Medicaid expansion in Wisconsin - a good idea that makes even less sense to oppose today

As it is with any state budget, Medicaid and health services will play a central role. And the budget that Governor Evers will release on Tuesday will have several items that look to expand and improve health services for the COVID and post-COVID worlds.

Gov. Tony Evers will try again to expand Medicaid coverage in Wisconsin, announcing Wednesday that his state budget proposal will also have more than $150 million in other health initiatives, including bolstering student mental health support, addressing the opioid crisis and increasing telehealth accessibility.

"The COVID-19 pandemic has only further exacerbated the need for and underscored the urgency of making sure we have affordable, accessible services available to folks when they need it most, and that's why it's a top priority in our budget," Evers said in a statement....

Other funding proposals Evers announced Wednesday include:

— $40 million to increase Medicaid rates to bolster access to outpatient mental health services, including substance abuse treatment and psychiatric services for children and adolescents.

— $25 million for a variety of measures to combat the state's opioid crisis, including expanding the BadgerCare Medicaid program to cover room and board costs for Wisconsin residents receiving treatment in residential substance use disorder treatment facilities. The money would also be used to allow for acupuncture and other alternative care methods to be covered under Medicaid; increase grants supporting needs of tribal communities and programs that provide needle exchanges, peer support and recovery coaches.

And while the state does have extra money in its coffers (for now), Evers wants to have the Feds pay for most of these services by expanding Medicaid under the provisions of the Affordable Care Act. And the Wisconsin Examiner noted recently that it could be even more advantageous for the state to expand Medicaid this year, due to some recent changes in Federal law, and proposals from President's Biden's stimulus bill.

States whose residents have lower average incomes get higher reimbursement rates. In March, Congress increased the reimbursement rate for all states for as long as the COVID-19 emergency remains. The Biden administration has said it will extend that emergency until at least the end of 2021.

The House proposal would further increase the reimbursement rates for new expansion states by 5 percentage points.

The new incentives would be part of a larger congressional effort to address the fallout of the COVID-19 pandemic. Democrats’ relief bill covers everything from distributing vaccines to supporting transportation networks to doling out stimulus checks.

Wisconsin would be one of those “new expansion states”, and it would translate into getting another 35%+ of expenses covered by the Feds. It's not like additional federal funds for health care is something that WisGOPs are completely opposed to, as they have been fine with taking the expanded coverage of Medicaid expenses from the current COVID emergency for nearly a year.

In fact, a big reason that the state has more money to play with in 2021 is the projected surplus of nearly $615 million in state Medicaid dollars, despite an increase in Medicaid expenses overall.

That surplus has led the WisGOPs to call for more tax cuts. So why wouldn’t they want to save even more money and more Wisconsinites covered by expanding BadgerCare under the ACA? You know, besides Koched-up corruption and anti-Obama race-baiting?

I have little doubt the WisGOPs in the gerrymandered Legislature will find some lame reason not to expand Medicaid in the 2021-23 budget. Maybe they'll claim that we have enough of a surplus so it's not needed, or maybe they'll claim that Wisconsinites living just above the poverty line really don't need to have their health care taken care of. Maybe they'll cry crocodile tears about the US budget deficit (while ignoring the GOP Tax Scam and negligence on COVID-19 that are the main reasons behind that deficit).

But there is also little doubt that the COVID World, and the bumps in aid from DC that followed, have illustrated how absurd WisGOP's prior stances against government-assisted health care were. And it has shown how our current, private-based health system leaves so many behind, and requires a public option like BadgerCare to give support and options to people who insurance companies don't consider important enough or profitable enough to be offered affordable and adequate coverage.

Evers has the advantage of public support on the issue of expanding BadgerCare, and on health care in general, and it looks like he is going to press it. As he should.