Health insurance, round two
August 20th, 2008

Health insurance, round two

Sunday, June 29, 2008 2:08 AM MDT


CHEYENNE -- So many people I have chatted with lately are focused, maybe even obsessed, about the need for reasonably priced health insurance.

Some of the more radical citizens would like to see national health insurance as the answer to the spiraling costs of health care and the inability of thousands of people in Wyoming to afford health insurance at all.

Last winter, Senate File 85 sailed through the Wyoming Senate 30-0 but bogged down fatally in the House Committee on Labor, Health and Social Services. The bill would have created an insurance pool for working people who earn too much money to quality for Medicaid but don't receive health insurance through their jobs.

I arrived late at this dance. The bill died before very many people knew about it. Members of the state's health care commission and other interested groups didn't learn about SF 85 until the bill was presented to the lawmakers.

And that was the difficulty. It won't be repeated.
In April, Gov. Dave Freudenthal met with Sen. Charles Scott, R-Casper, who spearheaded SF 85; and the health care commission co-chairmen Rex Arney and Larry Kirven and others to discuss reviving the bill, probably in an altered form, for the 2009 general legislative session.

The health care commission people also attended the recent meeting of the Joint Interim Committee on Labor, Health and Social Services, headed by Scott as chairman. They offered some suggested additions to the bill.

Scott said the basic idea for the pilot program came from the governor's office. "The governor and I have a road map as to where we want to go. Now we've got to get there," Scott said last week in a telephone interview.

Freudenthal's chief of staff, Chris Boswell, said the governor considers the new bill "a start."

Sarah Gorin, chairman of the Equality State Policy Center, a nonprofit advocacy group, said lack of accountability by the administrator of the program was one problem with SF 85.

"It seemed like they wanted to get a population they could experiment on," by pushing people into healthy choices, like quitting smoking, Gorin said.

Although quitting is laudable, the administrator appeared to have the power to kick someone off the program who didn't comply, she said. There also was the possibility that people would be dropped from the program if the money ran out.

She questioned why the state can't expand the existing health insurance program, Kid Care.

The federal government has not approved a waiver to expand Kid Care. But Gorin said the state could foot the bill for $6 million and insure an additional 3,000 adults.

"We want something to happen," Gorin said. "It's not like we're sitting here carping."

Other states that have tried health coverage reform, like Tennessee, got into financial trouble because health care costs are rising faster than economic growth, Scott said.

He cited four elements in the bill that can hold cost increases to reasonable levels:

-- An enhanced preventive package, to include some free prescription drugs, like blood pressure medication.

-- Lower co-pays for primary care physicians and higher co-pays for surgeons or other specialists. The goal is to push people into prevention or less costly alternatives, such as physical therapy instead of surgery for a back ailment.

-- Personal health accounts, financed by the state and the individual on a sliding scale according to the person's ability to pay.

-- A team approach for people with costly catastrophic illnesses, including an advanced nurse practitioner and a clinical pharmacist to negotiate the health care system to find the right treatment and care.

If the chatter continues, the health insurance issue could be at or near the top of the agenda for the Legislature next year.

Contact Joan Barron at or by phone at 307-632-1244.