Tuesday, January 15, 2013

Walker's BadgerCare decision

By Robert Kraig
Jan. 10, 2013
Of all the decisions Gov. Scott Walker is likely to make in 2013, none will have a bigger impact than whether Wisconsin accepts over $12 billion in federal health care reform money over the next decade to fill the holes in BadgerCare. The case for accepting this investment is so overwhelming that it is hard to believe any responsible leader would seriously consider turning it down.
It will guarantee hundreds of thousands of working Wisconsinites the freedom to control their own health care decisions, create thousands of 21st-century jobs in the health care professions and actually save the state budget hundreds of millions of dollars. It would be nothing short of public policy sabotage to turn the money down for the narrow partisan purpose of undermining the health care reform law. Yet Walker seems poised to do so.
To understand why this would be so damaging, some brief background is needed. Under the Affordable Care Act, health coverage is expanded in two primary ways: building competitive health insurance marketplaces (called exchanges) for moderate- and middle-income people, and filling the holes in Medicaid (BadgerCare in Wisconsin) for low-income residents by extending it to everyone under 133% of the federal poverty level - $14,856 in annual income for single individuals and $20,123 for couples.
BadgerCare is already more generous for the parents and caretakers of minor children, going up to 200% of the poverty line, but most low-income people without children or whose children are grown fall between the cracks. There are over 140,000 Wisconsinites on a growing waiting list. A recent report by the highly respected Kaiser Family Foundation finds that if Wisconsin takes the new Medicaid money, in 10 years an additional 211,000 Wisconsinites will be enrolled in BadgerCare.
Filling the holes in BadgerCare is essential because the health insurance market has failed to provide low-income Wisconsinites with affordable health insurance options, and low-wage jobs are far less likely to include affordable coverage.
People who lack access to stable and affordable health coverage do not have a fair shot at the American dream because they face a constant threat of having their careers devastated by health disasters that also become financial disasters. The critical role of government is to step in and fill the gaps when the private market fails to provide equal economic and social opportunity.
In addition to giving hundreds of thousands of low-income Wisconsinites the freedom to control their own health care decisions and to get ahead economically, accepting the new federal Medicaid money also will create jobs in the health care industry. According to an independent analysis by Jack Norman commissioned by Citizen Action of Wisconsin and the Wisconsin Council on Children and Families, the $12 billion in federal money for BadgerCare will generate a net of 10,000 new jobs. These new jobs will especially benefit women. A recent report by the National Women's Law Center found that Medicaid spending currently creates over 65,000 jobs in Wisconsin's health professions, 80% of which are held by women.
The public good done by filling the holes in BadgerCare justifies increased state spending, but the deal offered to Wisconsin under health care reform is so favorable that the state budget will actually save millions of dollars. Walker's health services secretary, Dennis Smith, seems to be laying the groundwork for turning down the money, claiming last month that it would be costly for Wisconsin.
However, according to the Kaiser study, Wisconsin would actually save $248 million over the next 10 years by accepting the increased Medicaid money because the federal government would pay over 90% of the costs of coverage for many current BadgerCare recipients for which the feds currently pay only 60% of the costs. According to the study, Wisconsin also would save an additional $247 million in the cost of uncompensated care because more people would have health coverage. In total, Wisconsin would save at least $495 million over the next 10 years by accepting the federal money to fill the holes in BadgerCare.
With a deal this good for Wisconsin, it is hard to believe that any responsible leader would refuse it. The most plausible explanation for Walker's hesitation are political calculations such as his desire to placate tea party extremists who want to sabotage health care reform at all costs and the influence of special interests such as the big insurance companies. Such an act of public policy sabotage would be shameful.
The governor does not have to announce his decision until he introduces his state budget in February, so there is still time for him to consider the true public interest and to do the right thing.
Robert Kraig is executive director of Citizen Action of Wisconsin, a statewide advocacy organization located in the Walker's Point neighborhood of Milwaukee.

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Robert Kraig
Executive Director, Citizen Action of Wisconsin
221 S. 2nd St., Suite 300
Milwaukee, WI 53204
(414) 322-5324 (mobile)
citizenactionwi.org
Donate to Citizen Action of Wisconsin

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