The 2016 Wyoming Legislature marked the halfway point earlier this week. Tuesday was the crossover period for the House and Senate, meaning that any legislation that had not passed third reading in its house of origin is dead.

The bills that passed the House are now before the Senate, and those that made it through the Senate files are being considered by the House.

One of this session’s higher-profile bill failures was Medicaid expansion, with the Senate refusing to pass the measure, both as a bill and, on a second try, as a budget amendment.

However, another bill involving health care was still very much alive as of Wednesday.  The bill, Senate File 86, aims at creating a “Wyoming solution” for uninsured residents passed the Senate. It was introduced in the House and referred to the House Labor, Health and Human Services Committee.

We understand Republican lawmakers’ frustration with, and distrust of, the federal Affordable Care Act, or Obamacare. But, as Gov. Matt Mead, also a Republican, has noted, it is the law of the land, and our federal tax dollars are going toward funding it. Now, instead of helping Wyoming residents without health insurance receive the care they need, and reducing the burden of unreimbursed care on hospitals in the state, our tax money is going to Medicaid programs in other states.

Because Mead also understands the Legislature’s dislike and mistrust of Obamacare, he suggested making Medicaid expansion legislation dependent on federal funding. If the federal government backed out of its funding obligation, the state would back out as well.

Interestingly, that seemed to shift some of the debate about the issue. Sen. Charles Scott, R-Casper, who has been one of the chief opponents of Medicaid expansion, was quoted in an Associated Press story as saying, “The best information we have, it isn’t going to do much good for the health status of the people who will be covered.”

That would be a bitter pill to swallow for the estimated 20,000 uninsured people who could have benefited through Medicaid expansion.

Another bill, Senate File 86, did pass the Senate and now is up for consideration by the House.

That bill, sponsored by Scott, Sen. Phil Nicholas and Rep. Kermit Brown, both R-Laramie, and Rep. Elaine Harvey, R-Lovell, is Scott’s alternative to Medicaid expansion. It would provide $20,000 for the development of a medical assistance program for people who cannot afford adequate health insurance.

As envisioned, that program would “maximize improvements in the health status of program participants” and “seek to create a pathway for participants to leave governmental assistance and become self-sufficient” by encouraging participants who are able to become and remain employed.

It also would include incentives for participants and health-care providers to avoid unnecessary health-care costs.

We completely agree with those goals, and would advocate for the Affordable Care Act to adopt them as well. But there is one big problem that stands in the way now in Wyoming: Money — or, the lack of it, for such a program to function.

The bill stipulates, “The design shall seek to avoid spending monies that Wyoming does not have,” and it prohibits the state from submitting a request for Medicaid expansion to the federal government.

It states that the program’s design “shall consider financing the medical assistance program from savings ... in the existing Medicaid program,” in other health and welfare programs and “from the financing mechanisms available to the Wyoming health insurance pool.”

While that would be great, there is no guarantee that those savings, if realized, will be substantial enough to pay for the proposed program.

The bill’s fiscal note doesn’t provide much information, either. Beyond noting the $20,000 Senate File 86 would provide for creating the proposed program, it says only, “Any additional fiscal or personnel impact is not determinable due to insufficient time to complete the fiscal note process.”

The Legislature has gone down this path before, even to the point of starting a prototype program, Healthy Frontiers, a few years ago, which it later canceled, calling it unsuccessful. And that was during much better economic circumstances than those the state is facing now.

Efforts since then to create a Wyoming solution for meeting the health-care needs of residents who cannot afford insurance have died on the floor of the Legislature without ever seeing the light of day. 

It’s even harder to imagine one succeeding now.

We hope a Wyoming solution can be reached for state residents who cannot afford health insurance.

But, given recent history, we’re doubtful that the Legislature has the will to pass Senate File 86. Even if it does, such a program won’t be developed overnight. It will take a long time — certainly months, and likely years, if it happens at all.

In the meantime, Wyoming residents who can’t afford insurance and don’t meet qualifications for other programs will continue to be without health-care options.

We are thankful that there are programs and services here to help meet the medical needs of people living on low incomes and without insurance: Heritage Health Center in Powell, and soon, the Ag Workers and Health Services Program, formerly Migrant Health Services, also in Powell. Interestingly, Heritage Health and the Ag Workers and Health Services Program both are funded by federal dollars.

The only non-federally funded option here now is Heart Mountain Volunteer Medical Clinic in Cody; the free clinic in Powell closed last fall due to a lack of medical volunteers.

It’s seemingly easy for lawmakers to thumb their collective noses at Medicaid expansion. But too many Wyoming residents don’t have any medical coverage, and they’re the ones, along with hospitals in the state, who are affected by the Legislature’s failure to act. Contrary to public perception, many of them are hard-working people who simply have no health insurance options.

It’s time — past time — for Wyoming lawmakers to work seriously toward a solution, whether that be Medicaid expansion or a customized program for Wyoming.