Gov. Scott Walker’s rejection of Medicaid expansion received extensive Republican support at Tuesday’s budget committee meeting, with only Democrats and one Republican in opposition.
The Joint Finance Committee, comprised of 12 Republicans and four Democrats, convened for the Department of Health Services’ budget briefing, resulting in mostly Republican praise for Walker’s plan.
Walker’s health care plan, announced last month, covers slightly fewer people than the Medicaid expansion, which would cover everyone under 133 percent of the poverty level. The federal government would largely pay for the expansion, with it never paying under 90 percent of the costs.
At Tuesday’s hearing, however, DHS Secretary-elect Kitty Rhoades said the federal government may not be able to maintain the funding it promised. If that happens, Rhoades said, Wisconsin would be left with massive costs.
“[The governor’s plan] preserves the health care safety net for our most needy citizens while reforming entitlements back to their true purpose of transitioning people from a cycle of dependence to independence and self-reliance,” Rhoades said.
The plan would put those under 100 percent of the poverty level in Medicaid and move anyone above that level to private insurance. In the insurance exchanges under the federal health care law, individuals between 100 to 400 percent of the poverty level would receive some premium subsidies.
Republicans spoke mostly in support of Walker’s plan, but Sen. Luther Olsen, R-Ripon, who with two other senators has split from some of Walker’s education proposals, said he has some concerns about the Medicaid plan.
Olsen said from his interactions with hospital officials, many worry about the rise in uncompensated care, such as the unpaid hospital bills that could arise from the fewer people insured under Walker’s plan.
According to a Legislative Fiscal Bureau analysis, the state would also save money with the Medicaid expansion. Olsen said the state should take the federal dollars and if federal funding levels change, then consider changing the program.
“It seems to me we’re sort of leaving some money on the table,” Olsen said. “If it goes away later, then we have to make some serious changes.”
However, Rep. John Nygren, R-Marinette, a JFC co-chair, said Wisconsin would not be able to take health care away from the poor if the funding level changes, exposing the state to major fiscal costs.
Nygren emphasized Walker’s reforms would end the waitlist and finally give health care to all adults below the poverty level.
“For the first time with this proposal, for the first time in state history, we have a plan that provides access to Medicaid for everyone — everyone — under the poverty line and a means to obtain affordable subsidized private insurance for everyone else,” Nygren said.
The committee must approve the budget in order to send it to Legislature, where Republicans hold a large majority in the Assembly and an 18-15 majority in the Senate.
Democrats continue to criticize Walker’s plan and have been pushing for a bill that would take the Medicaid expansion.
“Under your plan, we cover fewer people, we spend more money… and we allow federal money that would be available to us to be spent in other states,” Rep. Jon Richards, D-Milwaukee, said. “Why is that a good deal for Wisconsin?”