Wednesday, August 20, 2014

Walker, WisGOP fail on Medicaid expansion grows even larger

I've documented for the last two years how fiscally stupid Scott Walker's decisions have been on health care, but we have new evidence that shows it's even dumber than we thought.

Democratic Senators such as Jennifer Shilling and Kathleen Vinehout asked the Legislative Fiscal Bureau to give updated numbers regarding what would happen if the state chose to take the expanded Medicaid funding that is available to states in the Affordable Care Act (aka Obamacare). The LFB responded by saying the decision by Governor Walker and the GOP-led Legislature to turn down Medicaid expansion had cost Wisconsin taxpayers huge amounts of money.
You asked what the difference in spending would have been, compared to current law,if Wisconsin had implemented a full Medicaid expansion, effective April 1, 2014….The estimated total biennial spending for parents and childless adults in BadgerCare Plus would have been $355 million higher over the biennium, which is the net effect of a decrease in state general purpose revenue (GPR) spending of $206 million, and an increase in federal spending (FED) of $561 million. The estimated average monthly enrollment in Medicaid for parents and childless adults would have been 87,000 higher in fiscal year 2014-15 under a full expansion.
So we would have saved $206 million in state taxpayer dollars and covered 87,000 more people- an even higher cost than the $119 million in extra cost projected in February 2013.

But wait, there’s more! The LFB then projected ahead, and showed that even in a conservative, “low-enrollment” scenario, Wisconsin taxpayers would be shelling out another $261 million in order to TeaBag Obamacare. That number stretches to $315 million in a “high-enrollment case- similar to the high enrollment that has caused our current $93 million Medicaid deficit.

Of course, Walker is still trying to spin his way out of the situation (because adjusting to reality would be wrong). Check out these comments that he made Monday.
"Anybody that's been paying attention to the Federal government knows it has about a $17 trillion debt," Walker said. "They've reneged many times in the past, whether on medicaid or special education funding."

Anyone who believes the federal government will keep up its end of the bargain, Walker said, is "living in a bit of a fantasy."

GOP Joint Finance Chairs Alberta Darling and John Nygren gave similar excuses, claiming that because the 90-100% federal coverage of expanded Medicaid expenses was only temporary, and therefore it wasn't a good idea to take advantage of it now. But a quick look at the state budget and the Wisconsin GOP's own policies in recent years shows who's really "living in a bit of fantasy"- anyone who buys into what Walker and company is trying to sell them.

First, why is Obamacare’s expanded Medicaid singled out as the place where we have to be careful about the future flow of funds from D.C.? Obviously, WisGOP isn’t too concerned about getting Medicaid and other federal health funding in other areas, as the Department of Health Services is projected to take more than $10 billion in Medicaid funds over the two-year budget. This includes counting on $1.17 billion in federal dollars to help pay for Walker’s and WisGOP’s anti-Obamacare plan, from the same source as the 100% full funding they'd get from taking Obamacare's Medicaid expansion. The only difference is that the feds are only chipping in 58% of the cost instead of all 100%. So are the Walker folks also saying they won’t include a projected $1.35 billion dollars in Medicaid assistance, which the LFB estimates they need in federal Medicaid money in 2015-17 to continue their plan, since that’s “not promised” either? OF COURSE NOT!

That doesn’t even bring up the other departments. The state budgeted $19.7 billion in federal aid for 2013-15, over 28% of all the funds to be spent. If WisGOP is so scared about future federal funding, why did we set aside $183 million in federal funding to start work on the Zoo Interchange and other SouthEastern Wisconsin Mega-projects, especially since the Zoo project isn’t scheduled to be complete till 2018? Using Walker’s Obamacare “logic”, it's "a bit of fantasy" to assume those funds will still be there, and we shouldn’t be taking any federal funds if we can’t finish that project, riiiight?

And why did we set aside nearly $977 million in other federal road aid when no money had been allocated for highway funding had been allocated for the final year of the state’s budget cycle? And does anyone think the DOT isn’t counting on more than $1 billion to be there for the next go-around in 2015-17, even though federal highway funds are only available through May 2015? OF COURSE THEY PLAN ON GETTING THAT MONEY.

What about the $3.7 billion that the UW System receives that goes a long way toward paying for things such as research and financial aid? For example, the 2013-14 annual budget shows that the UW System was slated to receive $622 million in federal research aids (Fund 144), $839 million in student loans (Funds 147 and 149) and nearly $91 million in indirect cost reimbursements from the feds (fund 150). That’s for only 1 year of the two-year budget cycle. Are we going to take those billions of “uncertain” dollars out, because we don’t have a long-term budget deal in Congress, and then project these items to be replaced dollar-for-dollar with state funding in the next budget? HELL NO.

Of course, this crew would probably count on replacing any lost federal funding with some private party who might be more interested in getting a certain conclusion out of the “research” instead of legitimate information and conclusions that can solve problems (cough- Charles Koch running Florida State’s economics program- cough). But the point stands- why is it only Obama-backed programs such as high-speed rail, rural broadband and Medicaid expansion that get these crocodile tears of “Oh, we don’t know if the debt-ridden federal government will keep paying for this!”, while a whole lot more federal money is expected to be there for the next 2 years and in many future years after that? It shows why the stance of Scott Walker, Alberta Darling and John Nygren is absurd. These guys know better than to be this selective with their concerns about future federal funding, but they think the people of Wisconsin are stupid enough to fall for it.

But if you want the greatest guarantee that the funding will be there, you could make sure that Democrats are put in charge of both houses of Congress, to avoid any Tea Party-related defunding of Obamacare or other Koch-backed bubble-world tactics. And if you value Wisconsin tax dollars, then elect Mary Burke governor, as she will gladly take the expanded Medicaid funding for as long as it’s available to us, and that move will go a long way toward alleviating the $1 billion budget deficit that Gov Walker has shoved off onto us for the next budget.

As a final note, when the Walker-endorsing Journal-Sentinel is ripping Walker and WisGOP for turning down the Medicaid funds, calling it a "phantom argument" , you know the WisGOP position on this issue is an EPIC FAIL, and the debate is over outside of the right-wing bubble.

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