The long-running, presumed dead debate over expanding Medicaid in Wyoming continues to be somewhat resuscitated as the race for the next governor enters its final weeks before the Nov. 6 general election.

The four candidates for the job were asked, and sometimes responded when not asked, at a debate at Casper College on Thursday whether the state should accept the money from the federal health insurance program for the poor to cover about 20,000 residents who do not have access to health care.

The Legislature has repeatedly rejected it, and Republican Mark Gordon of Buffalo agreed with that decision.

The Republican-dominated Congress has reformed, and President Donald Trump has signed, the Obama-era Affordable Care Act that allows more flexibility in how insurance companies can operate, Gordon said.

He also favored greater transparency in medical billing, and Wyoming needs to craft its own system, he added.

Constitution Party candidate Rex Rammell of Rock Springs opposes expansion, saying it's "putting our poor citizens in bondage." The more government subsidizes health care, the more people depend on it, he said.

Libertarian Lawrence Struempf of Laramie said he's spoken to representatives of hospitals who've told him that they would have higher profit margins and be able to offer preventative care that would lower costs.

Democrat Mary Throne of Cheyenne said she favors expansion and it's one of the reasons she's running. Montana expanded its Medicaid program and the number of its uninsured residents dropped.

The state already accepts $2 billion in federal funding, but it's not willing to accept Medicaid expansion, Throne added.

 

Expanding Medicaid also would help provide better mental health services, she said.

Gordon and Rammell again disagreed, with Rammell saying the lackluster economy affects people's mental health.

Rammell later said more insurance companies would come to Wyoming, but its regulations are too strict.

Throne said Medicaid expansion would help lower health insurance premiums. When people don't have health insurance they use emergency rooms more and hospitals shift those costs to those who have insurance.

Gordon, however, said  Medicaid doesn’t address cost and savings, and Wyoming needs to develop its own system.

When asked about the lower life spans of Northern Arapaho and Northern Shoshone tribal members on the Wind River Indian Reservation, Struempf said he grew up on the reservation and would be able to work with the tribes.

Throne said the tribes will have a partner in her administration. "They don’t want a hand out but a hand up."

Gordon said Wyoming already has a role in tribal health services.

Rammell said with due respect to the tribes, their health care system "is socialism at its best, when government tries to redistribute wealth."

In other issues, Throne disagreed with the other candidates that Wyoming should not allow people to change their party affiliation when they vote in the primaries.

Struempf said people should "stick to their guns" and not interfere in another party's business.

Gordon said he would consider the proposal.

Rammell took the opportunity to lash out at Gordon, because he believed a lot of people changed their party affiliation to Republican to vote for Gordon. That "vote splitting" allowed Gordon to win the primary instead of unsuccessful GOP primary candidate Foster Friess.

"You're the most liberal Republican I've ever met," Rammell said.