The column below reflects the views of the author, and these opinions are neither endorsed nor supported by WisOpinion.com.
Rural Wisconsinites “have higher rates of poverty, less access to healthcare, and are less likely to have health insurance.” Moreover, they are at increased risk for “heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke” (CDC). The Kaiser Family Foundation (KFF) amplified CDC’s analysis: rural residents “are older, sicker, and poorer and have less access overall to providers compared with people who live in urban areas.” The American Hospital Association and the Wisconsin Medical Society agree.
The KFF reported that 109,827 rural Wisconsinites are covered by Affordable Care Act (ACA) private insurance. Many other rural Wisconsinites are covered by Medicaid. However, the callous failure by Trump and the GOP-led Congress to extend ACA enhanced premium tax credits and passage of the so-called Big Beautiful Bill (BBB) are making a bad situation worse.
“Overall, the BBB cuts taxes by $4.5 trillion over the next decade (mostly for the wealthy)” while cutting $1 trillion from the ACA and Medicaid (Center for American Progress). Although the healthcare coverage cuts were designed to mostly hit after the November midterm elections, ACA enrollment has already declined by more than 1 million, including over 22,000 in Wisconsin, as ACA premiums soared, often doubling.
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Future ACA and Medicaid cuts and policy changes will by 2034 result in 17 million, including 276,000 Wisconsinites, losing health coverage. Down the road, a shortened ACA enrollment period, less enrollment assistance, more red tape, the end of ACA automatic reenrollment and burdensome Medicaid eligibility requirements, roadblocks to states trying to pay for Medicaid costs and needless work requirements (73 percent of Wisconsin Medicaid adults work – KFF) will be catastrophic.
The BBB is so unpopular that Republicans, including 3rd CD Representative Derrick Van Orden, now disingenuously refer to the BBB as the Working Families Tax Cuts Bill. Moreover, their Band-Aid approach “to strengthen and modernize rural healthcare access across America” is completely inadequate. Putting lipstick on a pig doesn’t change facts. 12 rural hospitals in Wisconsin are at risk of closing. 2 Wisconsin hospitals closed in 2024¸ other hospitals have closed labor and delivery units and “unpaid medical care is again on the rise in Wisconsin” (WPR).
Republicans feared that BBB draconian healthcare coverage cuts, alarming financial jeopardy for hospitals, and sharply lower education loans for medical and nursing students (will reduce health professionals for rural areas) spelled political disaster in the November midterms. So to help pass the BBB and get some political insurance, a $50 billion Rural Health Transformation Program was included. Highfalutin words that will not come close to offsetting BBB healthcare cuts for rural America: “$137 billion reduction in federal Medicaid spending in rural areas” (KFF).
Moreover, this time-limited federal money will be long gone as the permanent ACA and Medicaid cuts finally kick in. Rural hospitals will get some temporary help as financial storm clouds only increase. Wisconsin Democratic Governor Tony Evers will spend Wisconsin’s $203 million grant wisely. However, it’s a Band-Aid, amounting to no sustainable lifeline as multiple deadly financial tornadoes approach Wisconsin.
Kaplan wrote a guest column from Washington, D.C., for the Wisconsin State Journal from 1995 to 2009.