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Legislatively Speaking

Wisconsin Governor Calls for Special Session on Medicaid Expansion

Lena C. Taylor

Frequently, I get asked “what’s the difference between Medicaid and Medicare?” Without fail, the next question is “Why do Republicans hate Medicaid expansion?” These questions have again resurfaced since Wisconsin’s Gov. Tony Evers recent call for a special legislative session on Medicaid Expansion. Let’s start with the easy question first.

Both Medicaid and Medicare provide a way to get health care. Medicaid is run by state governments and is income based. Each state determines how their Medicaid program will work but the overall goal is to provide residents with a lower cost health care option. Medicaid programs across the country typically cover children, elderly adults and people with disabilities, pregnant women, and some low-income adults. Wisconsin Medicaid is a joint federal and state program that provides services to over one million Wisconsin residents.

Medicare is run by the federal government and is typically for people aged 65 or older. There are some exceptions based on disabilities that would cover younger people who may qualify due to a disability. While these definitions are just the nuts and bolts, let’s tackle question number two.

The phrase “Medicaid expansion” refers to the need and desire to cover more uninsured low-income people in the state. This was one of the paramount provisions in the 2010 Patient Protections and Affordable Care Act (ACA) developed during President Barack Obama’s administration. Many strongly believe that the ACA was met with opposition from the Republican members of Congress for no other reason than political partisanship. Over the years, we saw a number of lawsuits to either chip away at pieces of the law or gut it entirely. Many of us remember the individual and employer mandates. However, the legal challenge that stands out the most is Medicaid Expansion.

In 2012, the U.S. Supreme Court ruled that states could not be forced to expand their Medicaid programs. Each state could decide whether to participate or expand the program for themselves. Nearly nine years later, Wisconsin remains one of the holdouts on Medicaid Expansion thanks to Wisconsin Republicans. First, we need to be clear. Not ALL Republicans hate Medicaid expansion. To date, 39 states (including D.C.) have adopted Medicaid expansion. Some of these states include Republican supporters. Citizens have demanded referendums on local ballots to help weigh in on expansion, because most folks want to be able to obtain affordable healthcare services when they need it.

Wisconsin, because of state Republicans, is one of 12 states that have not expanded Medicaid. Common arguments against insuring more people centers around old arguments: welfare, handouts, bootstraps. Sometimes, the arguments include cost and whether the state can afford to extend medical coverage to the nearly 323,000 uninsured Wisconsinites. COVID-19 has exacerbated the consequences of health care inequities. However, as a result of the federal COVID-19 relief bill passed under the Biden administration, Wisconsin could gain more than $1 billion if Medicaid is expanded. While that money would be for two years, we have already seen other states benefit drastically from Medicaid expansion.

I applaud Gov. Evers’ call for this special session. Some folks stand in the gap, and others stand in the way. We need Republicans to move.

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