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Medicaid expansion is dead, but that doesnt mean looking out for the uninsured in Wyoming and the hospitals that serve them isnt foremost in the minds of legislators.

Representative Elaine Harvey

The week began in the House of Representatives with the second reading of the supplemental budget and numerous amendments. With the deadline past for introducing new bills, representatives are adding amendments to the budget as a last resort.

Everyone is kind of scrambling, trying to do things through the budget, explained Rep. Elaine Harvey of Lovell. People are trying to correct things through the budget.

We are looking at other ways to deal with health care costs. One of them is Senator Petersons bill that deals with the hospital end of things, but I also have an amendment in the works that could also provide some relief.

Harvey said she is submitting an amendment for consideration on the third reading of the budget, which is expected to take place on Thursday. The amendment would offer reimbursement to hospitals for uncompensated care. The amendment takes $4 million from an $8 million building project at the University of Wyoming. The $4 million would be funneled to community health centers and rural health clinics, compensating them for some of the uncompensated care they provide to the uninsured.

Community health centers operate in underserved areas and serve the needs of a wide variety of clients from the indigent to the fully insured. She said these clinics typically provide a wide array of services, even dental care in some cases, and are typically bigger and more comprehensive in services than rural health clinics.

In contrast, rural health clinics, such as North Big Horn Hospital, are typically located in smaller communities, offering limited services. They are spread throughout the state, which allows people in adjacent communities to drive a reasonable distance to the clinic for care.

Both types of clinics offer services on a sliding fee scale. The proposed amendment would allocate funds to reimburse the clinics for a portion of the uncompensated care they provide through the sliding scale method of billing. Harvey said the amendment would allow the clinics to bill the State Dept. of Health for reimbursement for uncompensated care. It differs from Medicaid expansion in that the money comes from the state instead of the federal government.

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Health care issues still a hot topic in the legislature