Neither Wyoming nor Florida has expanded Medicaid eligibility under the Affordable Care Act. But both states have tried different coping mechanisms to ensure their hospitals receive some form of safety-net funding.
To date, 22 states have yet to expand Medicaid eligibility, even though it has reduced uncompensated care burdens in the 28 states that have expanded the program. As a result, non-expansion states have often turned to creative ways to try and plug safety-net related shortfalls.
In Florida, the political leadership pushes the federal government to continue a program that provides more than $1 billion a year in additional payments to safety-net hospitals, while lawmakers in Wyoming have essentially created a fiscal bailout for some of the state's poorest hospitals.
Florida Gov. Rick Scott wrote a letter to President Obama imploring the federal government to continue what is known as the Low Income Pool (LIP) program, which provides federal funding to safety-net hospitals.
"Should your administration decline to accept a new LIP model and therefore terminate this program, I will not support using any state funds to backfill this federal program," Scott wrote. "Florida taxpayers fund our federal government and deserve to get a return on their investment."
However, Democratic lawmakers in Florida insist that the program's end is near. U.S. Sen. Bill Nelson told the Palm Beach Post that the program has run its course and that the federal government will not make LIP payments twice. Its only alternative is Medicaid expansion, he added.
In Wyoming, lawmakers approved a $2.5 million general fund grant that will serve as an infusion to the state's hospitals for their uncompensated charity care. That includes $2 million that will be divided among all Wyoming's hospitals, with one-third going to large hospitals and two-thirds going to hospitals with 25 beds or fewer, the Casper Star-Tribune reported.
However, lawmakers apparently greatly reduced the $5 million that had been earmarked to bail out critical access hospitals, reducing the amount to $1 million, Healthcare Finance News reported.