Washington has given up on health care reform. Now it’s up to us

This article originally appeared in the Jackson Hole News and Guide on May 15th, 2019.

After President Trump instructed the Justice Department this past winter to support a Texas ruling invalidating the legality of former President Barack Obama’s health care law, he then correctly suggested that the GOP get serious about the No. 1 problem facing Americans: “The Republican Party will become The Party of Healthcare!” he tweeted. But within days, Republican Congressional leaders said that while they were fine invalidating the Affordable Care Act, they had no intention of working on a replacement.

“I made it clear to him that we were not going to be doing that in the Senate,” Majority Leader Mitch McConnell, R-Ky., announced one week later.

That’s right, just months after the new Congress was sworn in, the GOP is putting off work until after the next election. The good news is that there is much an individual state can do, provided our Wyoming legislators show the courage our federal politicians lack.

The economic stakes for our state and our families are even greater after Congress made the situation worse in 2017 by punting on comprehensive health insurance reform and eliminated the individual mandate. By doing so, they lit the fuse on a health care time bomb that will create an economic catastrophe for our state in the coming decade.

Here’s why: Wyoming ranks between 44th and 49th place in affordable health insurance. Our premiums run 37% to 59% higher than in nearby Idaho or Nebraska. As a result, Wyoming has one of the highest uninsured rates in the country, ranking in the bottom five nationally. In Teton County, a 60-year-old with $50,000 in income faces as much as $1,237 per month for the least expensive plan. This problem is repeated throughout our state, whether it be the 25-year-old man I spoke with in Gillette who served meals at Subway and faced an unrealistic $7,000 annual premium, or the National Guardsman I spoke with in Cheyenne whose insurance plan would not cover the necessary treatment for his son’s brain tumor.

Our crisis goes beyond just those who cannot afford any insurance. There is an even greater number of Wyomingites who are only able to purchase catastrophic insurance. For these people, every trip to the dentist, pharmacist or doctor is an out-of-pocket expense.

As a result, many are foregoing routine preventative care, and this represents both a social and an economic time bomb for our state. As more and more Wyomingites ration their preventative care, chronic conditions such as cancer, heart disease and diabetes that could be cured or controlled if detected early go untreated, leaving families needlessly devastated.

As expensive late-stage curative procedures replace preventative or early stage interventions, each year the total price of health care in our state will rise, putting increasing pressure on the price of health insurance, making it less affordable for even more families. The crisis before us only deepens as the population of Wyoming ages at a rate 20% greater than the rest of the country.

But we are not totally at the mercy of Washington’s fecklessness. Other states have recognized Congress’ ineptness and have taken matters into their own hands.

Arkansas and Tennessee have shown promising cost reductions using Episode-Based Payment, which creates an incentive for health care providers to control costs. Maryland successfully implemented a Medicare and Medicaid Services waiver program that shifts incentives to hospitals to control costs and has saved the state more than $500 million since 2015. Under former GOP Gov. Mitt Romney, Massachusetts now offers one of the lowest deductibles in the country while keeping premiums at the national average. Minnesota, California, Hawaii and Washington are other states that have proactively worked to reduce health care expenses.

I’m not suggesting that we necessarily adopt any of these specific models. Instead, I list them to demonstrate that other states have not waited for Congress to take action. Given our dire situation, neither should Wyoming. Until our Wyoming delegation musters the statesmanship to forego short-term political gain and demonstrate a willingness to consider all good solutions regardless of partisan advantage, our state legislature must fill the void.

Health care reform is complex and requires political courage. But there is no better priority for the Wyoming GOP to champion than lowering the cost of health care for our families so that basic health care in our state can become affordable to any hardworking person.

David Dodson is a resident of Teton County and a former candidate for the U.S. Senate. The views expressed in this column are solely his own.