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

In April, 18 million people, including hundreds of thousands of Wisconsinites, could lose continuous Medicaid coverage (Urban Institute and MJS). A 2022 Urban Institute review of a Health Reform Monitoring Survey found “most adults with family Medicaid enrollment were not aware” of being dropped from Medicaid coverage when the COVID public health emergency (PHE) ends. 62 percent of “adults with family Medicaid enrollment had heard nothing” of this possibility.

Congress and the Trump administration agreed to continuous Medicaid enrollment, waiving income limits, to guarantee healthcare coverage during the pandemic. In return, states received a 6.2 percent federal increase of Medicaid funding. However, the recently passed omnibus appropriations bill allows Wisconsin and all other states (in April) to begin ending Medicaid coverage, “regardless of when the emergency declaration is lifted” (NYT). Earlier, Wisconsin Democratic Senator Tammy Baldwin had voted against a shortsighted resolution calling for ending the PHE. But Wisconsin GOP Senator Ron Johnson gave Wisconsinites the back of his hand, voting to end healthcare coverage.

Moreover, wishful thinking doesn’t mean the pandemic is over and can’t guarantee that those dropped from Medicaid will find other affordable quality healthcare coverage. This is an all hands on deck moment. Everyone, including Wisconsin Democratic Governor Tony Evers, the GOP-led state legislature, employers, hospitals and doctors must step up. “Low awareness of the resumption of Medicaid renewals (disenrollment) indicates state programs may face significant information gaps among enrollees about the looming change” (Urban Institute). Many who lose Medicaid coverage will be eligible for Affordable Care Act (ACA) private insurance with enhanced tax credits. Children may be eligible for the Children’s Health Insurance Program. And, private employers have a responsibility to enroll their employees in affordable quality private insurance. Hospitals and doctors must lean forward and not be timid.

This isn’t politics as usual. Coordination is imperative or thousands will fall between the cracks. The good news is the Wisconsin Department of Health Services is trying to keep in touch with Medicaid enrollees and update contact information. And, the Wisconsin Office of the Commissioner of Insurance has highlighted ACA private insurance: 70 counties offer at least 3 ACA private insurance policies, enhanced ACA tax credits mean $10 a month premiums for many and “an estimated 69,000 more Wisconsinites may now be eligible for these premium subsidies thanks to a Biden administration fix that extends subsidies to more families who were not previously eligible under the Affordable Care Act.”

But one key tool is missing from the Wisconsin healthcare coverage tool box – Medicaid expansion. Time to face reality; uncompensated care will soar. Wisconsin must join the rest of the nation (39 states). North Carolina GOP Senate President Phil Berger said: “If there’s a person in … North Carolina who has spoken out against Medicaid expansion more than I have, I’d like to meet that person … (and) … talk to that person why my view on this has changed … . Medicaid expansion has now evolved … it is good state fiscal policy… .” Let’s not be last.

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

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