November 2022. Some Wyoming state lawmakers are introducing yet another Medicaid expansion bill.

This would be the 8th Medicaid expansion bill in the past 2 years. Yet the fight to expand goes back as far as when Obama was president.

“We’re sitting on a record amount of money right now,” said state Sen. Cale Case, R-Riverton, in favor of the bill. “Man, we need to do this. It will have a tortuous path to go through the Legislature, but let’s just get this done.” (Cowboy State Daily).

There is always that claim that the state is losing out on a lot of money by not expanding.

But there are hidden costs to expanding that are not being considered.

Let's look at what has happened to other states that have expanded Medicaid. 

Documents with title debt consolidation on an office table.

Investors Business Daily pointed out that one program (Medicare) was going bankrupt, while another federal program (Medicaid) is bankrupting states.

Medicaid improper payments represented about 21.4 percent of federal program spending—more than $85 billion—in the fiscal year 2020, an increase of nearly $30 billion from 2019 according to the Government Accountability Office. 

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Back in 2015, Medicaid accounted for 20 percent of state budget spending. It jumped to $603 billion in 2018. That was a big chunk of state budgets back then. In 2020 Medicaid spending accounted for over 30 percent of state budgets.

47 states saw Medicaid overwhelm their budgets by 2000, with 32 states spending up to 30 percent or more of their budgets solely on Medicaid. Missouri, Ohio, and Pennsylvania are all spending close to 40 percent of their budgets on Medicaid.

Ohio’s increase in Medicaid spending equates to a 260 percent increase since 2000.

AFP via Getty Images
AFP via Getty Images

Meanwhile, in Louisiana in 2000 they spent $3.4 billion on Medicaid, accounting for roughly one out of every five dollars in the budget. By 2009, that amount doubled to $6.2 billion. By 2018, after three years of Medicaid expansion under the Affordable Care Act. By 2019, Louisiana was spending 35 percent of the state budget on Medicaid and the cost only kept going up in 2020.

The promise in the Wyoming bill is that the federal government will pay for 90%. If the feds fail, the bill says, the state will drop it. That promise is a farce. But I'll go into why another time.

One of the many reasons for the explosion of costs to the states is how many people have actually taken advantage of expansion, whether they needed it or not.

Lawmakers in Wyoming who want expansion claim expansion will help an estimated 25,000 Wyomingites. But in every state mentioned above, far more people showed up to take advantage of the program than anticipated. Many of those people come from out of state.

In each of the above-mentioned states, Medicaid was overwhelmed by the sheer number of people taking advantage of a government system that was easy to play for a sucker.

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