Republicans Support Medicaid Expansion

Wisconsin GOP Assembly Speaker Robin Vos has led the Assembly since 2013, and is the outgoing president of the National Conference of State Legislators. He is at the apex of power, but at a crossroad. Does Vos want to continue to play to part of Wisconsin, the small minority of voters (25% according to a Marquette Law School poll) who oppose the expansion of Medicaid, or leave a broader legacy?

Healthcare used to be a bipartisan issue in Wisconsin. In 1966, GOP Governor Warren Knowles implemented Medicaid. It was later expanded by GOP Governor Tommy Thompson. Democratic legislators strongly supported both policies. Thompson, a conservative, is beloved by most Wisconsinites because he has a heart. No other state Republican has had his level of bipartisan support.

Vos was appointed as a student representative to the UW Board of Regents in 1989 by Thompson. It behooves Vos to talk with Thompson about legacy. Vos should also reflect on our mutual hero, Arizona GOP Senator John McCain, whom Vos endorsed for president in 2008. Stricken with cancer, McCain voted against repealing the Affordable Care Act (2017). Medicaid expansion was saved.

Wisconsin Democratic Governor Tony Evers’ budget is before the GOP-led legislature. Predictably, Vos and other GOP leaders are again ruling out expanding Medicaid. They have put themselves in a self-imposed corner, making no fiscal sense. The American Rescue Act gives Wisconsin a 5 percent federal boost (for 2 years) for its traditional Medicaid program if it expands Medicaid; and keeps a permanent 90 percent federal match for Medicaid expansion enrollees. Expanding Medicaid would cover 90,000 Wisconsinites (hardworking and low-income). Finally, Wisconsin would get a $1.6 billion windfall over 2 years. The savings could be used for education and infrastructure.

Joan Alker, of Georgetown University’s Center for Children and Families, said: “We have over 400 studies showing why Medicaid expansion is a good thing. It has not busted the budgets of the states that have done it, it’s supported their budgets, it’s reduced mortality, it’s improved health outcomes, it’s supported hospitals – the evidence is piling up. And, so saying ‘no’ is getting harder and harder.”

In 2018, Virginia GOP House Speaker Kirk Cox, “fiscally conservative, anti-abortion and pro-gun rights” (as the Washington Post described him), helped pass Medicaid expansion. He said: “I felt like we had to govern. You couldn’t just think of yourself. … You need to get things done.” And, in 2019, former Oklahoma GOP House Speaker Kris Steele said he now supported Medicaid expansion: “I totally acknowledge my evolution … . Healthcare in rural Oklahoma is in crisis. If there’s a way to bring some of our tax dollars back home to benefit the people who live in our state, I don’t know why we wouldn’t do that.”

More recently, Wyoming GOP Speaker Eric Barlow led the House in passing Medicaid expansion, but it was narrowly rejected by a GOP-led Senate committee. Barlow said: “I voted no multiple times on this issue. I’m going to vote yes this time, because I haven’t seen any other solution. No one has brought anything forward … .”

Vos should lead for all of Wisconsin. Circumstances have changed. He, too, could leave a legacy.

This column was originally published by Wispolitics.com.

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