Last year, we reported on House Budget Committee Chairman (and Wisconsinite) Paul Ryan’s Path to Prosperity Medicaid block grant, and the damage it would have done to state budgets and numbers of uninsured people. Fortunately, the Senate kept it from being enacted.
Last week the Housed passed a similar bill, on a nearly party line vote, which would make even deeper cuts in programs like Medicaid and Medicare and provide even more in tax cuts for the rich. A report released today by Families USA details the state-by-state impact of $2.75 trillion in cuts to vital health programs over the next 10 years. As in last year’s budget proposal, Chairman Ryan converts Medicaid into a block grant – a federal program with a spending cap. This would fundamentally change the nature of the Medicaid, which would no longer be a program that responds to states in times of need by matching every $1 in state spending with $1.53 (on average) in federal funds (and more in difficult times, like the recent ARRA bump in federal match). Instead, states would get a set amount each year, with a one third reduction in federal funding by 2022.
Block-granting Medicaid would shift a much larger share of Medicaid costs to states, where there are already substantial budget challenges. The Families USA analysis concludes that in the next 10 years Wisconsin would lose $14.3 billion in federal funds under a Medicaid block grant.
Additionally, the House Republican budget wholly repeals the Affordable Care Act (ACA). This would stop the 2014 Medicaid expansion to all adults up to 133% of the federal poverty level, with enhanced federal match funding for that newly eligible population. The repeal of that expansion and enhanced federal funding is expected to cost Wisconsin $14.4 billion in federal matching funds over the next 10 years. Repealing the ACA would also effectively raise taxes on the middle class by taking away the tax credits to families to help buy health insurance on their own – an additional loss of $17.4 billion over 10 years for Wisconsin families.
The state-by-state report from Families USA outlines the Medicare cuts in the House Republican Budget as well, but the other report they released today goes into more detail on the implications for seniors and people with disabilities. Suffice to say, transforming Medicare into a “premium support” or voucher system and doing away with the ACA improvements to Medicare prescription drug benefit would cost Wisconsinites $4 billion in the next 10 years.
The total impact of the Medicaid cuts, Medicare cuts, and repealing the Affordable Care Act’s tax credits would cost Wisconsin a total of $50.2 billion over the next 10 years. These cuts would have a dramatic effect on the state budget, uncompensated care costs, and the structures and benefits of Medicaid programs. Without even considering the effects of cuts to the Medicaid program, Families USA estimates that by 2022 there would be 341,200 uninsured people in Wisconsin, due to the repeal of the ACA.
We know that without the maintenance of effort provisions in the ACA alone, proposals from the Wisconsin Department of Health Services this year would have resulted in 29,000 children losing their BadgerCare coverage. Let’s not find out how many more Wisconsinites would be harmed by this House Republican budget proposal’s slashing of valuable health care programs. We know that BadgerCare, Medicaid, and Medicare work for Wisconsin families every day – we need to keep them strong, and funded.
Sara Eskrich
