Medicaid expansion could be a major budget and political topic as Wisconsin plans for state spending and taxation in the 2017-2019 biennium.
Gov. Scott Walker and the Republican-controlled Legislature have refused to fully participate in the Medicaid expansion provided under the Affordable Health Care Act (also known as Obamacare).
The decision meant Wisconsin is turning down hundreds of millions of federal health dollars. Usually governors try to maximize the federal dollars and programs their states receive.
Walker has predicted the program would collapse because the federal government could not afford it. The Republican-controlled House of Representatives repeatedly has voted to repeal Obamacare, something that won't occur while Barack Obama is president.
Nor will Obamacare go away if Hillary Clinton is elected president. Donald Trump has said if elected he doesn't plan to change Medicare or Social Security. But that is not Medicaid which provides health coverage for the poor below the age of 65.
Republicans vow they will replace Obamacare, but details are scant. House Speaker Paul Ryan, R-Janesville, has floated a plan that would preserve Obamacare benefit improvements while ending mandatory participation requirements.
But the Ryan plan did not contain the detail on how such a plan would work financially without required participation.
Late last month, Gov. Walker issued direction to state agencies on what he expects in their requests for the state's 2017-2019 budget. The directions call for state agencies to provide two budgets - one at zero base growth and the other with a five percent reduction in spending.
But there were some major exemptions to the directions, including Medicaid, the prison system, and state aid for elementary and secondary education. Medicaid is taking much of the spending increase in the current biennial budget.
Medical costs seem to increase regardless of what elected officials say or do, and Wisconsin's population is older than the national average. Older people have more health care needs.
The governor repeated his pledge to reallocate any budget savings toward higher state aid to elementary and secondary schools. Public school advocates have been sharply critical of state-aid levels and using state tax dollars to help finance private schools.
That criticism has been especially loud in western and northern parts of the state. The governor's political support has slipped in those regions. He has tried to bolster the ratings with widespread "listening sessions" which have been closed to the press.
When the Legislature takes up the next biennial budget, Democrats are sure to say that increased federal dollars for expanded Medicaid could redirect more money for school aids.
But Walker is not easily moved on budget items. State Rep. John Nygren, R-Marinette, co-chair of the Legislature's budget committee, released estimates that nearly $1 billion more is needed for roads and local transportation needs. Walker flatly rejected that prescription.
Rejecting tax and fee increases is easy politics. Refusing additional federal health dollars is tougher. The issue could test the state's political temperature for the 2018 elections.
- Matt Pommer is a 35-year veteran of covering state government in Madison. His column is published Tuesdays in the Times.
Gov. Scott Walker and the Republican-controlled Legislature have refused to fully participate in the Medicaid expansion provided under the Affordable Health Care Act (also known as Obamacare).
The decision meant Wisconsin is turning down hundreds of millions of federal health dollars. Usually governors try to maximize the federal dollars and programs their states receive.
Walker has predicted the program would collapse because the federal government could not afford it. The Republican-controlled House of Representatives repeatedly has voted to repeal Obamacare, something that won't occur while Barack Obama is president.
Nor will Obamacare go away if Hillary Clinton is elected president. Donald Trump has said if elected he doesn't plan to change Medicare or Social Security. But that is not Medicaid which provides health coverage for the poor below the age of 65.
Republicans vow they will replace Obamacare, but details are scant. House Speaker Paul Ryan, R-Janesville, has floated a plan that would preserve Obamacare benefit improvements while ending mandatory participation requirements.
But the Ryan plan did not contain the detail on how such a plan would work financially without required participation.
Late last month, Gov. Walker issued direction to state agencies on what he expects in their requests for the state's 2017-2019 budget. The directions call for state agencies to provide two budgets - one at zero base growth and the other with a five percent reduction in spending.
But there were some major exemptions to the directions, including Medicaid, the prison system, and state aid for elementary and secondary education. Medicaid is taking much of the spending increase in the current biennial budget.
Medical costs seem to increase regardless of what elected officials say or do, and Wisconsin's population is older than the national average. Older people have more health care needs.
The governor repeated his pledge to reallocate any budget savings toward higher state aid to elementary and secondary schools. Public school advocates have been sharply critical of state-aid levels and using state tax dollars to help finance private schools.
That criticism has been especially loud in western and northern parts of the state. The governor's political support has slipped in those regions. He has tried to bolster the ratings with widespread "listening sessions" which have been closed to the press.
When the Legislature takes up the next biennial budget, Democrats are sure to say that increased federal dollars for expanded Medicaid could redirect more money for school aids.
But Walker is not easily moved on budget items. State Rep. John Nygren, R-Marinette, co-chair of the Legislature's budget committee, released estimates that nearly $1 billion more is needed for roads and local transportation needs. Walker flatly rejected that prescription.
Rejecting tax and fee increases is easy politics. Refusing additional federal health dollars is tougher. The issue could test the state's political temperature for the 2018 elections.
- Matt Pommer is a 35-year veteran of covering state government in Madison. His column is published Tuesdays in the Times.
