Wisconsin Medicaid: Partial Expansion, Partial Success

Jan 5, 2018

Credit University of Omaha

MADISON, Wis. - Wisconsin has seen mixed results from a four-year experiment of partially expanding Medicaid, which in Wisconsin is called BadgerCare.

According to a report from Kids Forward, the partial-expansion experiment has put a huge dent in the number of uninsured state residents. Jon Peacock, research director for Kids Forward, said partially expanding BadgerCare under the Affordable Care Act has been a good thing. "But that partial expansion is costing state taxpayers far more than a larger expansion, and we're covering 80,000 fewer adults, who are now struggling to afford health care," Peacock said. "We can do a lot better than that."

While the number of uninsured Wisconsinites has gone down under partial expansion, the report said 80,000 more adults would be covered under a full expansion. Thirty-one states elected to take the full Medicaid expansion, and the percentage of uninsured is significantly lower in those states. Wisconsin's four neighboring states - Illinois, Iowa, Minnesota and Michigan - all opted for full expansion. "We cover substantially fewer adults in Medicaid than those states do and it's costing us a lot more money," Peacock said, "because if we expanded a little further than under the Affordable Care Act, we would get additional federal matching dollars."

But it's the idea of taking federal dollars that stands in the way of further expansion in Wisconsin. The mindset of the Republican administration is that taking federal money makes the state too reliant on the feds. Peacock said the alternatives are narrowing, because of the tax bill passed by Congress late last year, which guts the federal mandate for people to purchase health insurance. "Wisconsin said, 'Instead of expanding BadgerCare as much, we're going to move people into the subsidized Obamacare marketplace coverage.' And that is what's really at risk now," he explained. "Our alternative to a full Medicaid expansion is looking really shaky."

Peacock said if conservatives make the Obamacare marketplace collapse, the number of uninsured individuals would skyrocket.