of increasing enrollment in the Medicaid program. Wyoming already has budgeted more than $500 million to cover its share of the Medicaid program in the two-year budget cycle that started in July. The federal government roughly matches that amount in the state to fund the program that provides health care for the poor.
There are now roughly 67,000 Wyoming residents on Medicaid. Mead has said he's concerned that the Affordable Care Act could expand the program to add as many as 30,000 more over coming years. He said he doesn't trust federal promises to pick up increased costs.
There are now roughly 67,000 Wyoming residents on Medicaid. Mead said the proposed federal expansion could add as many as 30,000 more over the next few years.
The Wyoming Department of Health on Thursday unveiled consultant reports estimating that the additional cost to Wyoming of expanding Medicaid to comply with the federal Affordable Care Act could range from $53 million to $310 million from 2014 to 2020.
Erin Shields Britt, spokeswoman for the U.S. Department of Health and Human Services in Washington DC, said Thursday the department didn't have any comment on Mead's position on the exchange issue or when the department would respond to his questions.
"The Affordable Care Act gives states the option to create a state-based exchange, to work in partnership with the federal government or to have a federally-facilitated exchange in their state, so that Americans across the country will have access to competitive marketplaces with affordable insurance options beginning in 2014," Britt said. "We look forward to continuing to work closely with Wyoming as the state explores its options."
Under Mead's leadership, Wyoming in early 2011 entered the multi-state legal challenge against the Affordable Care Act that resulted in a decision this summer by the U.S. Supreme Court upholding most provisions of the law. Mead said Thursday he was disappointed in the ruling.
Mead noted that Republican presidential nominee Mitt Romney has pledged to dismantle the Affordable Care Act if elected. Mead, a Republican and Romney supporter, said there's no question that he and others are thinking about the prospect Wyoming might not have to implement the law at all if Romney is elected.