by patti carpenter
A Wyoming alternative to Medicaid expansion, stiffer penalties for negligent employers for workplace deaths, a raise for minimum wage workers, firing squads, legalization of marijuana and changes to how minerals are taxed are just a few of the hot topics expected to be debated during the upcoming session of the Wyoming Legislature set to begin on Tuesday, Jan. 13 in Cheyenne.
A bill endorsed by the Joint Labor, Health and Social Services Committee is expected to advance to the full legislature offering a Medicaid expansion alternative similar to a plan already in place in the state of Indiana. The bill, if passed, could offer low cost insurance to more than 17,000 uninsured individuals, often referred to as the “working poor,” who make too much money to qualify for Medicaid but are too poor to afford insurance offered through the Affordable Health Care Marketplace. The plan will require individuals to make a relatively small contribution toward a plan that is set up similar to a health care savings account and may include a work requirement.
This is not the bill recommended recently by the State Dept. of Health and Gov. Matt Mead called the “share plan,” requiring the same group of individuals to pay a small premium and copays similar to a private health insurance plan. Though not endorsed by the committee, it is expected that the share plan will be introduced as an individually sponsored bill. In either case, the topic of Medicaid expansion is expected to generate much discussion.
“I wouldn’t say it’s going to be smooth sailing by any stretch of the imagination, nor that it should be,” said Rep. Elaine Harvey of Lovell who co-chairs the committee. “I think that it needs to be carefully discussed and completely understood before we vote on it.
“I think it’s important for our medical providers and it will help balance out uncompensated care.”
According to Harvey, the plan has a built-in “trigger” that will cancel the program if the federal government does not come through with promised funds to support the program.
“If the federal government backs out on their part of the agreement, that is, if they aren’t going to pay the percent that they said they will pay, the program will end,” she said. “Even if the program doesn’t last, it will give uninsured individuals the resources to take care of their most immediate health care needs while they have it. I think even if we do have to pull the trigger, people will be helped and hospitals will be helped.”
This is somewhat of a change of heart for Harvey, who in the past has opposed any kind of expansion.
“I’ve never really been in favor of it (Medicaid expansion), but I now recognize the economic realities for the hospitals and providers and patients involved. I feel like the federal government has put us in an impossible situation and our job is to do the best we can with the law as it is written today. When the law changes, we’ll deal with that change.”
Sen. Ray Peterson of Cowley is also on the committee. He noted that Medicaid expansion has already been voted down three times with most senators not liking the fact that personal incentives, like the work clause and paying for a portion of the cost, were not built into previous bills. He said he doesn’t like the Share Plan because it does not include a “buy in.” He said it seemed like a “reincarnation” of past bills he’s seen.
“I like the work element and premium participation offered in the Medicaid expansion alternative plan,” he said. “Any plan will have to be a Wyoming fit. We are holding our guns on that. That means it has to be realistic and affordable for Wyoming.”
He pointed out that many states that accepted a straight Medicaid expansion are now complaining that they can’t control costs.
According to Harvey, a recent poll conducted in the state showed that 67 percent of its citizens would support some kind of Medicaid expansion.
Another bill that would increase minimum wage from $5.15 to $9 per hour and to $7.25 for businesses engaging in interstate trade is also expected to be on the table during the legislative session. The bill would increase the wage for tipped employees from $2.13 to $5 per hour. A similar bill was submitted last year but was defeated.
“We see those bills all the time. Rarely do they pass,” said Harvey. “I think market forces need to drive the minimum wage, not the government.”
Peterson said he is also opposed to the increase in minimum wage.
“Any hike in the minimum wage is a deal killer for Wyoming small businesses,” he said. “I think it will cause them to have to raise prices and possibly layoff workers. I’ve never been in favor of something that creates more hardship for small businesses that are already struggling to meet payroll as it is.”
A bill adjusting the base rate for worker’s compensation premiums according to a company’s accident history and worker’s comp claims is also expected to reach the floor during the session. Currently rates are based on the risk level of the job. Both Harvey and Peterson pointed out that Wyoming is a high-risk state because of the nature of the jobs available in the state. Peterson added that the low population also creates an unfavorable equation, making Wyoming appear to be one of the most work-accident prone states in the country.
“Since we live in a pretty dangerous state (with industries like mineral extraction, agriculture and travel as part of the job) and we have a relatively low population, we will always have a higher per capita rate,” he explained. “No matter what we do, we will always end up in the top three because this combination doesn’t make for good math.”
Harvey said she likes she likes the idea of rewarding companies for good safety practices as presented in another bill.
“So we’re saying, if you have a good safety record and very few claims and the claims are minor we’re going to give you credits,” she explained. “Those credits could be plus or minus 68 percent. So if the company has a very good safety record with very few claims, the rate could be as low as 32 percent of what the original rate was. On the flip side is that if you have a lot of accidents and a poor safety record, the company could pay as much as 168 percent. It’s a way of rewarding the good players, the ones that develop a culture of safety and a way to wake people up.”
A mandatory $50,000 fine for knowingly ignoring workplace conditions that cause fatalities has already been debated in committee. Both Harvey and Peterson said they would not support a bill imposing high fines for workplace deaths.
“You can’t put a value on human life, whether it is $7,000 or $50,000, it doesn’t go to the family, it doesn’t bring the family member back,” Harvey explained. “It just removes money from the companies and makes it harder for them to comply.”
Peterson added that he thought it would discourage employers from hiring less experienced workers. He said he thought it would especially hurt young people looking for summer or other short-term employment.
Harvey said she didn’t think most business would take that risk of hiring disabled workers if the bill were to become law.
“We’ve been trying to get employers to take on people with disabilities,” she said. “What employer would want to take on that risk with this hanging over their head?”
A headline-grabbing bill that would authorize firing squads to enforce death penalties will also be heard. Peterson said he expected the bill to generate more headlines than support.
“I think it’s more of headline bill than an important bill right now,” he said. “I’m all in favor of saving the state money but since we only have one or two inmates on death row right now, I don’t think this is all that important.”
A bill legalizing marijuana, similar to a law recently passed in Colorado, is also on the table. Peterson said he is a strong opponent of the bill and sees it as a threat to Wyoming.
“Colorado is already having a lot of problems,” said Peterson. “It’s a nightmare in terms of the problems it has created for them. I think what we’re seeing is a handful proposing this bill but I expect that the majority will say no.”
Mineral severance tax
Peterson said changes to how minerals are taxed are also expected to generate extensive discussion. Peterson, who is chairing the revenue committee, said he expects a task force to be formed that will last at least a few years to study improvements that could improve the system, which generates about a third or more of the state’s revenue.
Bills allowing extended reimbursements for nursing school students, surgical centers to create post-operative convalescent centers and requiring an insurance pool to be maintained for high risk patients are among the many topics that will be discussed during the eight-week session. A bill requiring licensure of massage therapists (co-sponsored by Peterson and Harvey) is also in the works.
With many days still ahead before the cutoff is imposed on submitting new bills, even more will be submitted for scrutiny by the full legislature.