Medicaid Director Jones, Reps. Sanfelippo, Riemer discuss Medicaid expansion

Wisconsin’s work requirements for some Medicaid recipients are still in force despite a federal judge blocking Medicaid work requirements in Kentucky and Arkansas, according to state Medicaid Director Jim Jones.

Jones, speaking yesterday at a WisPolitics.com forum on Medicaid expansion at the Medical College of Wisconsin in Wauwatosa Thursday, said the state is waiting on guidance from the federal Centers for Medicare & Medicaid Services.

“We’re going to follow that state law to the letter, and right now we’re waiting for more guidance from CMS as it relates to our waiver,” Jones said. “We think there’s a long road that they’re going to go through.”

He also noted Wisconsin’s work requirements differ from those of Kentucky and Arkansas. He said it’s unsure yet whether the problematic portions in the requirements for those states are a part of Wisconsin’s policy.

Jones, who provided opening remarks at the event, said expanding Medicaid in the state will cover about 82,000 additional people under Medicaid. It will also allow the state to invest in raising provider reimbursement rates, boosting caregiver pay, expanding access to dental services and more.

Jones said the state would save $324.5 million in state funds and be able to access $1.6 billion in new federal money “to make a historic investment in Wisconsin health care.”

Assembly Health Committee Chair Rep. Joe Sanfelippo, speaking on a panel with fellow Health Committee member Rep. Daniel Riemer, said Republicans are working on their own plans to increase health coverage without expanding Medicaid.

“You’ll definitely see some options coming out from the Republican caucus that will leverage additional federal dollars, but use them in a way so that we’re not expanding Medicaid, a government-run program,” said Sanfelippo, R-New Berlin.

He said plans could include providing a state subsidy in addition to the federal one for those who get insurance through the Affordable Care Act but whose incomes are several times above the poverty level.

Sanfelippo said Republicans have several concerns about expanding Medicaid.

Sanfelippo said though Evers’ budget cites a figure of 82,000 that would be added to Medicaid under the expansion, the Fiscal Bureau and the Department of Health Services has pegged that closer to 76,000. Of those, Sanfelippo said about half are already covered under marketplace plans and would lose subsidies. They would then likely move to Medicaid. The other half, he said, are those without insurance who would be eligible. The bump in new people being covered under Medicaid would stress the program and exacerbate problems accessing providers who accept Medicaid, he said.

He also expressed doubt the federal government would continue to make good on its financial obligations under the program. Currently, the federal government reimburses the state for 60 percent of the program. Under the expansion, that rate would increase to 90 percent for newly covered people.

Riemer, D-Milwaukee, said expanding Medicaid would help improve people’s health and financial stability and free up money for the state to invest in other areas.

Should the Medicaid expansion in the ACA be struck down in court or the federal government renege on its reimbursement commitments, Riemer said the state could make changes to the program. The state’s legislation to expand Medicaid could also include provisions to reduce eligibility if the federal government reduces payments, he said.

“I don’t think that’s ideal,” Riemer said. “It wouldn’t be my preferred solution, but it could be a way to get Republicans and Democrats to talk to each other about addressing a concern that I think is a legitimate one.”

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