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Medicaid expansion could be a major budget and political topic as Wisconsin plans for state spending and taxation in the 2017-’19 biennium.

Gov. Scott Walker and the Republican-controlled Legislature have refused to fully participate in the Medicaid expansion provided under the federal Affordable Care Act.

The decision means Wisconsin is turning down hundreds of millions of federal health dollars. Walker has predicted the program will collapse because the federal government cannot afford it.

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Late last month, Walker issued direction to state agencies about what he expects in their requests for the state’s 2017-’19 budget. The directions call for 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.

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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.

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 aid.

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 2018.

-Matt Pommer is the “dean” of Capitol correspondents in Madison. His column is published with permission from the Wisconsin Newspaper Association, but does not reflect the views or opinions of the WNA or its member newspapers.

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