Governor Walker and More GOP Governors Seek to Expand MA Coverage
Governor Walker is pushing state legislators to expand Medicaid and take the federal funding for that purpose – Governor Bill Walker that is, who took office in Alaska on December 1, after winning election last month as an Independent. An NPR story that ran on Monday quotes Walker as saying, “I always will default back to what is best for Alaskans, and it’s best for Alaskans to have the health care coverage we’ve already paid for.”
Even more noteworthy is that a number of GOP Governors in the 23 non-expansion states have been working with federal officials to develop compromise Medicaid expansion proposals. Some of the latest Republicans to get on that bandwagon represent the states of Tennessee, Wyoming and Utah. Tennessee’s GOP governor is the latest to put forward an expansion plan. As the New York Times reported on Dec. 15th:
“Under mounting pressure from financially strapped hospitals, Gov. Bill Haslam of Tennessee proposed on Monday an alternative plan for ….using federal Medicaid funds available under the law [ACA] to cover some 200,000 low-income residents through their employer’s health insurance plan or the state’s Medicaid program.”
A blog post this week by the Center on Budget and Policy Priorities provides an overview of some aspects of the “Insure Tennessee” plan, which “contains elements that the federal government has approved for other state waivers,” such as the waiver plans being implemented in Michigan and New Hampshire.
It’s encouraging to see a number of Republican governors pragmatically making progress in improving access to affordable health care, rather than getting locked into rigid ideological positions. As Governor Mead of Utah said to the Casper Star-Tribune in late November:
“.. we need to either go forward with this or if the Legislature wants to come up with a different plan, I certainly would be open to that. But I don’t think we can say to those people in Wyoming who are working who cannot get insurance that we’re not going to do anything.”
That reasoning and other arguments for expanding Medicaid are also very compelling in Wisconsin, but the substance of the debate is a little different here than in the other “non-expansion” states. Because our state is currently covering adults in BadgerCare up to the federal poverty level (FPL), expanding eligibility to 138% of FPL won’t boost coverage as much as in a number of other states. On the other hand, because the partial expansion here was done without the enhanced federal financing, the savings from qualifying for that federal funding are especially large in our state. The Legislative Fiscal Bureau estimated in August that even if the expansion doesn’t start until January 2016, Wisconsin could save between $261 million and $315 million during the 2015-17 biennium (and greater-than-expected enrollment of childless adults since August will probably put the savings at or above the upper end of that range).
Though GOP lawmakers in Wisconsin haven’t shown much inclination to reconsider the decision they made to reject the federal funding, several factors are likely to keep the issue in the spotlight – including the very strong public endorsement of BadgerCare expansion in the November referenda, and the strong possibility that the Governor’s budget will include significant cuts to BadgerCare to help close a Medicaid funding shortfall.
As BadgerCare options are debated during budget deliberations, the new Medicaid expansion measures being advanced in other states could be very useful for any policymakers who are willing to consider different alternatives with an open mind.
Jon Peacock
