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March 16, 2010 4:23 am

Legislature passes health care bills

Written by Tribune Staff

Bills designed to reduce health care, insurance costs

Two bills that passed the Wyoming Legislature and signed into law earlier this month aim at reducing the cost of health care and health insurance in the state.

Senate File 61, which called for putting up $750,000 from the state's tobacco settlement trust fund to establish personal health savings account for as many as 500 participants, was signed into law by Gov. Dave Freudenthal last week.

Sen. Charles Scott, R-Casper, was the primary sponsor of the bill. He praised the Legislature for passing the measure, which he said has promise of reducing the costs of medical care for the uninsured in Wyoming.

“Nationally, we've seen the need for health care reform, but we're not getting anything done. Well, in Wyoming, we are getting things done.”

“We're experimenting at this point,” he said during a telephone interview. “We're trying to do it by using a combination of incentives and advice and consultations rather than prohibitions.”

The program would establish health savings programs for up to 500 people who are working at least 20 hours per week and have household incomes of 200 percent of the federal poverty level or less. A sliding scale would adjust according to each individual's income, and participants would put some money into their accounts as well.

“That enables you to use the co-payment system all of us who have private health insurance are familiar with,” Scott said.

That money then could be used to help pay for health care costs and a limited health insurance plan.

“People will treat the money in the account as if it was their own money, and will be motivated to not spend it unless they need to,” Scott said.

Rep. Dave Bonner, R-Powell, said he sponsored and supported the bill in the House. (Bonner is also publisher of the Powell Tribune.)

One of the things that convinced lawmakers to vote for it was the fact that participants “have some skin in the game” by putting some of their own money into their health savings account, he said.

Another was the hope that the program will reduce the state's mounting Medicaid costs down the road, he said.

“There is a gathering storm in Medicaid hanging over states,” as states soon may have to bear a larger share of the costs for the program, he said. The Medicaid program is funded by federal and state dollars.

Scott said the program will focus on prevention. A team with a pharmacist and a nurse practitioner will work with participants to help them get the care they need — but avoid extra testing and care they don't need.

“That can do more harm than good,” Scott said.

Bonner said the current path for many people without insurance now leads to the emergency room because they don't have money for preventive health care.

“This will be a way up for them while holding down health care costs, and hopefully Medicaid costs,” he said.

Scott said the bill was a joint project between Republicans and Democrats, and he also worked with Freudenthal.

In a news release last week, Freudenthal said, “I'm pleased and encouraged that the Legislature chose to act on this. I have said before that it would not be wise to wait for a national fix to our problems here in Wyoming.”

Freudenthal said the program's focus on prevention will lead to earlier detection of chronic disease.

“This allows the project to pay for health rather than sickness, resulting in better quality of life and cost savings,” the release said.

People with chronic conditions will get help managing their illnesses to improve their health and quality of life, the release added.

Scott said statistics show that 50 percent of medical costs come from 2.5 percent of the population with medical bills of $30,000 or more.

“The initial enrollment in the project will be fewer than 500 individuals,” Freudenthal said, “but if its design proves effective, it could have significant impact in the way health care is provided by Wyoming employers and businesses as well as state government.”

Scott said, “We're trying it at first with no more than 500 people to get the bugs out of our benefit design. I'll almost guarantee we'll have to back up and redesign it. Once we get that done, either a year from now or maybe a little longer, we will try with 3,000 people.”

Rod Barton, chief executive director of Powell Valley Healthcare, said the program aims at some of the people most in need of health care.

“These are the people that need the help,” he said. “It's the group that's caught in the middle ... They're too rich for Medicaid, but they can't get insurance through their employer or on the open market.

“It's an experiment, so I don't know that it's going to solve all the problems (with the health care system). But the status quo is not acceptable. Something's got to change, and so, therefore, I support efforts like this pilot program.”

Scott said the passage of the bill, and the governor's support, shows Wyoming can accomplished what Congress has not.

“It does show that, in Wyoming, we can work across party lines and get the job done.”

Another bill, House Bill 128, also passed the Legislature and was signed into law by the governor last week. That bill allows the Wyoming Insurance Commission to work with commissions in other states to find ways to allow Wyoming residents to buy health insurance plans across state lines.