Wisconsin is the only state in the nation to have gone down a very shortsighted and bizarre path with respect to the Medicaid expansion – one that has resulted in serious fiscal challenges for the state.
So what did Wisconsin do? Well, in an attempt to “stick it to the man”, Governor Walker said no to the very generous 100% federal matching dollars and expanded coverage for childless adults under the poverty line at the state’s regular matching rate – which is a little over 58 cents on the dollar. If Wisconsin had gone to 133% of the poverty line, the state could have gotten the full federal match, but federal rules do not permit states to go part way and get that full match.
Parents were already being covered in Wisconsin; unwise changes were made by the state that have been very detrimental to parent coverage but that is a topic for another day.
As our colleague Jon Peacock at the Wisconsin Budget Project blogged about this week, Governor Walker’s attempt to appease fiscal conservatives has contributed to a serious deficit in the state’s budget. The nonpartisan Legislative Fiscal Bureau estimated in August that the state would save between $261 to $315 million over the 2015-17 biennium by accepting the federal dollars.
In fact, Peacock argues persuasively that the savings that would accrue from accepting the federal dollars are likely to be well above what the Fiscal Bureau estimated – largely because enrollment of childless adults is projected to be about 50% higher than the state had originally predicted. These folks are voting with their feet – they desperately need the health coverage that Medicaid provides. As enrollment rises, perhaps the state will reconsider this unwise decision and accept the federal funds.