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Amidst discussions of possible federal spending cuts, Senator Tammy Baldwin recently toured the state made multiple stops throughout Wisconsin to listen to the stories of Medicaid enrollees. She highlighted that 300,000 children rely on Medicaid in Wisconsin, and throughout the tour she shared multiple stories of enrollees with disabilities and chronic diseases—implying that they are at risk of losing their coverage due to “deep cuts” to the program.
This could not be further from the truth.
In fact, not a single currently eligible Wisconsin Medicaid enrollee is at risk of losing coverage under the current budget proposal. And nationwide, no children, elderly, or disabled enrollees are at risk either, despite Senator Baldwin heavily implying this throughout the tour. Indeed, this tour was little more than fearmongering to mislead Wisconsinites for political gain at the expense of the most vulnerable.
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The House Republicans passed a budget bill that tasks several congressional committees to set their budgets at certain levels with an overall target of reducing federal spending by $2 trillion over the next decade. The House Energy and Commerce Committee which oversees energy, consumer protection and health care issues, must find ways to cut $880 billion over the next ten years across the many federal agencies and programs they oversee, which Medicaid is just one of. Medicaid is not specifically targeted for cuts, and the committee has discretion over how they will implement them. If they do decide to reduce Medicaid spending, we have good reason to believe that they would not reduce coverage.
Republican leadership has held the position that they do not plan to cut Medicaid coverage for the millions of people on the program, but do plan to cut out waste, fraud and abuse which there is plenty of.
Between 2015 and 2024, CMS reported $543 billion dollars in improper Medicaid payments. The Paragon Institute estimates that it was closer to $1.1 trillion dollars when considering that full audits were not conducted most years. This waste is mostly explained by states enrolling ineligible people, but there are also common fraudulent schemes to steal from the program.
Given that Medicaid lost at least $543 billion in the last decade, the committee cracking down on fraud and eliminating this loss over the next decade could complete more than 60% of their required $880 billion of spending cuts—without reducing Medicaid services.
There have been proposals to cut program spending, but only for the 90% reimbursement rate for the expansion population (childless, able-bodied adults up to 138% of the federal poverty line). Children, the elderly and disabled are the traditional Medicaid population, which is has its own reimbursement rate formula, and is not getting reduced. Anyone who is part of the traditional population, in Wisconsin or elsewhere, is not at risk of losing their coverage. Senator Baldwin focusing on children and disabled falsely implies the opposite.
The 40 Medicaid expansion states should be concerned if the 90% reimbursement rate for childless, able-bodies adults is reduced. They would either have to pick up the cost for those enrollees which would be devastating to their budget, or repeal expansion and take away coverage for anyone whose income is no longer eligible.
Luckily, Wisconsin is not an expansion state. Not a single Wisconsin Medicaid enrollee is part of the expansion population. Not a single person Senator Baldwin spoke to on her statewide tour is at risk of losing coverage. That is, unless they were ineligible for Medicaid in the first place.
Medicaid is an important program that millions of people rely on, and Democratic leaders have the right to voice their concerns. But Senator Baldwin doing a tour in Wisconsin, which is not an expansion state, and using the stories of our most vulnerable to imply they will lose their coverage, is very misleading and causes unnecessary fear among her constituents. Wisconsin deserves better.
– Miranda Spindt is the policy analyst and project manager at the Wisconsin Institute for Law & Liberty in Milwaukee, where she specializes in health care policy. Follow her on X @miranda_spindt.
