Republican legislators say Gov. Tony Evers' push to accept federal Medicaid expansion is a “nonstarter,” and several of the state’s think tanks calculate expanding the program would cost taxpayers an additional $600 million; single-payer $30 billion in the first year alone.
Wisconsin provides Medicaid to residents earning up to 100 percent of the federal poverty limit. Medicaid expansion would increase eligibility to 138 percent of the poverty limit, and increase the reimbursement rate for Medicaid expenses from the federal government. Wisconsin, among 13 other states, has not participated in Medicaid expansion since it was offered under the Affordable Care Act.
According to an analysis produced by the Center for Research on the Wisconsin Economy (CROWE) and Wisconsin Institute for Law and Liberty (WILL), Medicaid expansion would create $545 million in benefits by raising healthcare costs by $1.145 billion, resulting in a net cost of $600 million to Wisconsin.
CROWE and WILL say that states that accepted Medicaid expansion saw private sector healthcare costs increase by $177 per person.
“While healthcare costs in all states increased in the time frame of analysis, costs increased more in states that participated in Medicaid expansion,” their analysis states. Wisconsin’s expansion would move it from having the seventh highest private-sector healthcare costs to fourth highest.
Moving toward a single-payer healthcare system also would cost taxpayers an additional $30 billion in the first year alone, the state’s free market think tank, the MacIver Institute, calculates.
“Should liberals take Wisconsin to a single-payer, government-run health care system, taxpayers would face $30.2 billion in additional costs in the first year alone,” MacIver’s M.D. Kittle and Chris Rochester said. “The low-end estimate is drawn from data obtained from the federal Centers for Medicare and Medicaid Services. MacIver’s analysis arrives at the hefty figure by calculating government and private sector health care spending in Wisconsin, at $64.069 billion for 2019.”
Concerns about costs come after an analysis of fewer Wisconsinites relying on the program that Evers wants to expand.
“While Wisconsin has seen Medicaid enrollment fall – diverging from the national trend – spending has dramatically increased,” Ola Lisowski at the MacIver Institute says. “The sheer billions of dollars spent in this industry have a massive impact on the economy, on the welfare of our state, and the size of our government.”
According to state records, 1,011,600 individuals, or 18 percent of Wisconsin’s population, was enrolled in Medicaid in 2011. By 2017, that number dropped to 948,600 individuals, or 17 percent.
Yet state spending increased during the same time period. In 2011, the state’s per capita spending was $7,971; by 2014 it was $8,702.
According to the Centers for Medicaid and Medicare, which report on total publicly and privately funded health care spending per capita every five years, Wisconsin’s funding was higher than the national average. The national average for 2011 was $7,292. It was $8,045 for 2014.
The number and total percentage of Wisconsinites enrolled in Medicaid has fallen, which is opposite of the national trend, the McIver analysis states. Nationally, 18 percent of the population was enrolled in Medicaid in 2011; by 2017 the number increased to 21 percent.
“The cost of expanding Medicaid is staggering and represents a misguided policy choice that would burden hard-working Wisconsin families already struggling with the cost of healthcare,” Will Flanders, research director at WILL, said. “Because Wisconsin doesn’t have a coverage gap, Medicaid expansion would only serve to provide government healthcare coverage to individuals who already have access to subsidized plans on the exchange.”
Health care experts at the think tanks argue that Wisconsin should consider other, market-based alternatives to expansion in order to reduce costs while also assisting low-income residents. CROWE and WILL suggest that the state consider increasing access to Short Term Limited Duration plans, and make primary care more direct without the “insurance middle-man.”