Hospitals Could Fix State’s Health Care

Former Health and Human Services Secretary Kathleen Sebelius and President Barack Obama. Official White House. Photo by Pete Souza.

Most Americans hold Congress in contempt. Why?:

• Last week on Groundhog Day, seemingly clueless House Speaker Paul Ryan presided over the 63rd GOP attempt to gut or repeal the Affordable Care Act. More endless than the film;
• Politico reported that Speaker Ryan said: “Regardless of the outcome, we have now shown there is a clear path to full repeal without 60 votes in the Senate. It is also just one in a number of steps we’re taking to hold President Obama accountable for the failures of the law”;
• However, on Thursday the U.S. Department of Health and Human Services announced: 12.7 million people signed up for affordable quality private insurance for 2016, with most to receive tax credits to help pay the cost. This includes 239,034 Wisconsinites, “a 16 percent increase from the same point last year” (Milwaukee Journal Sentinel). Some “failures”;
• To date, 31 states have taken 100 percent federal funding to expand Medicaid, including 10 states that were GOP-led and all states bordering Wisconsin.

Across the nation state hospital associations, including the Wisconsin Hospital Association, have expressed strong support for Medicaid expansion. But hospitals in Indiana, Louisiana, New Hampshire, Tennessee, Utah and Virginia have offered to help pay the state share of Medicaid expansion after 2016, as federal funding declines to 90 percent in 2020 and thereafter. The hospitals know that the federal funding of Medicaid expansion means: less uncompensated care, help for struggling rural hospitals, more jobs for health care workers and coverage of many uninsured. Finally, states that expand Medicaid can use the resultant substantial state savings for other unmet needs, e.g., education, highways and mass transit.

Alaska Independent Gov. Bill Walker (elected on a fusion ticket with a Democratic Lt. Gov.) saw the economic, fiscal and moral benefits of expanding Medicaid. GOP legislative opponents hoped a high-level report (commissioned by them) would undermine support for Medicaid expansion. But the health consultants said it was a win-win for Alaska, “a highly attractive policy change, financially.” Without Medicaid expansion Alaska would lose “$90 million” in federal taxes to other states. The report concluded that expansion meant economic support for hospitals and coverage of the uninsured.

Wisconsin GOP Gov. Scott Walker should pay attention to his Alaska namesake It’s long past time for him to give up his ideological stubbornness and learn from his failed presidential fantasies. More to the point, the Washington Post reported that data from the Federal Reserve Bank of Philadelphia showed 7 states, including Wisconsin (and Alaska), “likely saw their economies contract during the last three months of 2015.” We need federal funding! The Wisconsin Hospital Association should step up to the plate and offer to pay the state share of Medicaid expansion. It will help Walker and GOP legislators out of their self-imposed corner, make state hospitals beloved and save Wisconsin $1 billion through 2020-21 (Legislative Fiscal Bureau).

Kaplan wrote a guest column from Washington, D.C. for the Wisconsin State Journal from 1995 -2009.