The column below reflects the views of the author, and these opinions are neither endorsed nor supported by
Author Thomas Frank provocatively asked “What’s the Matter with Kansas?”.  Last Thursday, the Kansas GOP-led House answered: nothing.  28 Republicans, putting state over party, joined 41 Democrats to approve expanding Medicaid to cover 150,000 Kansans.  GOP state Representative Don Hineman, farmer-rancher and chair of the House Rural Revitalization Committee, said Medicaid expansion “will provide immediate help” to rural Kansas and its hospitals facing closure.  The issue now goes to the GOP-led state Senate.
Kansas Democratic Governor Laura Kelly won last November after 8 years of GOP rule.  Same for Wisconsin Democratic Governor Tony Evers.  Both face GOP-led legislatures.  Kelly got the Kansas House to “yes” on Medicaid expansion, echoing Evers and Andrea Palm, Secretary-designee of the Wisconsin Department of Health Services.  Like Kelly they are speaking to voters, health care providers, other stakeholders and legislators to get to “yes”.  With Kansas moving forward there are only 3 Midwest states still resisting Medicaid expansion: Missouri, South Dakota and Wisconsin.
“Wisconsin is the only state in the country that expanded eligibility for its Medicaid program (throwing thousands off, but covering thousands more) … while not accepting the federal money available to states through the Affordable Care Act” (Milwaukee Journal Sentinel).  State Republicans shot themselves and Wisconsin in the foot by leaving $1.1 billion in federal funding on the table for other states. However, the federal funding can still be substituted for state funding to cover both those added and 76,000 additional Wisconsinites if Medicaid is expanded (Legislative Fiscal Bureau). It’s needed.
A new study by the Robert Wood Johnson Foundation and the UW-Madison Population Health Institute ranks the “healthiest and least healthy counties in Wisconsin”. Rural northern counties and Milwaukee County are the worst, while affluent Ozaukee County is ranked first.  The takeaway point is that both rural and urban Wisconsinites would benefit from Medicaid expansion.  And, other studies make clear the fiscal and moral imperatives of expanding Medicaid.
The American Medical Association said: “data … indicates Medicaid expansion has had a positive impact on patient access and health as well as strengthening the financial stability of safety-net institutions. …(And,) researchers have discovered a positive impact on hospitals … reductions in uncompensated care, improved operating margins – especially for small hospitals – and reduced likelihood of closure, especially among rural hospitals.”  (The Wisconsin Hospital Association and Wisconsin Medical Society support the concept of Medicaid expansion).
The Georgetown University Center for Children and Families outlined the fiscal benefits of Medicaid expansion for Colorado, Louisiana, Michigan, Montana and Virginia.  “In each of these states, … expanding Medicaid has either been a positive for the state’s general fund revenues or has not resulted in any additional cost to the state.  The reason is a combination of substantial state savings from Medicaid now largely paying for formerly state-covered services (e.g., mental health) and additional revenues as a result of expansion from increased economic activity and hospital/health plan contributions.”
It’s time for Wisconsin GOP legislators to come to the bargaining table.  Wisconsin wants to get to “yes”.
–Kaplan wrote a guest column from Washington, D.C. for the Wisconsin State Journal from 1995 – 2009.
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