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Thursday, Dec. 5, 2013

Issue of the Week: Walker Should Fully Expand Medicaid

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Sometimes the simplest solution is the best one.

That’s true in the case of the Medicaid expansion as set forth in the Affordable Care Act. The law provides 100% of funding for Medicaid expansion in the states, then drops back to 90% after a few years. That was a win-win for the states, since states usually pick up about 40% of Medicaid costs and the provision would allow more impoverished people to have health care coverage and reduce uncompensated care at hospitals.

Unfortunately, the U.S. Supreme Court opened up a big loophole when it ruled that the federal government couldn’t force states to expand Medicaid. States could opt in, though.

Half of the states have done the smart, simple thing and are expanding Medicaid under Obamacare. Even red-state governors like Chris Christie in New Jersey, Jan Brewer in Arizona and John Kasich in Ohio have opted in.

But Wisconsin Gov. Scott Walker?

No, he couldn’t do the smart, simple thing. He rejected the federal funds and developed his own health care “reform,” which would move 72,000 low-income parents and caretakers off of BadgerCare into the new insurance exchanges, while moving 80,000 impoverished people onto BadgerCare on Jan. 1, 2014. Walker’s “reform” will cost the state an extra $119 million over the next two years and cover fewer people than the full Obamacare expansion.

That was bad enough. But the Republican-dominated Joint Finance Committee just made Walker’s reform even worse. On Monday, the committee approved Walker’s new plan to delay transitioning people on to BadgerCare by three months, which locks them out of health care coverage until April. The committee also voted to delay kicking off the BadgerCare parents and caretakers until April.

Republicans, of course, are blaming the rocky rollout of the online insurance exchange for the delay. But it was Walker and his fellow Republicans who chose not to create a state exchange, but rather to force Wisconsinites onto the federal exchange, which is obviously a far more complex instrument. Furthermore, the issue with the exchanges is separate from the Medicaid expansion, which Walker can still accept if he would just take the time to study the facts and look at the savings for Wisconsin.  

Walker’s game-playing with Wisconsin’s most vulnerable residents is immoral, unwise and simply bad policy. He promised that he would offer BadgerCare coverage to 80,000 people on Jan. 1, 2014, but this promise, like his vow to create 250,000 new jobs in four years, is all sound bite, no substance. There’s a better solution at hand—accepting the full Medicaid expansion—but unfortunately, Walker is using Wisconsin’s poor as a stepping stone on the way to the White House and he sees his actions as a way to ingratiate himself with the tea party leadership.