Medicaid expansion baked into Tony Evers’ budget, health agency leaders say

March 13, 2019

Funding increases for hospitals, dental care, women’s health, long-term care, mental health services and other health programs in Democratic Gov. Tony Evers’ budget depend on expanding Medicaid to cover more low-income people, leaders of the state Department of Health Services said Tuesday.

There’s no back-up plan if the Republican-controlled Legislature turns down Medicaid expansion, as GOP leaders have vowed to do, Andrea Palm, secretary-designee of the health department, told reporters.

The budget is “anchored in Medicaid expansion,” said Palm, who is traveling around the state to discuss the proposal released late last month. “Part of how we get to ‘yes’ with the Legislature is to have a Wisconsin community … who see themselves in the budget and feel invested in getting it to the governor’s desk.”

Evers called for covering about 82,000 more adults who earn up to 133 percent of the federal poverty level through Medicaid. Under the Affordable Care Act, the federal government will pay at least 90 percent of the cost instead of its regular 60 percent share.

The higher federal payment would save the state $324 million over two years, which could be invested in other programs to draw down more federal dollars, for a total $1.6 billion investment in a variety of health services, Palm said.

Assembly Speaker Robin Vos, R-Rochester, and Senate Majority Scott Fitzgerald, R-Juneau, oppose Medicaid expansion and have talked about writing their own biennial budget. The federal money for Medicaid expansion could fall through, and private health care costs could go up if providers increase prices to offset low Medicaid rates, they say.

Wisconsin is one of 14 states that haven’t adopted Medicaid expansion. Among them, it’s the only one with no gap in coverage for residents below the poverty level, as the other states don’t cover adults up to the poverty line.

State Sen. Dale Kooyenga, R-Brookfield, said Tuesday he is open to considering Medicaid expansion.

“I’m personally flexible,” Kooyenga said at a Wisconsin Health News forum.

However, he said Wisconsin could lose federal money now going to tax credits for low-income people who buy commercial insurance on the Affordable Care Act marketplace.

Speaking at the same event, Wisconsin Medicaid director Jim Jones reiterated Palm’s stance in saying “there is no plan B” if Republicans reject Medicaid expansion.

“We are not willing to give up on Medicaid expansion,” Jones said. “We want to reinvest in health care in Wisconsin; we want to see better health outcomes. We are willing to work with anyone to try and get to yes.”

Palm, whose confirmation awaits approval in the state Senate, said doctors, hospitals, nursing homes and other providers would see higher payments with the federal money obtained through Medicaid expansion.

Mental health crisis programs, now funded solely by counties, would get some state money, Palm said. Postpartum coverage for women would extend from 60 days to a year, she said.

Asked if she would be willing to compromise to achieve Medicaid expansion, Palm didn’t offer suggestions. “I’m interested in getting to ‘yes’ on Medicaid expansion as envisioned in our budget,” she said.

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