Expanding Medicaid Is Best for State
Why it's the smart, compassionate, and fiscally responsible thing to do.
Tony Evers and Robin Vos.
If a man from Mars had watched Governor Evers’ State of the State address, and the Republican response given by Speaker Vos, I believe that he would have concluded that they were talking about two different states.
In a way, they were.
I think that Speaker Vos was talking about the Wisconsin where well-to-do individuals and corporations are thriving in our economy, and Governor Evers was talking about the “Other” Wisconsin where people such as children, minorities and lower income are not thriving and, therefore, need help with things like healthcare. Unfortunately, there are too many people still living in the Other Wisconsin and we need to stop ignoring them.
Perhaps nothing illustrates this dichotomy more than the issue of Medicaid expansion that the Governor plans to include in his 2019-2021 state budget, and that the Speaker is adamantly opposed to. As a part of the Affordable Care Act (ACA) states could choose to expand the Federal/State funded healthcare program for the poor by increasing the income eligibility to 133% of the Federal Poverty Level (FPL). As an incentive the federal matching rate would be 100% for the first few years gradually decreasing to 90% in 2020 and beyond. This compares to the average Wisconsin rate of 58-59%.
I remember a time when previous Governors would have “laughed all the way to the bank” with a deal this good.
Also, if you are thinking why people above the FPL should be eligible, it is because the FPL is very low with 133% being only $16,612 annually for an individual and $34,248 for a family of four. The Legislative Fiscal Bureau estimates that 76,000 more people (a little more than the population of the City of Waukesha) would be eligible for Medicaid healthcare under full expansion.
Even though Wisconsin has missed the opportunity for the huge increases in federal funds and huge savings in state funds, there is still a big upside to expanding Medicaid in the 2019-2021 budget. Again, the Fiscal Bureau indicates that full expansion in the next state budget would add $793 million in federal funds and a savings of nearly $280 million in state tax dollars. The state savings could then be used for other state priorities such as transportation, education, or healthcare.
Speaker Vos claims that Medicaid expansion is “socialized medicine” or “government run healthcare.” It isn’t either. Medicaid healthcare is provided by private doctors, clinics, and hospitals. Doctors may choose whether or not to participate in the Medicaid program. Just as Foxconn, a private corporation, could have chosen not to accept $4 billion from state and local governments. In both cases, Medicaid and Foxconn, the government is contracting for something of value and if one is Socialism so is the other one.
In 1962 Michael Harrington authored a book entitled The Other America that was a study of poverty in the United States. The book is credited by some people for influencing the development of healthcare programs such as Medicare and Medicaid. Now the issue of healthcare is back in the national and state spotlights because we need to improve upon what was initiated back in the 1960s. The benefits from Medicaid expansion to lower income families and the state are pretty obvious but as long as some politicians can’t see that there are thousands of Wisconsin citizens who live in the Other Wisconsin, where they are unable to thrive, it will be harder than it should be.
Having access to healthcare will help them thrive if we are smart, compassionate, and fiscally responsible.
Tom Frazier is a member of the Common Cause in Wisconsin State Governing Board, and was the executive director of the Coalition of Wisconsin Aging Groups from 1983 to 2010.
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Tom Frazier’s focus on the “other” and his reference to Michael Harrington’s “The Other America” is right on target. But he then becomes a little too generous to the Republicans in the state legislature and elsewhere. If you look at different states, few have become as “otherized” as Wisconsin, with inner-city Milwaukee being the focal point of the otherization project. There used to be joke about Wississippi. Not much of a joke these days.
And, the notion that the opposition of people like Vos, Kohenga and the gang is based on fiscal prudence or some other principle of good governance or that they would like to see the “others” thrive is simply not true, especially in the age of Trump. What passes for policy is almost all driven by otherization, most of it fueled by racial animosity. In this world, the coin of the realm is to make sure that the others don’t get anything, especially if it involves expenditures of “hard-earned (white) tax dollars. But, even if it doesn’t, money shouldn’t be spent on the others, and anything with the word “public” in front of it must be opposed. All one need do is check out the JS Online comments section for confirmation of this reality. Without this animus, the Republicans would go the way of the Whig Party within a single election cycle.
In Arthur Koestler’s 1940 novel, “Darkness at Noon,” the Bolshevik jailer of a previous comrade, now imprisoned, explains, “Experience teaches that the masses must be given for all difficult and complicated processes a simple, easily grasped explanation. According to what I know of history, I see that mankind could never do without scapegoats.” The others are the designated scapegoats in our age of racially-driven reaction and dishonesty, and the Walkers, Kohengas, Fitzgeralds and others cannot pass up an opportunity to stick it to them and their liberal advocates because that is what their scapegoat-seeking base demands.