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GOP-led Wisconsin was one of the first states to implement Medicaid (1966). Arizona was the last state to adopt Medicaid (1982). Today, under the Affordable Care Act, Medicaid expansion (39 states) is nearly complete. North Carolina and Wyoming will likely expand in the coming months. And, Kansas may follow. Regrettably, Wisconsin likely stands alone with Mississippi and other Southern states in refusing 90 percent federal expansion funding and an additional 5 percent federal funding for 3 years.
Medicaid expansion in Wisconsin: Would cover 90,000 more Wisconsinites, substitute federal for state funding for tens of thousands of currently enrolled Wisconsinites, improve a wide number of health indices (e.g., infant mortality and premature death), lead to economic gains and help troubled rural hospitals. In his recent inaugural address, Wisconsin Democratic Governor Tony Evers once again asked the GOP-led legislature to pass Medicaid expansion: “People voted because they believe, as I do, that we should expand BadgerCare (Medicaid) and work to ensure everyone has access to quality, affordable healthcare.”
GOP legislative leaders responded that Evers was pushing “partisan” policies. But Republican legislators are the outliers. A recent poll by the American Cancer Society Cancer Action Network showed 70 percent of Wisconsin voters supported Medicaid expansion. Moreover, many GOP-led states passed Medicaid expansion. Why? Medicaid has a wide base of support because it covers working low-income people plus middle-working class disabled and elderly. “Wisconsin has the (dubious) distinction of being the only state in the country (under GOP Governor Scott Walker) that partially expanded eligibility for Medicaid (2014) – covering all adults up to the poverty threshold – but didn’t take the additional federal dollars (for full expansion up to 138 percent of poverty level) through the Affordable Care Act” (MJS). The total loss for Wisconsin 2014 – 2023 is $3.2 billion.
What accounts for this fiscal and moral blindness? GOP legislators have told so many whoppers about Medicaid expansion that they remain in a straightjacket of their own making. Former GOP state Senator Luther Olsen tried to use the COVID pandemic to help Republicans out of their self-imposed corner. Nobody listened. Why? The strings of GOP legislators are pulled by the ultra-reactionary Wisconsin Manufacturers & Commerce (WMC). The WMC said: “The state should oppose efforts to expand Medicaid, and thereby increase the number of Wisconsinites receiving taxpayer-subsidized health insurance. Federal Medicaid dollars will decline over time (a big lie), leaving state taxpayers responsible to pay for a large unfunded entitlement.”
In contrast, the U.S. Chamber of Commerce, joined by America’s Health Insurance Plans, the American Hospital Association and American Medical Association support Medicaid expansion. It’s time to move forward. Former Wisconsin GOP Governor Tommy Thompson once said: “I don’t get hung up on ideological dogma when looking at problems.” Thompson acted in that vein when he expanded eligibility for BadgerCare when he was governor. It was a model for the rest of the country, covering more working low-income Wisconsinites.
Governor Thompson, your everlasting legacy could be to advocate bipartisan Medicaid expansion. Let Mississippi be last – not Wisconsin.
— Kaplan wrote a guest column from Washington, D.C., for the Wisconsin State Journal from 1995 – 2009.