Wisconsin’s Medicaid Hot Potato!

Wisconsin remains in the minority of states who haven’t accepted the Medicaid expansion as part of the Affordable Care Act. As a result, Wisconsin still has 82,000+ residents who are uninsured or under-insured and has lost $1.1 billion in federal government support dollars for Medicaid. These amounts aren’t being disputed. But former Governor Scott Walker and his GOP junta of Assembly Speaker Robin Vos and Senate Majority Leader Scott Fitzgerald like it like that…just fine.

Current Governor Tony Evers ran with a campaign plank to accept the Medicaid expansion. And he defeated Scott Walker. And Wisconsin wants the expansion, 70% of the voters are in favor of it. But the GOP powers that be are pulling the plan from the governor’s People’s Budget anyway.

Now, expanding Medicaid and accepting the additional federal funding is projected to save Wisconsin $324 million in the proposed biennial 2019 – 2021 budget. I haven’t seen that number disputed either. Yet the fiscally prudent GOP leadership is willing to leave those millions on the table (money that could be directed elsewhere in the budget) and ignore the wishes of a solid majority of the electorate. Let’s see what’s been going on this week: Monday and Friday

The week started out with a bit of talk about compromise but it didn’t get very far:

Wisconsin Republicans open to a possible compromise with Democratic Gov. Tony Evers on Medicaid expansion are looking at ways to accept the federal funding while not appearing to cave in on the issue, even as GOP leaders remain steadfastly opposed.

Because…there’s Robin Vos:

Assembly Speaker Robin Vos has been the most outspoken against taking the Medicaid expansion, seemingly leaving little room for compromise. He acknowledged last week that there has been talk of looking at what other states have done, but he’s unmoved.

“I don’t know why people are talking about that because we’re not doing it,” Vos said.

Well the Walker line was always…we can’t trust the federal government to continue funding the program…but if his president hasn’t removed the funding in two years of beating the ACA over the head…it isn’t going to happen in the next biennial either. Now accepting the money would expand coverage to those aforementioned 82,000 people…but apparently some of them are already receiving coverage purchased on the federal exchanges.

About half of them are receiving insurance through private plans sold on the marketplace that are heavily subsidized, while the other half don’t have insurance.

Vos and other Republican opponents don’t want to move more people onto Medicaid, which they say will push more costs into the private sector for providers who receive low reimbursement rates for care. Republicans also say the federal government can’t be trusted to keep up funding levels, which will shift more expenses to the state.

So first…some of them are insured through ACA? So the Republicans are saying that it is working as designed? That’s a good thing right? But taking the Medicaid expansion would take them off of the ACA plans and move them to Medicaid they claim. So I am asking for some help from our readers here. I thought Medicaid was available to those who were eligible…but that they had to apply for it. So happy ACA users could stay with ACA or would they be forced to take Medicaid? I am thinking they only move if it is somehow better for them. But there’s that old trope about the feds again.

And remember what I said about Wisconsin being in the minority? Well, 36 states have signed onto the Medicaid expansion…red states and blue states. So there should be a pretty clear track record on the success and costs of the program…yet the GOP has its doubts.

Wisconsin Republicans contend Evers’ plan to tap into Obamacare funding would drive up private insurance rates.

emphasis mine

Contend? We can’t get any facts out of the 36 states currently part of the program?

Assembly Democratic Leader Gordon Hintz of Oshkosh said that argument is false, pointing to a 2016 study by the U.S. Department of Health and Human Services under Democratic President Barack Obama showing such expansions lower premiums for everyone — including in the private sector. 


But it seems that some of the Republicans do in fact want to look to other states for their experience…but not the primary states running the expansion as offered…but some little states who are implementing arcane little offshoots…

Arkansas and Utah are frequently mentioned as models. In Arkansas, the Medicaid expansion money had to be used to purchase private insurance through the marketplace, an approach that could win over some free-market Republicans. In Utah, lawmakers are asking for increased federal funding to cover 90% of the cost even though they plan to cover fewer people than specified under former President Barack Obama’s signature health-care law.

Two Wisconsin Republican senators — budget committee co-chair Alberta Darling and health committee chair Patrick Testin — say both approaches are worth a look.

Why am I not surprised the Senator Alberta Darling is the leader of the movement toward healthcare arcana for Wisconsin? Sigh and a smack to the forehead.

This should be pretty simple really…70% of Wisconsin wants to expand Medicaid under the auspices of the ACA and cover another 82,000 of their friends and neighbors. They like the fact that the state will save $324 million in state tax revenues that could go to what? education? infrastructure? clean water? I don’t know…cool stuff we all expect our state to support?

And that thing about not trusting Washington? That’s about how I am feeling about Madison right now!


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