A bill to expand Medicaid in Wyoming is once again moving it's way through the Wyoming legislative body. One bill in the Senate has failed, another in the house may make it to the floor for debate. A few Republican law makers have changed their mind and are now in favor of Medicaid expansion.

Before Wyoming lawmakers make their call they should look at what has happened to other states that have expanded Medicaid. 

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 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.

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 in 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.