EDITORIAL: Medicaid block is bad for state’s fiscal and physical health

Leaders of the Wisconsin Legislature have some explaining to do about the billions of dollars they have cost state taxpayers by blocking Medicaid expansion. Recent analyses by two nonpartisan agencies expose the cost of the Medicaid obstruction as enormous and the excuses for it as lame.

The Wisconsin Fiscal Legislative Bureau reported that the state taxpayers have paid $2.1 billion in health care costs that would have been covered by federal taxpayers since the Republican majority in the Legislature started blocking Medicaid expansion in 2014.

The Wisconsin Policy Forum reported that if the state agreed to expand Medicaid eligibility now, it would save $1.7 billion in health care costs over the next two years.

If the Legislature continues to refuse the federal health care aid, the total loss for taxpayers will be nearly $4 billion at the end of the two-year budget cycle.

The Policy Bureau estimates that signing on to expanded Medicaid eligibility would add about 70,000 residents to the state’s BadgerCare Plus program, with a savings for Wisconsin taxpayers, rather than additional cost.

Legislators attempted to justify their refusal to accept Medicaid expansion when it was first offered in 2014 by warning that the federal government would renege on the payments at some point.

Other states had no such qualms. Eighty percent of them, including many with Republican controlled Legislatures, approved the Medicaid expansion. A decade later, enhanced federal Medicaid payments flow unimpeded. Wisconsin is one of only 10 states not getting them.

The opposing legislators also defended the rejection of federal health care money with the claim that hospitals and other health care providers would be paid less for treating Medicaid patients than those with commercial insurance. The takeaway from that would seem to be that corporate health care profits are more important than affordable health care for low-income state residents.

Some of the obstructionists even resorted to musty prejudice about people who receive government assistance, arguing that expanded Medicaid benefits would discourage recipients from working.

States that accept expanded Medicaid benefits agree to cover people with incomes up to 138% of the federal poverty level ($15,060 income per year for individuals, $31,200 for a family of four). The federal government then pays 90% of the cost for the added Medicaid recipients.

With expanded Medicaid, the federal government would also raise the share of the cost it pays for adults currently covered by Medicaid from 60% to 90%. That feature alone would save more than $200 million a year for the state on health coverage it already provides.

It is estimated that more than 20,000 uninsured state residents would receive health insurance coverage under expanded Medicaid.

It is also expected that low income individuals and families who have limited health insurance purchased through the Affordable Care Act would opt for the better coverage and lower out-of-pocket expenses available under expanded Medicaid.

The most dramatic measure of the Legislature’s epic Medicaid failure is the multi-billion-dollar financial penalty it has assessed on state taxpayers. But no less damning is the human cost of its denial of the decent health insurance that would be available to low income state residents.

Gov. Tony Evers included Medicaid expansion in his 2023-2025 budget. The Legislature’s majority leaders made sure it was dead on arrival.

The legislators blocking Medicaid expansion  have offered no coherent explanation of why they think it’s a good idea to repeatedly refuse federal aid that would help every Wisconsin resident in one way or another.

Maybe it’s just a bad habit. If so, it’s an unhealthy one that is detrimental to Wisconsin’s fiscal and physical health, and after 10 years it’s time to get over it.