Monday, May 20th, 2019

Sneaking Obamacare past the legislature


The pressure is on the Republicans in the legislature, especially in the state senate, to expand Medicaid beyond the plan envisioned by Governor Scott Walker. Over at the MacIver Institute, I explain why it’s bad policy and why the supporters of the Medicaid expansion are being dishonest.

Darling is joined by a number of special interest groups, including the Wisconsin Hospital Association (WHA), an endorser of creating a state-run health care exchange, and the Metropolitan Milwaukee Association of Commerce (MMAC), who sent a letter to the legislature also asking for the expansion of Medicaid because of potential delays in the implementation of the federal health care exchanges.

“We believe any transition of Medicaid enrollees into the exchange should only occur after a Wisconsin exchange is demonstrated to be properly functioning and able to serve this low income population.”

It’s a solution in search of a problem. Under Walker’s current proposal, if the federal government does not have the exchange ready for Wisconsin by the deadline, Wisconsin will wait before transitioning to the exchange those above the poverty line enrolled in the BadgerCare programs.

The WHA and the other health care groups that sent the letter to the legislature are also expressing concern that the costs to the individual participating in the exchanges created by the Affordable Care Act may not be so affordable. In their letter to the legislature,

“These out of pocket costs could equate to as much as 20% of total income and could cause this vulnerable group to fall out of coverage and into the ranks of the uninsured.”

That’s not an implementation problem on the state level, that’s a design flaw in the federal program. Those projected costs are the result of the federally mandated coverage provided, and that is not going away after a transition period.

It’s worth noting that while Darling talks about a temporary Medicaid expansion, the letter to the legislature from the WHA and MMAC says no such thing. These groups clearly do not see their recommendation for an expansion of Medicaid beyond the governor’s proposal as temporary. And once Wisconsin commits to the expansion of Medicaid spending beyond the governor’s plan it will be nearly impossible to roll back, even as the federal share of the expansion costs shrink leaving Wisconsin taxpayers picking up the bill.

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