After the Assembly passed Gov. Scott Walker’s bill to delay BadgerCare transitions for 77,000 families and more than 80,000 childless adults, a Madison legislator proposed a bill Tuesday that would give counties the option to expand Medicaid under the federal health care reform law.

According to bill author Rep. Melissa Sargent, D-Madison, Walker’s plan leaves about 800,000 Wisconsinites without health insurance that her plan would cover.

Additionally, the bill would create 10,000 jobs and take advantage of millions of dollars of federal money that Walker’s plan will not, Sargent said.

“My plan would also allow for the counties to make the decision for themselves on whether or not it is right for their county to have the funds, so it honors local control,” Sargent said.

While Sargent’s first choice for the bill would be to allow federal health care expansions throughout all of Wisconsin, Walker rejected the Medicaid funding to expand BadgerCare, Sargent said.

Therefore, with her newly introduced bill, Sargent said she accepted an alternative in which long-term payments will fall upon counties if the federal government was not able to pay them.

Sargent said if at some point the federal government may not be able to sustain its share of the plan, the counties can then decide whether or not they want to continue with it. They could choose to do it for a couple of months, a couple of years or could opt out all together.

“If it ever became apparent that the federal government wasn’t able to continue providing these expanded [Medicaid] benefits, the counties could then say to the people in their communities, ‘We are very sorry, there has been a change at the federal level and we cannot continue this.’” Sargent said. “And that’s happened in the past, so it would not be anything new.”

Budget analyst for the nonpartisan Legislative Fiscal Bureau, Charles Morgan, said there is great speculation as to the terms and conditions of Sargent’s proposal.

“I think there is a greater uncertainty as to whether [Centers for Medicare & Medicaid Services] would approve such a proposal and again what strings are attached to the proposal if the bill were enacted and counties took this action,” Morgan said. “I don’t know for example if CMS would say we guarantee to provide enhanced federal funding for a certain period or if the federal government ever chose not to provide that enhanced federal funding if counties would then discontinue the program as soon as that decision was made.”

Sargent said the bill would ask the State Council to reach out to the federal government and request a waiver to allow the counties to do that. Currently, Cuyahoga County in Ohio has been successful in getting a waiver with the help of its state government.

If the county board passes a resolution saying it wants to expand the medical assistance dollars into their community, the Wisconsin Department of Health Services would have to reach out to the federal government and get approval to do it at the county level, Sargent said.

“I anticipate it will be pretty difficult [to pass this resolution],” Sargent said. “I wish I could say differently, but despite what local governments are saying and despite what local residents of Wisconsin are saying, in fact the party with the majority in Wisconsin, the Republican party is being very partisan and they are not putting the people first.”

Calls to Sen. Leah Vukmir, R-Wauwatosa, and Rep. David Craig, R-Big Bend, sponsors of a bill that would not allow state agencies to create a federal health care exchange without a majority vote from the Legislature, were not returned.