Wyoming Doesn't Need Medicaid Expansion to Help the Truly Needy

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Wyoming has always stood out. It’s the state with the first national park and the first national monument. The first state to give women the right to vote. The first state to elect a woman as governor. And, of course, it still has the smallest and least dense population in the country.

But Wyoming quietly leads the country in another category and has done so for years: Medicaid spending. As a percentage of its state budget, Wyoming spends less on Medicaid than any other state — about 14 percent

Wyoming isn’t leading this category out of cold, heartless thrift. It’s because Wyoming focuses its limited Medicaid dollars on the truly needy — individuals with disabilities, seniors, and kids — rather than able-bodied adults.

In fact, even without expanding Medicaid to able-bodied adults under Obamacare, Wyoming has become more generous to the truly needy, more than doubling its Medicaid spending since 2000.

Yet, advocates for expanding Medicaid under Obamacare remain in Wyoming. And they continue to downplay the effect expansion will have on the state’s taxpayers and truly needy.

Advocates rely on projections that, in other states, have proven to be consistently wrong. Take Montana, for example, which expanded Medicaid to able-bodied adults in 2016. Montanans were told that no more than 59,000 able-bodied adults would enroll. Almost 100,000 have. The program has ballooned from 15 percent of the state’s budget before expansion to 25 percent.

Montana is not an outlier, nor is the pandemic to blame. In fact, expansion states usually enroll more than twice as many individuals as projected.

For over 10 years, in state after state, the projections turn out wrong. The promises are empty. And states expand ObamaCare with no easy way out.

But today, because Wyoming has wisely avoided expansion to able-bodied adults, the state has a unique ability to make other investments in education, infrastructure, and public safety. Just ask legislators in Montana and Wyoming’s other Obamacare-addicted neighboring states, who face rising health care and welfare costs.

And Wyoming’s health care system is better off, too. Medicaid expansion would only make life harder for the state’s rural hospitals, force thousands off their federally subsidized private health coverage and into government dependency, and raise premiums for the families which still have private plans.

Perhaps most striking, Wyoming has avoided doubling down on Medicaid’s waste and fraud. Medicaid’s improper payment rate was more than 20 percent, or $86 billion, last year.

That’s right, the federal government wasted about 15 times more money on Medicaid than Wyoming spent on everything.

The program is simply not preserving welfare for the truly needy. But Wyoming, more than any other state, is. And that’s in large part because the state hasn’t built on the broken foundation of Obamacare and expanded Medicaid to able-bodied adults. 

Scott Centorino is a senior fellow at the Foundation for Government Accountability.



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