Bill Kaplan: After the budget, Medicaid expansion

Governor Tony Evers wisely approved the budget passed by the GOP-controlled legislature, despite its being, “in many ways, insufficient”. Evers said: “Vetoing this budget in its entirety would have been more of the same divisiveness and petty, political theatrics that the people of Wisconsin have had to put up with for far too long.” Moreover, Evers ingeniously used a partial veto “to boost K-12 education funding in Wisconsin by about $65 million …” (Wisconsin Public Radio). That was on top of the $500 million increase that GOP legislators approved, having read the election-year tea leaves.

The most glaring budget omission was the failure of the GOP-controlled legislature to include Medicaid expansion. Evers decried Republican willful fiscal and moral blindness: “70 percent of Wisconsin citizens (43 percent of Republicans) support expanding Medicaid because they understand it will allow us to expand coverage to more than 80,000 Wisconsinites, save $324 million in state tax dollars, and bring in $1.6 billion in new federal investment into our health care system in Wisconsin …, and make health care more affordable by lowering premiums for folks who have private insurance.”

The June 20, 2019 JAMA Forum (Journal of the American Medical Association) supported Evers: “A series of new studies being released … are all starting to point to a single action that is behind … reducing mortality from … cardiovascular disease and cancer; addressing seemingly intractable racial disparities that plague the U.S. health care system; reducing hospital bad debt and rural hospital closures; decreasing maternal and infant mortality; lowering payday lending and housing foreclosures; creating jobs …; improving medication compliance; and lowering the cost of insurance. That action? Passing and implementing Medicaid expansion”.

Evers promised to “continue to fight for Medicaid expansion through separate legislation, future budget bills, and otherwise through every executive power I am afforded.” This can be done with a GOP-controlled legislature. Crackerjack Urban Milwaukee journalist Bruce Murphy opined that Senate Majority Leader Scott Fitzgerald exposed a division among Republicans in December, 2018 when he said he would not “rule it (Medicaid expansion) out”. Although Fitzgerald quickly walked back his comment, there are 3 GOP state senators who might support Medicaid expansion.

Republican state Senators Luther Olsen (Ripon) and Jerry Petrowski (Marathon) have both considered taking the federal money to expand Medicaid on multiple occasions. And, Republican state Senator Robert Cowles (Green Bay) showed independence in opposing the 2018 GOP power grab that limited the powers of Democratic Governor-elect Evers. All three conservatives are central to begin getting Medicaid expansion passed. Local media, business, community and religious leaders as well as doctors, nurses and hospitals need to reach out to these senators.

Former Ohio GOP Governor Kasich offers inspiration: “Ronald Reagan expanded Medicaid” and “When you die and get to the meeting with Saint Peter, he’s probably not going to ask you much about what you did about keeping government small, but he is going to ask you what you did for the poor”. Senators Cowles, Olsen and Petrowski should consider their legacies.

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