The column below reflects the views of the author, and these opinions are neither endorsed nor supported by

Short answer, many Republicans support Medicaid expansion. The Kaiser Health Tracking Poll indicates that 55 percent of Republicans support states expanding Medicaid (federal government pays 90 percent of total cost). Fiscal prudence, state savings and increased health care coverage converge. No wonder 10 GOP governors, supported by many GOP legislators, expanded Medicaid years ago. And, 7 other GOP governors continued Medicaid expansion initiated by Democratic predecessors. In total, 36 states have passed Medicaid expansion, including most of the Midwest. Wisconsin is an outlier.

Strange. The Wisconsin Medicaid program was established by GOP Governor Warren Knowles and enlarged by GOP Governor Tommy Thompson (partially reversed by defeated GOP Governor Scott Walker). Presently, state GOP legislators are resisting “substituting federal for state expenditures for currently-enrolled childless adults” (would cover 82,000 more Wisconsinites) that the state would receive under Medicaid expansion (nonpartisan Legislative Fiscal Bureau).

However, the GOP-led Joint Finance Committee (JFC) inexplicably said no. I asked Democratic state Senator Jon Erpenbach to react: “Expanding Medicaid would not only save Wisconsin … $325 million state dollars, and pull in $1.6 billion in federal funding, but it would lower insurance premiums for every person on the individual market (Health Affairs June 6, 2019). While JFC Republicans are aware of these facts, and know that 70 percent of Wisconsinites approve … expansion, they still choose to charge taxpayers more to get less coverage. Wisconsinites know that taking … Medicaid expansion is the right choice, and hopefully it is only a matter of time before Republicans come out in support of the proposal”. Moreover, Erpenbach told the Milwaukee Journal Sentinel that he thought some individual GOP state legislators might support Medicaid expansion.

In an exclusive interview with former GOP state Senator Dale Schultz, I asked his opinion of the current stalemate: “Medicaid expansion is an obvious opportunity, but there is a lack of open discussion in the GOP-led legislature”. He indicated he thought there are GOP legislators “open to Medicaid expansion”. And, that failure to pass Medicaid expansion “will cost Republicans down the road”. Schultz, a farmer from rural Richland Center, knows that Medicaid expansion would greatly benefit rural Wisconsin. Why?

The Robert Wood Johnson Foundation’s new survey said: “When asked what was the most important thing that could be done to improve their health, … 36 percent of rural adults identify options related to fixing health care, including improving access, quality and reducing costs”. Moreover, the Georgetown University Center for Children and Families reported that Medicaid expansion reduced the uninsured rate for low-income (most working), non-elderly rural adults by more than half. Medicaid expansion is (moral) common sense.

The Associated Press reported Tuesday that “longtime Virginia Republican (state Senator Emmett Hanger) who was an outspoken supporter of expanding Medicaid … held off a primary challenger.” Hanger is “a kind of bleeding-heart conservative who see caring for the poor as a Christian imperative. For years he had wanted to expand Medicaid” (Washington Post). He won big, 57 percent!

Take heart, Wisconsin Republicans who (privately) favor Medicaid expansion.

— Kaplan wrote a guest column from Washington, D.C. for the Wisconsin State Journal from 1995 – 2009.


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