Wisconsin Hospital Association: Get off the sidelines
By Bill Kaplan
The column below reflects the views of the author.
Gov. Scott Walker and the GOP-led state legislature remain adamantly opposed to expanding Medicaid, defying common sense and math. Medicaid expansion receives 100 percent federal funding through 2016, declining to 90 percent in 2020 and thereafter. The fiscal year 2017 federal match for Wisconsin's (non-expanded) Medicaid program is 58.51 percent. Do the math. Moreover, Medicaid expansion would give Wisconsin an increased federal matching rate (phased-in) for its coverage of low-income childless adults prior to the Affordable Care Act. And, the nonpartisan Legislative Fiscal Bureau said expanding Medicaid would save Wisconsin $1 billion through 2020-21, and cover another 80,000 low-income (many working) Wisconsinites.
Expanding Medicaid in Wisconsin would also reduce uncompensated hospital care ($234 million in 2014 - WHA), prevent cost-shifting to employers / private insurance plans, strengthen financially struggling rural hospitals, generate budget savings for education and roads and create more jobs for health care workers. Other states have grasped these fiscal benefits. 31 states, including 10 GOP-led states and all states bordering Wisconsin, have expanded Medicaid.
This year GOP govs. in Oklahoma, South Dakota, Utah and Wyoming tried to expand Medicaid, with the support of Democratic and moderate GOP state legislators. Recalcitrant opposition from hard-right GOP legislators prevented progress. However, South Dakota GOP Gov. Dennis Daugaard may call for a special session of the state legislature. He won a key concession from the Obama administration for 100 percent federal coverage of Native Americans seeking health care coverage outside Indian Health Service facilities (could benefit Wisconsin) as part of expanding Medicaid.
The South Dakota Association of Healthcare Organizations (SDAHO) said: "Expanding Medicaid is SDAHO's highest priority, and we appreciate Gov. Daugaard's ongoing leadership and support of this important issue. We will continue to work with our members and the broader (health care) coalition to share the benefits of this plan". South Dakota hospitals showed leadership with their support for Medicaid expansion.
The way forward for Wisconsin and 18 other states that have not expanded Medicaid will involve state hospital associations. The American Hospital Association (AHA) is leading the way. It strongly supports the Obama administration's proposal to give the remaining non-expansion states 3 years of 100 percent federal funding, when they move forward with Medicaid expansion. The AHA said: "The administration's...promise to fund Medicaid expansion in states that have not yet done so (is) welcome news". Moreover, Wisconsin Democratic Sen. Tammy Baldwin has introduced legislation to provide for this funding.
And, state hospital associations in Indiana, Louisiana and New Hampshire have agreed to help pay for their state's share of Medicaid expansion after 2016. In addition, state hospital associations are strongly pushing for Medicaid expansion in many GOP-led states. So it's time for the WHA to get off the sideline and push for Medicaid expansion. The WHA can help break the Wisconsin deadlock: submit op-eds outlining the benefits, leverage social media platforms, buttonhole the gov. and GOP legislators and become a strong voice for rural and urban hospitals. Make Wisconsin proud.
Kaplan wrote a guest column from Washington, D.C. for the Wisconsin State Journal from 1995 - 2009