Bill Kaplan: New Year’s resolution, expand Medicaid

Politics can lead to unexpected outcomes. As the House impeachment inquiry proceeded, Democrats Andy Beshear and John Edwards won gubernatorial elections in Kentucky and Louisiana respectively, succeeding in states Trump carried in 2016. Moreover, Trump campaigned for their GOP opponents. Beshear and Edwards explained their success: “To win, we had to reach out to people across the political spectrum, including people who voted for President Trump. So we campaigned everywhere, treating every voter with respect, as winnable, because showing up still matters to the people we wanted to lead” (Washington Post).

Beshear and Edwards had a message that resonated: “Families in both Kentucky and Louisiana worried that their health care coverage and our states’ Medicaid expansions were going to be ripped away by a Republican governor” (WP). Medicaid expansion is now a mainstream issue. It has extended health coverage to well over 12 million Americans in 36 states, including 3 in progress. Polls show majority support among Democrats, Republicans and independents. Why?

“Multiple studies over the last five years find that the Affordable Care Act’s Medicaid expansion has increased health coverage, affordability and access to care while producing budget savings for states and reductions in uncompensated care costs for hospitals and clinics, according to a KFF review of more than 300 studies and policy reports” (Kaiser Family Foundation). It’s time for Wisconsin Democratic Governor Tony Evers and the state GOP-led legislature to make a joint New Year’s resolution to expand Medicaid.

The American Medical Association (AMA) and American Hospital Association (AHA) stand ready to help Wisconsin expand Medicaid. The AMA has offered to work with state doctors. It also supports Wisconsin Democratic Representative Ron Kind’s proposal to increase 90 percent federal funding for Wisconsin Medicaid expansion to 100 percent for the first three years. And, “(t)he AHA supports efforts to encourage every state to expand Medicaid coverage … .” These moderate organizations belie the allegation that Medicaid expansion is radical or welfare.

There is reason to be hopeful. Governor Evers strongly supports expanding Medicaid. And, there are GOP state legislators who privately want to accept the federal spending and savings from Medicaid expansion. Democrats and Republicans need to figure out how to cross the finish line. Wisconsin Department of Health Services Secretary (nominee) Andrea Palm praised the GOP-led legislature for passing a reinsurance plan (mix of federal and state funding) to lower ACA private insurance premiums. Medicaid expansion would have a similar, additive effect (Health Affairs).

Budget savings from expanding Medicaid ($325 million) could be used to help rural Wisconsin, largely represented by GOP legislators. The windfall could fund broadband infrastructure, improve roads, help struggling schools and support demonstration projects for renewable energy as well as efforts to protect the environment by small farms. The entire state would benefit. The Evers administration needs to think outside the box to get Medicaid expansion.

Consider asking former GOP state Senator Dale Schultz to be the point person with the legislature. He could help make a New Year’s resolution of expanding Medicaid a reality.

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

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