Nation Has Changed, Expand Medicaid

Amidst the devastating COVID-19 pandemic, retiring Wisconsin GOP state Senator Luther Olsen was prophetic in calling for consideration of expanding BadgerCare (Medicaid) last June: “When you’ve got that kind of money on the table and a lot of other Republican states have taken it, I think you have to look at that. When you change your mind in politics, you have to have a reason to do this. And this is a reason.”

Shortly thereafter voters in GOP-led Missouri and Oklahoma passed binding Medicaid expansion referendums, joining four other GOP-led states which passed similar referendums during the previous administration. Currently, eighteen GOP-led states have Medicaid expansion, and nine of twelve Midwest states.

In February, America’s Health Insurance Plans, the American Hospital and Medical Associations, the U.S. Chamber of Commerce and other national groups issued an extraordinary call for expanding Affordable Care Act private insurance coverage and federal fiscal “incentives for (the twelve) states that have not yet expanded Medicaid … .”: “Achieving universal (healthcare) coverage is particularly critical as we strive to contain the COVID-19 pandemic and work to address longstanding inequities in healthcare access and disparities in health outcomes.” It’s time for their Wisconsin counterparts to listen and act.

Moreover, GOP-led Wyoming is moving forward. State House and Senate legislative committees have approved expanding Medicaid. The effort was led by GOP Representative Steve Harshman, former Speaker of the House, other GOP legislators and the miniscule Democratic caucus.

The Wyoming Star-Tribune editorialized: “So what’s different this time? For one, it seems like Medicaid expansion is here to stay. Thirty-eight states — both red and blue – have taken the plunge. And expansion has now been in place for a decade, surviving three presidential administrations and multiple Supreme Court challenges. … Plus, it could actually make Wyoming money at a time when the state is desperate for a new source of revenue. Due to a change in federal law (American Rescue Plan) the 12 states (including Wisconsin) that haven’t expanded Medicaid would receive a 5 percent boost (for two years) for their traditional Medicaid program (and ninety percent permanent federal match for the Medicaid expansion enrollees).”

Wisconsin implemented traditional Medicaid in 1966 under GOP Governor Warren Knowles. So it has been disheartening that state Republicans left federal money on the table for other states with their refusal to expand BadgerCare. False and scurrilous attacks on Medicaid expansion as “socialism” and “welfare” are widely off the mark. Medicaid is a healthcare program with private providers, covering over 70 million (985,000 in BadgerCare) Americans. The nonpartisan state Legislative Fiscal Bureau recently said that Wisconsin expansion would save the state over $1.6 billion (and cover 90,000 more Wisconsinites).

JAMA has reported that Medicaid expansion “is like a silver bullet for improving U.S. healthcare”: reducing mortality from heart disease, cancer and childbirth; improving racial disparities; reducing uncompensated care; preventing rural hospital closures; helping economic-job growth and lowering the cost of private insurance. Wisconsin will have a healthier and stronger recovery by expanding BadgerCare now. Circumstances have changed.

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