WCCF Blog: Math Trumps Ideology in Some GOP States; How about WI

Thursday, January 17, 2013

Math Trumps Ideology in Some GOP States; How about Wisconsin?

Several Conservative Governors Decide to Accept Federal Funds for Improving Medicaid

Many Republicans governors don’t particularly like the Affordable Care Act (ACA); in fact, most have actively opposed it. Nevertheless, some of them are coming around and accepting the federal funding from the ACA to expand Medicaid up to 138% of the federal poverty level. An article today on Governing.com explains why some GOP governors have embraced the Medicaid opportunity in the ACA and many others are expected to follow their lead:

“Arizona’s Jan Brewer, Nevada’s Brian Sandoval and New Mexico’s Susana Martinez were the first Republican governors to break from the national party and embrace the expansion -- and they probably won’t be the last. Their stated reasons for their change of heart echo what policy analysts and advocates told Governing they would be long before the governors made up their minds.

“It all comes down to dollar signs. If states choose to expand Medicaid, the federal government will cover 100 percent of the costs [for newly eligible adults] from 2014 to 2016. The feds' contribution will begin to decrease in 2017, but will never be less than 90 percent, under the ACA.”

The full federal funding and the employment boost that infusion of money will cause are key issues, but they aren’t the only selling points. (See, for example, our top ten list of reasons.) In most states, policymakers have been hearing from health care providers who want to close this gap in coverage in order to reduce uncompensated care.  As Arizona Governor Jan Brewer said early this week in her State of the State address:

“We will protect rural and safety-net hospitals from being pushed to the brink by growing their cost in caring for the uninsured.…  Health-care premiums are raised year after year to account for expenses incurred by our hospitals.”

In Wisconsin, Governor Walker and Secretary Smith have noted on at least a few occasions that the federal funding isn’t “free money,” and at times they seemed to be leaning against accepting that money to close the gap in BadgerCare coverage. It’s true, of course, that the federal funding comes from all of us as taxpayers, but Governor Brewer attacks that argument head on:

“Saying ‘no’ to this plan would not save these federal dollars from being spent or direct them to deficit reduction. No, Arizona’s tax dollars would simply be passed to another state – generating jobs and providing health care for citizens in California, Colorado, Nevada, New Mexico or any other expansion state.”

Arizona, like Wisconsin, is a state that already provides coverage to some low-income adults who aren't caretakers of children, and those states will generally come out ahead because the federal government will pay a larger share of Medicaid costs for adults who are currently covered. With that in mind, Brewer’s speech concluded that taking the federal money and closing the gap in coverage would:

“reduce Medicaid pressure on the State budget… prevent health care expenses from eroding core services such as education and public safety, and improve Arizona’s ability to compete in the years ahead.”

The Governing.com article closes with a quote from Len Nichols, director of the Center for Health Policy Research and Ethics at George Mason University:

“Usually, in the history of the world, math trumps ideology.”

Whether that proves to be the case in Wisconsin remains to be seen.

Jon Peacock