The column below reflects the views of the author, and these opinions are neither endorsed nor supported by WisOpinion.com.
A record near 24 million Americans, including a new high of 306,470 Wisconsinites, have signed up for Affordable Care Act (ACA) private quality insurance coverage. With enhanced federal tax credits, most Wisconsinite enrollees can select a plan with big cost savings. Moreover, Wisconsin Democratic Governor Tony Evers said: “Wisconsinites in all 72 counties can choose from at least three different health insurance carriers on HealthCare.gov.” Finally, the Biden administration reported “that nearly three million rural Americans” had ACA private insurance.
I called former Wisconsin Democratic Representative Dave Obey to share the good news. Obey, longtime champion of expanding health care coverage, had presided over House passage of the ACA. Obey reminded me that Wisconsin GOP Governor Warren Knowles had wholeheartedly supported Medicaid implementation in 1966. Back then Obey was a young state legislator known for working with Republicans. He joined a bipartisan group of legislators to help with Medicaid implementation.
However, the missing ACA link for Wisconsin is the failure by the GOP-led legislature to approve ACA Medicaid expansion. 40 states, including 19 currently GOP-led states, have Medicaid expansion. About 23 million are covered by ACA Medicaid expansion, including millions of rural Americans. “A KFF (Kaiser Family Foundation) synthesis of recent studies finds that Medicaid expansion has been beneficial to the finances of hospitals and providers, driving decreases in the share of uninsured patients, increases in Medicaid-covered patients and declines in uncompensated care.”
A new study by the nonpartisan Wisconsin Policy Forum estimates that Medicaid expansion in 2025-2027 would result in a “total net benefit to the state (of) just over $1.7 billion … .” About 90,000 more Wisconsinites would get coverage and “residents of rural counties are most likely to benefit by Medicaid expansion.” The massive savings from Medicaid expansion (in part substituting federal for state funding, covering childless adults) “could be spent to improve the state’s healthcare system, address other spending priorities, reduce taxes, or some combination.”
November Democratic gains in the GOP-led legislature makes Medicaid expansion politically feasible. Passage would require only 2 GOP state senators and 5 GOP state representatives. I’m convinced a bipartisan coalition, as in 40 other states, can move the ball forward across the finish line. Below are some building blocks for a winning strategy to pass Medicaid expansion:
• As in North Carolina, enlist local sheriffs. Medicaid expansion could substitute medical treatment instead of jail for the incarcerated with drug addiction and mental health disorders;
• Organize a bipartisan support group of current and former elected officials. Talk with former GOP state legislators, including Luther Olsen, Jerry Petrowski and Dale Schultz;
• Collaborate with the Wisconsin Hospital Association. With Wisconsin hospital closures and uncompensated care increasing, as well as inadequate private insurance and Medicare-Medicaid payment, a deal with the extra federal funding looks possible;
• Engage former GOP Governor Tommy Thompson, a wily fox. Medicaid expansion could then be a bipartisan achievement.
Failure is not an option. Even under Trump, 7 states expanded Medicaid because of bipartisan voter support. It’s what most Wisconsin voters want.
– Kaplan wrote a guest column from Washington, D.C., for the Wisconsin State Journal from 1995 – 2009.
