Bill Kaplan: Expand healthcare coverage in 2021

The pandemic has not peaked, with a cumulative 24 million+ cases nationally and 400,000+ deaths. Wisconsin staggers from a cumulative near 525,000 cases with about 5,500 deaths, including a new daily record of 128 deaths. Moreover, the resultant recession resulted in millions losing employer-based healthcare coverage. But the Affordable Care Act (ACA) proved durable. Enrollment for ACA private insurance increased by 6.6 percent on the federal marketplace, including over 192,000 Wisconsinites. Medicaid enrollment increased nationally by over 5.8 million, including about 85,000 in Wisconsin.

However, millions remain uncovered, especially in the 12 states, including Wisconsin, that refuse to expand Medicaid. If ever a time to expand healthcare coverage was imperative the pandemic has made that clear. Bipartisan common sense and cooperation are required. And, last week Wisconsin Democratic Governor Tony Evers and the GOP-led state Senate got off to a good start for 2021, agreeing on a modest COVID-19 relief bill: Medicaid and SeniorCare would cover COVID-19 vaccinations, an incentive for college students to volunteer, some liability protection from lawsuits and continued waiving a one-week waiting period to receive jobless benefits. It also excluded some “poison pills” passed by the GOP-led state Assembly. The Senate vote was near-unanimous. Why?

There was bipartisan recognition that many voters want a reset and will blame Democrats and Republicans for doing nothing. And, new Democratic and GOP Senate leadership helped. Moreover, Evers is applying political skills to govern more effectively. Finally, all sides rediscovered essential governing building blocks – compromise, negotiation and respect for the opposition.

Similarly, the Evers administration, Wisconsin National Guard and the UW System are cooperating in sending mobile COVID-19 vaccination personnel around Wisconsin. UW System President Tommy Thompson said: “UW nursing and pharmacy students can provide critical help to get Wisconsinites vaccinated. We are pleased to offer this tuition credit and appreciate the partnership with Governor Tony Evers as we once again demonstrate the Wisconsin Idea at work – where there’s a problem facing Wisconsin, (the) UW System is part of the solution.”

These steps might help policymakers to take bigger ones such as expanding healthcare coverage. Wisconsin is losing available federal money to other states by not expanding Medicaid. That funding would cover more Wisconsinites while substituting federal for state funding. State spending would be saved on uncompensated care, mental health and drug-alcohol treatment. Savings could then be used for broadband expansion, roads and schools.

A new study by the Urban Institute found hospitals in Medicaid expansion states saw uncompensated care decline with millions in savings. Those hospitals were in better shape to fight COVID-19. Similarly, Health Affairs reported that Medicaid expansion made rural hospitals more viable. Medicaid expansion, embraced by 38 states, makes fiscal sense.

Moreover, the Biden administration has a mandate to expand healthcare coverage. It will likely extend ACA subsidies to the middle class and many below the poverty level to buy ACA private insurance, solving a coverage problem in Wisconsin.

However, should the GOP-led legislature want to leave federal money on the table with state budget problems unresolved?

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

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