The decision about whether or not Wisconsin should accept federal funding to expand Medicaid, which would cover an additional 80,000 Wisconsinites and save hundreds of millions in state dollars per year, should not be controversial. However, Republican legislators who oppose Medicaid expansion are relying on discredited arguments about the effects of expansion.
Researchers and experts have shown time and time again that residents in Medicaid expansion states who buy private insurance in the Marketplace have lower premiums than people in states that have not expanded coverage. All the evidence indicates Wisconsin will be the same as every other state should it decide to expand Medicaid.
The most recent research also shows the greatest savings for private insurance. In states that expanded Medicaid, premiums in the Marketplace were significantly lower. Two recent studies – one published this month by Health Affairs and one released by Wakely Consulting Group in May – show premiums being as much as 19% lower in expansion states.
Wisconsinites purchasing plans through the Marketplace could realize these benefits if the state legislature passes a budget that includes Medicaid expansion.
The study in Health Affairs is based on border county analysis comparing Wisconsin counties to neighboring counties in states which expanded Medicaid. In addition to the geographic similarity of these counties, other county-level data is controlled for. The researchers found that premiums were on average 19% lower in counties bordering Wisconsin during the 2014-2018 period. The growing costs of Marketplace premiums are of concern to policymakers. This analysis of counties that have similar demographics shows the potential benefits of expansion to Wisconsin residents.
Wakely was specifically tasked with looking at the impacts of the proposed Medicaid expansion in Wisconsin by the Office of the Commissioner of Insurance. Using data from the Centers for Medicare and Medicaid Services, Wakely estimated the average number of enrollees who would become eligible for Medicaid and who currently have Marketplace plans to be between 25,000 and 30,000 people. People eligible for Medicaid in expansion states (those between 100 and 138% of FPL) tend to be in poorer health, so their presence in the risk pool increases premiums. However, when that population is enrolled into Medicaid, the pool becomes less risky to insure and everyone’s premiums decrease. Looking at the broad body of available research, Wakely estimated that premiums in Medicaid expansion states were 7-11% lower.
Some readers may have seen a study from the Center for Research on the Wisconsin Economy (CROWE) and the Wisconsin Institute for Law and Liberty (WILL) in February that pointed to increased costs in the private healthcare sector. However, CROWE re-evaluated the original report and in mid-April published what was, in essence, a correction. The new report contradicted their original claims and in fact provided yet more evidence that Medicaid expansion will help to decrease health care costs.
The message is clear. The most up-to-date research that focuses on Wisconsin specifically shows savings to consumers in the Marketplace when comparing Medicaid expansion to non-expansion. Read more on that issue in our Kids Forward issue brief.
If policymakers want to lower costs to the more than 200,000 people purchasing their healthcare through the Marketplace, Medicaid expansion is a strategy that has been proven successful. Further, it saves hundreds of millions in state tax dollars and covers thousands more people. It’s a win-win-win for Wisconsin.
Hayley Young & William Parke-Sutherland
