Paul Adair is a 21-year Germantown resident, retired scientist, writer, and lecturer.
Governor John Kasich (R-OH) on Medicaid expansion- “Whenever federal resources are being distributed to the states then Ohioans shouldn’t be robbed of their fair share. I make no apologies for ever standing up for my state and any governor who would is in the wrong job.”
Gov. Rick Snyder (R-MI)-“This makes sense for the physical and fiscal health of Michigan. (Medicaid) Expansion will create more access to primary care providers, reduce the burden on hospitals and small businesses, and save precious tax dollars.”
These and many other Republican Governors have made a rational and pragmatic decision to cover their states' uninsured through the Medicaid expansion provision of Obamacare. Scott Walker faced a similar choice. He could do the right thing for Wisconsin and follow their lead. However, that would disappoint his corporate backers and Tea Party followers. Accepting federal dollars to expand Medicaid would hinder his chances in the 2016 Republican Presidential primaries.
Like so many times before, Walker made a decision that would enhance his own political ambitions to the detriment of Wisconsin. A decision that will cost our taxpayers hundred of millions of dollars. A decision that will lead to continued sub-par economic performance. A decision that will put even more financial burden on some of our state's poorest residents.
Last week, Scott Walker made a brief presentation to supporters at a Wisconsin Manufacturers and Commerce luncheon. His unilateral decision is that Wisconsin will not accept additional federal money for Medicaid expansion. Instead, many people currently covered under Medicaid will be thrown off of the program and encouraged to get private coverage through the federally-operated State Insurance Exchange.
This decision was not a surprise. Walker has resisted Obamacare at every turn. He spent taxpayer money to fight the law in court. He asked for state exemptions for several important provisions. He refused to develop a state-tailored insurance exchange. Walker's visceral hatred of Obamacare has affected his ability to make any rational decision on the law.
In 2012, Wisconsin had 1,175,000 people covered by Medicaid, mostly families with children and the elderly. Of those covered, 284,966 are childless non-elderly adults. However, due to caps on the program, Wisconsin has an additional 477,100 uninsured poor adults. Both Walkercare and expanded Medicaid attempt to address this uninsured group.
Under expanded Medicaid, all uninsured families or single adults with an income up to 133% of poverty level ($15,282/yr) would be covered. An additional 252,658 of the uninsured would gain coverage under Medicaid, cutting state uninsured by more than half. Many of the remaining uninsured, those making greater than 133% of the poverty level, will obtain coverage through the State Exchange
Under Walkercare, all single adults at or over 100% of the poverty line ($11,491/yr) would be removed from Medicare and encouraged to get coverage through the Obamacare Insurance Exchanges. The assumption is made that everyone who is moved from Medicare would be able to afford the subsidized private insurance of the exchanges. That they could pay the high deductibles and co-pays promoted by cheaper plans. Most likely, many of the poorest will simply do without coverage. Even by the governor's own rosy estimates, Walkercare would leave 28,100 more people uninsured than would expanded Medicaid.
Wisconsin currently gets 60% of its Medicaid funding from the federal government, with the state picking-up the remaining 40%. Under expanded Medicaid, the we would get 100% federal funding for the first 3 years, decreasing to 90% by 2020. According to the non-partisan Kaiser Foundation, accepting the federal funds would result in a savings to the state of $248 million dollars over the period 2013-2022. Over the same period, the additional federal funding amounts to $1.75 billion dollars. That $1.75 billion would help our neediest obtain basic health care. Those funds would allow doctors and hospitals to be compensated for the care that they provide. Those funds would contribute to the overall economic vitality of Wisconsin.
Under Walkercare, we would continue to get that 60% funding for Medicaid, but Wisconsin taxpayers would be on the hook for the other 40%. So in order for Walker to score ideological points; in order for Walker to earn Tea Party approval and support during the 2016 Republican primaries; state taxpayers must pay the additional 30% of Medicaid funding ourselves.
When asked about why Walkercare is such a good deal, State Republicans, uniformly voice a concern that the Federal Government might eventually renege on the 90% Medicaid funding. Sen. Alberta Darling says “There's no certainty with the federal government.” Assembly Speaker Robin Vos chimes in, “I have always been very leery about taking a promise from the federal government at face value.” Such concern is disingenuous. Walkercare is also based on a Federal promise- the promise that funding will continue for subsidies on the Insurance Exchanges.
It is ironic that Walker embraces a keystone of Obamacare, the State Insurance Exchange, in order to reject another keystone, expanded Medicaid. His Walkercare scheme has not yet received a green light from Health and Human Services Secretary, Kathleen Sebelius. It will be interesting to see if such a blessing is given.
Walker's reckless decision plays politics with the lives of thousands of Wisconsin citizens. It sends billions of dollars to other states that should be used to help our poorest people. It puts a continuing financial burden on hospitals throughout our state. One can only hope that our rubber-stamp legislature will do the right thing and overturn Walker's Medicaid edict.