The Affordable Care Act (ACA) brought insurance coverage to many, but too many Wisconsinites still do not have access to quality, affordable health care. Wisconsin could significantly reduce that problem and save hundreds of millions of dollars at the same time by using available federal funding to make about 80,000 low-income adults eligible for BadgerCare.

The ACA provides funding for states to expand health insurance coverage for adults with incomes below about $16,700 per year for a single person and $28,700 for a family of three. Instead of fully expanding BadgerCare and qualifying for almost full federal funding to help pay for newly covered adults, Wisconsin went its own way and partially expanded BadgerCare. Wisconsin paid for this by kicking nearly 60,000 parents off BadgerCare, counting on the ACA Marketplace to help them.

Wisconsin is one of only 17 states that have declined to use ACA funding to fully expand Medicaid for childless adults. This decision has cost state taxpayers more than $1 billion and leaves thousands in our state uninsured. Expanding BadgerCare would mean more adults—and kids—would be covered, and we would improve access to preventative care for thousands of Wisconsinites. We can still opt-in for full expansion and save more than $190 million per year, cover about 80,000 more people, and free up state and county funding to pay for other necessities.

Here are the top five reasons why fully expanding BadgerCare is a win-win for Wisconsin.

1. We would reduce the number of uninsured and spend less on uncompensated care.
   Many of the nearly 80,000 adults who could be in BadgerCare are uninsured because of Wisconsin’s choice not to take federal funding. That significantly increases the uncompensated care delivered by hospitals. The Governor included $30 million of state funding in each of his last two budgets to help hospitals, but fully expanding BadgerCare is the better, cheaper answer. Because the ACA brought insurance to more people the cost of uncompensated care dropped substantially in Wisconsin, but hospitals in states who fully expanded Medicaid have enjoyed even larger savings.
2. We could improve access to important preventative care and save lives.
   Reducing the number of people without insurance enables far more people to get preventative care, which makes our health care system run more smoothly and be more cost effective. States that have extended Medicaid coverage to more adults have seen fewer deaths—especially those caused by disease, accidents, injuries, and drug abuse.
3. We could save hundreds of millions of tax dollars per year.
   An April 2017 Legislative Fiscal Bureau (LFB) estimate concluded that covering adults to 138% of the federal poverty level (FPL) and accepting the full federal funding would yield a net savings for state taxpayers of nearly $190 million per year. By failing to qualify for the increased federal funding, we’ve unnecessarily spent more than $1 billion in state tax dollars since 2014 to cover a lot fewer people.
4. We could help ensure stable coverage for more low-income parents.
   When state lawmakers cut the BadgerCare income limit for parents from 200% of FPL to just half of that, they justified that decision on the basis that those adults could potentially buy subsidized insurance plans through the federal Marketplace. However, changes that threaten the viability of the Marketplace would mean that an even larger number of the 60,000 people who lost BadgerCare eligibility in 2014 are at risk of becoming uninsured. Expanding BadgerCare to 138% of FPL would significantly reduce the number of Wisconsinites at risk of losing their access to affordable health insurance.
5. 50,000 kids still don’t have health insurance; fully expanding BadgerCare would help them too.
   You wouldn’t necessarily think that expanding coverage for parents helps kids, but it does. Research shows that when parents have insurance their kids are more likely to be insured. Wisconsin was once a national leader in coverage for children, but other states are surpassing us by because they decided to fully expand Medicaid.

Wisconsin could save millions of dollars, cover thousands of adults and kids, better protect its residents, and decrease uncompensated care. Plenty of red, purple, and blue states have realized fully expanding Medicaid is the right thing to do. It’s well past time for Wisconsin to get on board.

William Parke-Sutherland