Wants the facts on the ACA? Go to the sources

Keep a few things in mind when trying to understand the Affordable Care Act.

Go to the correct sources for information. The main web site is http://healthcare.gov. That's where you find out the facts, ma'am (and sir). In Wyoming, look up Enroll Wyoming at http://enrollwyo.org. If you prefer talking on the phone, call 2-1-1. That's what smartphones are for.

Enroll Wyoming has a batch of navigators spread around the state. Three of them were at the town hall meeting in Cheyenne on Monday night. Their director said that she and her crew had given more than 30 presentations last week in Laramie County alone. At this point, there is probably no question that they haven't heard.

A crowd of 40 or so people heard a panel of experts spell out the ACA details at the Monday meeting.

In Wyoming, we are bombarded with misinformation from Know-Nothings. If you want to know the facts, avoid any comment or communique from the Republican Party. Don't read Rep. Cynthia Lummis's e-mail missives about Obamacare. Senators Barrasso and Enzi are no help either. Neither are state legislators with an "R" after their names. They all are so blinded by hate for our president that their lies never cease.

And Medicaid expansion? According to Phyllis Sherard, Cheyenne Regional Medical Center Population Health Officer, who was at the meeting, the Wyoming Hospital Association has spelled out the four main objections to Medicaid expansion and refuted each one. Go to http://wyohospitals.com. Here are some highlights of a recent press release from the WHA:

There are at least three key reasons that legislators should support the full expansion.   

First, the full expansion is good for Wyoming’s patients. One of the surest ways to improve overall health and control costs is for patients to receive the right care, from the right provider, at the right time. 

Providing coverage for more than 28,000 Wyoming citizens – often described as the working poor – will provide that access to care. We know that patients who receive preventive care, or who receive care earlier, tend not to be as sick when they do need care.

Second, the full expansion could save the state $47 million over six years, according to a study released by the Department of Health. These savings can only be achieved, however, if the Legislature supports the full expansion of the program. 

Finally, the full expansion will help ensure that Wyoming’s providers can continue to provide care for our vulnerable populations. In 2011, Wyoming hospitals provided about $200 million in uncompensated care – up from about $126 million in 2007.  At the same time, federal assistance for hospitals that treat large numbers of low-income and uninsured patients has been slashed. The impact of both the dramatic growth in uncompensated care and the reductions in this federal assistance would be significantly offset through the full Medicaid expansion.,

Who cares about hospitals? We do. Every community wants its own hospital so its citizens can be close to quality medical care. This isn't possible in Wyoming with its low population and great distances between centers of medical care. Casper currently is discussing the wisdom of adding a third hospital to its ranks. Cheyenne Medical Center recently added a cancer center and a state-of-the-art ER. Meanwhile, hospitals in Colorado and Montana and Utah beckon us with slick ads and promises of big-city medical care just a short drive over the border.

Medicaid expansion, it seems, is one way to ensure that our home-grown hospitals stay solvent and able to treat our rapidly aging population. I spent a fair amount of time and treasure this year at CRMC. As is the case with many in Cheyenne, I cast a dubious eye on our local hospital. I had a heart attack in late December and on January 2 had to be rushed to CRMC. I could have gone to Fort Collins or Denver but "minutes mean muscle" as those alliterative cardiologists say. The longer a heart patient goes without treatment, the more heart muscle can be lost. It's important that good care is close to home especially when it comes to the beating heart. I discovered that the Kardiac Kids at CRMC run a tight ship and make minutes count. There's a fine cardiac lab and a top-notch telemetry unit for recovery and a whole regimen of rehab.

I spent several hundred thousand dollars on my heart. I was lucky as I have insurance that I (and the State of Wyoming) has been paying into for 22 years. Some of those payments go toward paying some of $83 million over the past three years that CRMC has written off in uncompensated care. That shortfall has to come from somewhere. I've done my part and I'm not sorry. I could resent those "freeriders" that I paid for, but that wouldn't be very Christian of me, would it?

So get on with it, Wyoming Legislature, and expand Medicaid.