Being one of those who routinely “zooms out” when viewing Google Maps, I am inclined to address Medicaid expansion in Wyoming from a big-picture, overarching, perspective. The issues I believe we need to focus more on are trust and compassion.
Whenever legislative debates and rationale are reported on the subject, distrust of the U.S. government is routinely mentioned. Really? In a state with a high per-capita federal subsidy ranking, that certainly seems disingenuous. Or perhaps what’s really at the root of it all is a powerful legislative leadership role that subtly discourages independent thinking and action when seeking to improve Wyoming’s financial distress. Nostalgia for the good old days will not solve our current problem. Clearly, traditional energy production is in decline, if not on hiatus, and responsible representatives will be seeking ways to soften the blow while keeping Wyoming healthy and strong.
It is true that dragging our legislative feet has diminished the potential financial infusion of Medicaid expansion monies into Wyoming’s coffers. Benefits still exist, however, with the result that accepting Medicaid expansion is supported by a broad array of Wyoming interests, including Gov. Matt Mead, hospitals, and a myriad of human-service organizations, not to mention the many thousands of lower-paid workers who are not eligible for either Affordable Care Act health coverage or Medicaid for the poor.
These working poor are some of Wyoming’s most valuable infrastructure — providing the engine and gears for the second largest segment of Wyoming’s economy, tourist visitors. We need a viable workforce and health-care system as part of our essential infrastructure and to ensure a desirable future for our state. Without Medicaid expansion the burden of continuing, unsustainable, unpaid, emergency health care continues to weigh heavily on our hospitals and, subsequently, on health-facility access around our rural state. Someone will pay, sometime, somehow.
Rather than leave less-able neighbors to fate or to destructive behaviors resulting from hopelessness, would it not behoove us to provide some compassion by helping them to adjust to changing times? We can all aim for such a hand up to be one that contributes to enhanced future independence of Wyoming’s population. We can also work together to craft guidelines and assurances to strengthen a Medicaid expansion program for our state.
Round up the herd, including stragglers
The Wyoming open-range tradition of independence and self-reliance exerts strong influence on legislative attitudes and decision-making. I, too, appreciate the can-do outlook it creates. Leaving stragglers in the dust does not reap rewards, however. It also is tradition to round them up into the well-being of the herd and for economic gain.
While far from perfect, the Affordable Care Act has been a good-faith step to rein in escalating costs, offer coverage for millions of fellow citizens (a number hard to conceptualize in Wyoming, perhaps) and relieve hospitals of excessive emergency-care expenses that threaten their abilities to serve communities. Surely, no one believes the effort to make health care more widely available is done to aggravate the general population or turn hair prematurely gray? With all due respect to the Lone Ranger, his example is not how we will improve the situation, either.
More trust and compassion just might. My experience is that working as a team, with a good dose of listening and patience, goes a long way toward minimizing known problems. In this case, that would be supporting Wyoming as a unique and refreshing place to live, work and visit in the 21st century.
Now is the time for Wyoming people to come together to make that possible. Pushing the Legislature to recognize the majority support in Wyoming for Medicaid expansion is an important first step. But next we need to come up with solutions to the high costs of health care and insurance for all of our citizens. Perhaps a series of meetings around the state, carefully put together to focus on potential practical solutions, could help health-care experts, citizens, and legislators alike see what the next steps should be.
Sandy Shuptrine has lived with her family and worked, usually several jobs at a time, in Teton County since 1971. She was a County Commissioner for 12 years, currently serves as a Teton Conservation District Supervisor, and is a strong supporter of an informed democratic process — Ed.