Tom Tiffany approves of Wisconsin paying more for Medicaid, FoodShare, with less people insured

Every three months, the Wisconisn Department of Health Services releases an update on the state's Medicaid budget situation. And this week, we found out that our state is on track to need hundreds of millions of dollars to pay for Medicaid by this time next year.

As indicated in my March quarterly letter, across the country, payors and providers are experiencing a shifting healthcare landscape with costs increasing overall. While states’ Medicaid programs vary significantly, programs are facing growing budgetary challenges with approximately two-thirds of states predicting a high likelihood of budget shortfalls in the near term. Ongoing uncertainty around federal policy implementation and unpredictable economic conditions in the medium-term are further compounding these budget challenges.

The June projection reflects a continuation of trends identified in the March letter. Wisconsin Medicaid members need and are accessing essential healthcare services at a higher rate than assumed in the biennial budget. Most notably, the program is experiencing higher utilization in Family Care and other community-based long-term care, nursing home services, services for children with disabilities, prescription drugs, and safety net providers such as federally qualified health centers (FQHCs).

The Department projects Medicaid expenditures will exceed budget by $322.4 million GPR by the end of the biennium, which is 3.3% above budgeted GPR levels under 2025 Act 15, the 2025-27 biennial budget.

In a related note, Trump/GOP's Tax Scam 2.0 caused millions of Americans to not enroll in Obamacare in 2026.

Five million fewer people are currently enrolled in ACA marketplace plans compared to the record high reached last year. More than 1 million fewer people picked a plan for 2026, and then 4 million more either disenrolled or failed to pay their premiums and therefore dropped coverage.

Prices in the market skyrocketed after President Trump and Republicans in Congress failed to extend extra financial help for enrollees last year. The Department of Health and Human Services published a report about the data on its website Friday....

The steep drop in enrollment reflects what insurers, administrators, and other health policy experts expected earlier this year. After initial sign ups were lower than last year, they predicted that the picture would get worse as time went on and people found they could not afford to pay their premiums.

"The main takeaway is that enrollment is down 13% from last year," explains Cynthia Cox, director of KFF's Program on the ACA. "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced double or even triple digit increases in their premium payments with the expiration of enhanced tax credits."

Wisconsin also had a loss of enrollment in ACA insurance for this year, as the recently released effectuated enrollment numbers from the US Department of Health and Human Services shows. As defined by DHHS,

Enrollment in the Health Insurance Exchanges is considered effectuated if the enrollee paid their premium for the applicable month, if they have a non-zero dollar premium, or if the enrollee had a zero dollar premium. Enrollees are captured as effectuated in this dataset if they had an active policy and also paid their month’s premium, if applicable, at the time of the data retrieval.

And the number of Wisconsinites with actively funded premiums has plummeted by 17.6% since its peak in July, with the falloff being especially noticeable at the start of 2026, as premium subsidies were reduced under Trump/GOP Tax Scam 2.0.

But that's Obamacare enrollments in Wisconsin, so how does that affect Medicaid costs? Now that millions of Americans have found their Obamacare is unaffordable, they're more likely to be uninsured and use the emergency room as their doctor's office. And/or more people become likely to wait until they show more severe symptoms before getting treated in general, which also drives up costs, in addition to the lost productivity of work due to more severe illness.

And guess who signed off on Tax Scam 2.0, and who imposed these higher costs onto state taxpayers as a result of it?

Yep, it's Trumpy Tommy Tiffany. And I bet he's not promoting this part of the bill in his ads (come to think of it, he doesn't mention anything about his current job in Congress at all, does he?). Although he's probably going to claim that the working people that got screwed out of their health care by that Big Bunch of Bollocks were committing fraud anyway. It's easier to make up a story than to deal with reality, you know.

Tommy's Tax Scam 2.0 also drove up state costs in another way, because the Evers Administration had to ask the Legislature for $72.8 million earlier this year to hire and pay more of the salaries of workers for the state's food assistance program and make process improvements to avoid having to pay even more state tax dollars for Food Share. And we found out last week that this investment paid off for Wisconsin.

The rate at which Wisconsin distributes too much or too little food assistance is among the lowest in the nation, according to data released Wednesday by the U.S. Department of Agriculture.

According to the estimates measuring all states and U.S. territories, Wisconsin’s error rate for the last fiscal year was 5.72 percent. That’s just over half of the nationwide error rate of 10.62 percent.....

The USDA’s error rate measures both overpayments and underpayments of federal food assistance dollars, known nationally as the Supplemental Nutrition Assistance Program, or SNAP, and in Wisconsin as FoodShare.

Under a provision of last summer’s One Big Beautiful Bill Act, states that exceed a 6 percent error rate will have to shoulder a share of the cost of the program. The size of that share increases as the error rate grows.

That comes as other changes to the program were implemented, including requiring states to take on more administrative costs, and imposing new work requirements on older people and on families with children above age 13. The federal law also requires regular paperwork to prove exemptions from such requirements for some groups, such as families with special needs children.

The damage and higher costs from the Big Bunch of Bollocks that became law a year ago Friday is just becoming apparent in the data. And it's likely to continue as the year goes on and even more expensive 2027 Obamacare premiums are likely to be announced in the next 3 months.

I would hope whoever wins the Democratic nomination for Governor in 40 days will remind Wisconsin voters that Tom Tiffany is a big reason behind the higher costs and lack of insurance that many state residents are dealing with. And there are nearly $400 million in extra costs that are projected to be needed for Wisconsin's FoodShare and Medicaid because Tom Tiffany decided that the superrich and corporate needed another tax giveaway instead of doing something that improved the lives of Wisconsinites with real jobs.