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Jun 27, 201712:29 PMInside Wisconsin

with Tom Still

Wisconsin could be big loser under Senate health care plan

(page 1 of 2)

As the U.S. Senate prepares to vote on a Republican proposal to repeal the Affordable Care Act, the possibility looms that Wisconsin could lose billions of dollars over time for the very reason the GOP hated Obamacare in the first place.

That reason was the required expansion of Medicaid to more people and services, which Wisconsin rejected after the ACA was passed in 2010 based on calculations it would cost the state more than the federal aid was worth.

Now, some of the same Republicans in Congress who thought Medicaid expansion was a bad idea from the start are poised to pass a bill that would penalize those states that refused to do so.

Confused? So are many experts in the health care community, who are urging Wisconsin’s U.S. senators to find ways to eliminate what the Wisconsin Hospital Association has estimated as a $36.9 billion loss in federal aid by 2025.

Wisconsin partially expanded its Medicaid health program for the needy known as BadgerCare Plus some years ago. It didn’t do so fully, however, which meant the state has missed out on additional matching dollars from federal taxpayers.

By 2025, the 19 states that didn't expand Medicaid will lose out on $684 billion in additional federal money, an amount that would translate into $37 billion for Wisconsin alone, based on a report from the Missouri Hospital Association.

To date, Wisconsin taxpayers have spent $679 million more than they would have under a full expansion of Medicaid, the Legislature's non-partisan budget office has estimated.

The Senate measure, like the House bill, would phase out the extra money the federal government has provided to states as an incentive to expand eligibility for Medicaid. That phase-out would begin in 2021 and be nearly complete by 2024. Like the House bill, the Senate measure would put the entire Medicaid program on a diet, ending the open-ended entitlement that now exists.

In both bills, however, the Medicaid phase-out is delayed — which is why Wisconsin health care organizations are concerned.

“It locks in a massive (health care) funding disparity between expansion and non-expansion states,” said Eric Borgerding, CEO of the Wisconsin Hospital Association. “It’s really sort of astounding that you have states that rejected Obamacare and now in the bill they’re being penalized for rejecting it.”

(Continued)

Jun 28, 2017 09:59 am
 Posted by  Anonymous

None of the proposed solutions above actually address the bigger issue of how to make health care affordable but also accessible to Americans. One factor never looked at by pundits and especially Business pundits is the market effect of health care subsidies and medicare and medicaid are essentially subsides that enable groups of people to enter the health care market. Done right this can build health care systems in smaller markets. Rural Wisconsin is a smaller market facing major health care challenges. It is also a market heavily dependent (often more so than Milwaukee county)on public funding medicare, medicaid, and aca - add those up and you get some really hefty percentages in many rural counties. Cut those programs or increase their costs so people opt out and you lose your health car provider as the market shrinks. You might be insured but there may not be a clinic to use your insurance and hospitals may disappear. look at the current state of Kansas emergency rooms .

It also would be good to look at other strategies for cost containment both in the ACA- like reducing medical errors or reducing environmental pollution related to medical problems. Health is more than insurance and doctors - the best way to reduce health insurance costs is to reduce the causes of disease. Having clean water can do more cost effectively for improving health than setting up a hospital. Part of my family lived in a neighborhood on Chicago's south side that was built on the site of a huge factory during WW2 - everyone on several blocks got some form of cancer- many after they moved out and the new residents well the same thing is happening. Cleaning up the site or restricting building on it would have not only eliminated lots of suffering but save all of us millions in increased premiums do the costs of health and end of life care for those people.

The business community with its work against lead poisoning is going in the wrong direction to reduce health care care costs.

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Tom Still is president of the Wisconsin Technology Council. He is the former associate editor of the Wisconsin State Journal.

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