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Charles Scott, R-Casper, whose expertise is health care. Reacting to the recent unveiling of Wyoming SHARE, the latest expansion proposal, Mr. Scott said:"Frankly, it looks like an Obama administration wish list of how you do Medicaid expansion. I have some real problems with that."So what is lawmakers' opposition really all about? Is it the belief that the program fails to meet Wyoming's needs? Or could it just be that the Obama White House remains tied to it?Consider the range of legislative concerns that Wyoming SHARE (Strategy for Health, Access, Responsibility and Employment) addresses:- It costs nothing. First, the federal government would fund the majority of the expansion (100 percent for the first few years and tapering to 90 percent by 2020). Then the shutdown of several state safety net programs - no longer needed because of the expansion - is projected to fill any funding gaps. Thus, the expansion won't cost lawmakers a penny more of general fund money.- It requires "skin in the game," as some in the Legislature have demanded. Participants would be required to pay small premiums as well as make co-payments for some services. Wyoming SHARE also would offer services to help people find jobs. (Requiring recipients to work, as some have suggested, is not allowed under Medicaid expansion.)- It has a "trigger." If the federal government ever dips below its 90 percent commitment, the program would be ended. This should relieve legislators' worries that they will be stuck with the tab.But there are many benefits as well.First, it reduces the amount of uncompensated care that hospitals have to provide to the working poor who cannot afford to pay their bills. Wyoming's annual total for that is 200 million. That drives up medical costs for those who are insured, both due to cost shifting (someone has to pay for the care) and increases in health-care premiums.It also is important to note that the burden of uncompensated care is dragging down Wyoming's smaller community hospitals. If this continues, some may be forced to close their doors or special taxing districts will have to be created to support them.Health department officials also note that the federal dollars from the expansion - 100 million- 120 million a year - would provide a boost to the state's economy. Projections show that as many as 800 jobs will be created, 500 in health-care fields.Most importantly, the expansion means 17,600 residents will have access to medical care, creating a healthier population. And it would save as many as 69 lives a year, estimates show.Wyoming SHARE is the best of many worlds. It expands health care while giving Wyoming a say in how the program works. 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