Most states expand Medicaid, but not Wisconsin

By Bill Kaplan

To date, 30 states have taken 100 percent federal funding to expand Medicaid. This includes 10 states initially led by GOP governors, 2 of whom are running for the Republican presidential nomination (Christie and Kasich). Moreover, 3 other states that switched to GOP governors in 2014 have continued Medicaid expansion. And, that's not all: 

• Kaiser Family Foundation polling in 2014 and 2015 found: "Many Republicans in states that have not expanded Medicaid are favorable toward expansion"; 

• The New Orleans Times-Picayune on Saturday's Louisiana gubernatorial election: (Democrat John Bel) "Edwards came out of nowhere to take down a Republican candidate (56 to 44 percent) once seen as unbeatable in a solidly red state....(Edwards) is expected to bring Medicaid expansion to Louisiana shortly..."; 

• A Washington Post headline was crystal clear: "After extending Medicaid coverage it's hard to go back." The Post went on to say that even newly-elected Kentucky GOP Gov. Matt "Bevin has suggested he might settle for replacing the current (expanded Medicaid) program with a less generous model..." (more out-of-pocket costs for Medicaid beneficiaries); 

• Wisconsin Public Radio broadcast: "Poll indicates (58 percent) support for accepting Medicaid funds..." despite Gov. Walker's opposition; 

• Finally, the Milwaukee Journal Sentinel opined: "Gov. Walker's approval ratings among the lowest in the country." 

The spectacular collapse of Gov. Walker's presidential campaign has led many Wisconsinites to reconsider their support for Walker. The Walker era is coming to an end. Astute former GOP Gov. Tommy Thompson said: "I can't envision a possibility for him (Walker) running for reelection for governor..." Now is the time for Wisconsin GOP legislators to reject self-destructive partisanship and embrace fiscal, moral and political self-interest. 

State GOP Sen. Luther Olsen has opened the door saying: "We (turned down the federal Medicaid expansion) when we had money. Now we don't (have money), so everything changes." And, former state GOP Sen. Dale Schultz swatted down the objection that federal Medicaid funding could be curtailed down the road. Schultz said: "We have all kinds of interactions with the federal government - transportation and everything else. Do we stop doing business with them because they may not give us the money?" Moreover, it makes no sense to leave federal money, paid by Wisconsin taxpayers, on the table for other states. 

Wisconsin can learn from Louisiana. When federal funding of Medicaid expansion starts to decline from 100 percent in 2016 to 90 percent in 2020 and beyond, the Louisiana Hospital Association has agreed to pool money from the state's hospitals to pay Louisiana's modest share of the expansion cost. It's time for the GOP-led Wisconsin legislature and the Wisconsin Hospital Association to negotiate a similar deal. Wisconsin has already lost over $500 million in federal Medicaid funding. Moving forward with Medicaid expansion would mean fewer uninsured, reductions in uncompensated hospital care and more jobs for health care workers. It's a non-partisan no-brainer. 

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

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