Accepting more Medicaid funding from the federal government under the Affordable Care Act (Obamacare) has been the subject of much discussion recently. Some counties are putting an advisory referendum on the November ballot urging the legislature to accept the additional federal dollars. Note–as you read this, remember it is about Medicaid (a state administered program) not Medicare (a federal administered program).
To provide readers with some background, as Obamacare is implemented, states are being given the option by the federal government to receive federal dollars to expand their state Medicaid programs. In Wisconsin, Governor Walker opted not to take the federal funds to expand Wisconsin’s Medicaid program, but instead moved forward with his own plan to provide Medicaid coverage to individuals up to 100% of the federal poverty level.
I supported Governor Walker’s decision and there are two primary reasons why. The first being that the federal government has made no guarantee they will fully fund the expansion of Medicaid beyond three years. On the surface, it appeared that Governor Walker was turning down “free money” from the federal government.
However, those federal funds eventually taper to 90% of the benefit cost. Yes, it might provide our state with a short-term savings, but where it becomes problematic is when you look at the long-term impact. Given the fact that our national debt is currently over $17 trillion and counting, there is a real concern that the federal government will eventually shift their enhanced funding obligation to the states. If that were to happen, the cost to fund the expansion will eventually fall on state taxpayers and employers.
For example, when the Obama Administration instituted its stimulus program in 2009, the federal government sent Wisconsin an additional $900 million for Medicaid. After an initial expansion of Badgercare—Wisconsin’s Medicaid program—the Doyle Administration capped enrollment. More importantly, when creating the 2011 state budget, the federal government stopped additional Medicaid stimulus funding forcing Governor Walker and the legislature to take an additional $1.2 billion out of the general fund.
Secondly, when first running for public office I promised voters that I would think of the next generation not just the next election. With no guarantee of full federal funding after three years, I could not in good conscience leave Wisconsinites in jeopardy of paying for millions or potentially billions of dollars in tax increases if the federal government were not to follow through on the their promise.
Without taking the federal dollars, BadgerCare, Wisconsin’s own Medicaid program, is now covering an additional 80,000 Wisconsinites living at or below 100% of federal poverty level. After careful analysis, the Kaiser Family Foundation recently announced that Wisconsin is the only state that did not accept the Obamacare Medicaid expansion to not have gaps in coverage.
Historically, Wisconsin has been ranked near the top nationally for health outcomes and individual insurability. We have enjoyed a robust and competitive insurance market in our state and Wisconsin has been an innovator in areas like welfare reform and Senior Care. It would be more beneficial to states like ours if the federal government were to provide us with the flexibility to develop our own solutions rather than asking us to simply expand Medicaid.
If Wisconsin is forced to go down that road, we need greater assurance from the federal government that any temporary expansion of Medicaid comes with minimal strings attached.
As we have witnessed in the last year, there is great uncertainty with the federal Affordable Care Act. The website had major glitches forcing us in the legislature to do an emergency three month extension for those on HIRSP, the high risk program. People are being forced off their insurance contrary to promises made. People are not able to keep their doctors as promised. With such uncertainty, I could not put Wisconsin’s taxpayers in jeopardy for the long run.
State Senator Tom Tiffany represents Wisconsin’s 12th Senate District
