Republicans defend decision to reject Medicaid expansion

MADISON — Republicans who control the Wisconsin Legislature said Tuesday, June 4 they will increase funding for hospitals, nursing homes, health care workers and other health care programs over the next two years, standing by their decision to reject Gov. Tony Evers' plan to expand Medicaid and access $1.6 billion in federal money.

Republican leaders of the Legislature's budget committee said they don't want to add a projected 82,000 more people who earn between poverty level and 38% above to the state's BadgerCare Medicaid program. It makes more sense, Republicans argue, to keep them in the private insurance market where they can qualify for highly subsidized plans sold through the marketplace created under the Affordable Care Act.

Expanding Medicaid wasn't necessary because the state's economy is strong with plenty of available jobs, said Rep. John Nygren, co-chair of the budget committee.

"What we're doing is investing in people, not programs," budget committee co-chair Sen. Alberta Darling told reporters prior to the start of the meeting to vote on the funding levels. "We're not expanding welfare, that was the big concern."

Republicans said they were spending $200 million more on Medicaid programs over the next two years. An exact comparison of what the Joint Finance Committee planned to approve later Tuesday night with what Evers proposed was not immediately available.

Evers and Democrats say it's irresponsible to not take the federal money available under expansion to cover more poor people and free up funding that can be used to address a host of Wisconsin's other health care needs.

Evers took his victory over longtime Medicaid expansion opponent, former Gov. Scott Walker, as a sign that voters wanted to join the majority of other states in accepting the federal money. But Republicans made it one of the first items removed from his budget proposal. Republican Assembly Speaker Robin Vos has been particularly steadfast against, saying last month that Medicaid will be expanded "over our dead bodies."

Evers has been undeterred, vowing to "fight like hell" to save his proposal, pointing to public opinion polls showing support as high as 70%. But Republicans have shown no signs of bending and Democrats don't have the votes to stop them.

"Republicans are continuing to choose to follow their partisan marching orders rather than listening to the will of the people," Democratic state Rep. Chris Taylor, a member of the budget committee, said in a statement ahead of Tuesday's meeting.

While Republican legislative leaders have been staunchly opposed to expansion, some GOP lawmakers have said they are open to finding a compromise.

Under the Evers budget, the state would save $324 million by expanding Medicaid thanks to an influx of new federal money. He would then spend that money in other areas to leverage $1.6 billion in additional federal funds to pay for a wide range of programs targeting women's health, reimbursement rates for doctors and other health care providers, mental health and substance abuse services, dental health care and lead poisoning.

To date, Wisconsin has missed out on $1.1 billion in federal money for Medicaid expansion. It is one of only 14 states that have not accepted Medicaid expansion money and the only one that did a partial expansion to cover people up to 100% of poverty without taking the money.

The Evers plan would increase the Medicaid-eligible income level from 100% of poverty to 138%. That would raise eligible annual income from $25,750 for a family of four to $35,535. For a single person, the income cutoff would go from $12,490 to $17,236.

About half of the 82,000 people expected to qualify for Medicaid already have insurance now through subsidized plans sold through the marketplace. The other half do not have insurance.