Wisconsin must expand Medicaid, regulation of prescription drug prices

New proposals seek to increase health insurance eligibility, reduce burden of rising prescription drug prices

· Dec 7, 2023 Tweet

Abigail Leavins/The Badger Herald

Lt. Gov. Sara Rodriguez and other Democratic lawmakers recently proposed a plan to extend BadgerCare Plus — Wisconsin’s Medicaid coverage plan for low-income individuals — to a greater portion of Wisconsinites and reduce the cost of prescription drugs, according to The Cap Times.

According to The Cap Times, two of the proposed bills would increase income eligibility for Medicaid and introduce a public option for purchase by state residents and small business owners. A third bill would instate a cap on insulin prices, require price transparency and establish a review board who would examine current pricing of prescription drugs in efforts to reduce costs.

Wisconsin is currently one of only 10 states that have not expanded Medicaid coverage under the provisions of the Affordable Care Act of 2010, according to the Wisconsin Department of Health Services. Expanding BadgerCare would draw in $2 billion in federal funds and extend healthcare to 90,000 Wisconsinites, according to a press release from Protect Our Care. On the other hand, Wisconsin’s current partial expansion costs the state $190 million per year, yet covers 80,000 fewer residents, according to National Health Law Plan.

In addition to the financial advantages of expansion, studies show significant improvements in health outcomes in expansion states. Medicaid expansion states have seen a decrease in uncompensated care costs for hospitals and individual medical debts, and improvements in rural healthcare.

So, why is Wisconsin choosing to miss out on these benefits?

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Gov. Tony Evers’ ceaseless attempts to expand Medicaid since he took office in 2019 have been constantly thwarted by Republican lawmakers. In fact, Assembly Speaker Robin Vos has claimed no such policy will be passed as long as the Republicans maintain a majority in the Legislature, according to The Cap Times.

A major reason for Republicans’ refusal to expand Medicaid is their mistrust over the reliability of federal support in the long run. Republicans also don’t see a need for Medicaid expansion in Wisconsin, claiming there is no coverage gap between BadgerCare and the availability of private health insurance plans via the ACA’s Health Insurance Marketplace.

Uncertainty about the future of federal support creates concern that costs of expansion will eventually be dumped onto the state. Yet, according to a report by Georgetown University’s McCourt School of Public Policy, the allocation of federal funds to Medicaid expansion has survived under countless attempts to repeal the ACA. The report finds far greater uncertainty over the future of subsidies on private insurance plans via the ACA Marketplace.

Republicans fuel their arguments against Medicaid with claims that the marketplace effectively bridges gaps in coverage through subsidized insurance plans. In doing so, the legislators keep Wisconsinites from accessing a reliable source of federal support and reinforce the state’s dependence on the dangerously unstable private marketplace.

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Additionally, surveys show overwhelming support for federal financing of Medicaid — 89% of American voters wish to either maintain federal support for Medicaid or to expand it, according to Data for Progress.

This data speaks to constituents’ unwavering desire for Medicaid expansion that must be fulfilled by elected representatives. Republican legislators should set their doubts aside and embrace the federal dollars that would not only increase coverage, but also reduce taxpayer burdens.

There is further concern about the efficacy of Marketplace plans in increasing accessibility to insurance plans. According to the University of Wisconsin’s Population and Health Institute, enrollment in Marketplace plans has recently fallen for individuals below 200% Federal Poverty Line. These plans — unlike Medicaid provisions — often exclude behavioral health services and services for working individuals with disabilities. The cracks in current Wisconsin coverage are evident and indicate an urgent need for Medicaid expansion.

According to Urban Milwaukee, the bill proposal that targets prescription drug costs faces similar backlash from Republican lawmakers. Wisconsinites currently pay abominable prices for prescription drugs, and their vulnerabilities are regularly taken advantage of by powerful pharmaceutical companies. To fight this injustice, Evers included a plan to increase drug price transparency and caps on copays for prescription medications in his 2023-25 budget. Not surprisingly, these proposals were immediately shot down.

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The horrifying impact of this negligence on behalf of Republican lawmakers is evident in the 2023 finding that 25% of Wisconsinites did not refill their prescriptions, cut medications in half or stopped taking medications altogether due to high costs.

The state has also seen a seven-fold increase in insulin prices from 2001 to 2018, according to the Wisconsin Office of the Commissioner of Insurance. This often leads to rationing of medications, which can be life threatening. Moreover, individuals with chronic conditions like diabetes have no choice but to deal with rapidly rising costs for the rest of their lives. By refusing to reduce these outrageous prices, Republican legislators turn a blind eye toward individuals’ health and well-being.

Additionally, pharmaceutical drug companies are known to manipulate markets via misuse of monopoly power they receive under patents and lack of transparency about why prices are set so high, according to American Progress.

Numerous big pharmaceutical companies have also participated in price fixing — anti-competitive behavior through which companies collaborate to raise prices and take advantage of the inelastic demand for prescription drugs. We must not allow the profit maximization of pharmaceutical companies to supersede the health of Wisconsinites.

Rather than immediately shutting down policy proposals to expand Medicaid and increase regulation in pharmaceuticals, it is important Republican lawmakers take the time to consider the implications of these policies. There is no space for political polarization when lives are at stake.

Aanika Parikh ([email protected]) is a sophomore studying molecular and cell biology.


This article was published Dec 7, 2023 at 12:00 pm and last updated Dec 2, 2023 at 11:51 am


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