New national report says expanding Medicaid is best option for states

A new national study from the RAND Corporation says states choosing not to expand Medicaid under federal health care reform will leave millions of residents without health insurance and increase spending, at least in the short term, on the costs of treating uninsured residents.

Wisconsin is among the 14 states studied in the analysis, which examined the impacts of Medicaid expansion on insurance coverage, federal payments into the states and state spending on care for the uninsured.

“Our analysis shows it’s in the best economic interests of states to expand Medicaid under the terms of the federal Affordable Care Act,” said Carter Price, the study’s lead author and a mathematician at RAND, a nonprofit research organization.

The study says that if the 14 states decide not to expand Medicaid under the Affordable Care Act, as intended by their governors, those state governments collectively will spend $1 billion more on uncompensated care in 2016 than they would if Medicaid is expanded.

The study also says that failing to expand Medicaid could have more than financial consequences. The study estimates that an additional 19,000 deaths could occur annually if the 14 states studied do not expand Medicaid.

Last summer’s U.S. Supreme Court ruling on the Affordable Care Act gave states the ability to block the law’s expansion of Medicaid.
Wisconsin Gov. Scott Walker did just that on Feb. 13 of this year when he unveiled what he called a “hybrid” approach that includes tightening income eligibility for Medicaid, lifting a cap on a program that covers childless adults and forcing more people to buy insurance through the new, federally run health care exchange established through the Affordable Care Act.

The State Legislature’s Joint Finance Committee is scheduled to vote on Walker’s plan, along with budget measures on income taxes and school vouchers, on Tuesday. 

According to The Washington Post, 23 states and the District of Columbia have agreed to the Medicaid expansion. Nineteen states have decided against the expansion and eight are debating it.
Wisconsin legislators reportedly have engaged in negotiations over a deal that would still reject federal funding, but that would compensate hospitals with state money.

Citizen Action of Wisconsin has voiced opposition to this potential deal.

“By conceding that hospitals will be damaged by an increase in uncompensated care, such a deal would be an admission that Walker’s plan will cause tens of thousands people throughout Wisconsin to lose health coverage.  This has been denied by the governor and his allies in the Legislature up to now,” said Robert Kraig, executive director of Citizen Action of Wisconsin.  “It would be a stunningly callous and immoral act to compensate hospitals for impact of forcing people of health coverage, when it would be easy to prevent this tragic result in the first place by taking the federal health care dollars that are on the table.”

Women’s health advocacy groups have also voiced opposition to Walker’s decision on Medicaid. On Tuesday, the Wisconsin Alliance for Women’s Health (WAWH) will mark a Wisconsin Women’s Day of Action for Health Care Coverage supported by American Association of University Women–Wisconsin (AAUW), League of Women Voters of Wisconsin Education Network, Mid-Day Women’s Alliance, NARAL Pro-Choice Wisconsin, Planned Parenthood Advocates of Wisconsin, Reproductive Justice Collective, The Demeter Foundation, Wisconsin Women’s Network, the Women’s Fund of Greater Milwaukee and the Wisconsin Alliance for Women’s Health.

“Women are the primary recipients of Medicaid services because they make up a larger portion of low-income and elderly populations, and are likely to be custodial parents,” said WAWH executive director Sara Finger. “For those committed to advancing Wisconsin women’s health and economic security, they must protect current BadgerCare coverage and improve Gov. Walker’s initial proposal.”

The Wisconsin Nurses Association also released a statement opposing Walker’s proposal, as executive director Gina Dennik-Champion said, “Nurses are deeply concerned about the approximately 88,500 patients that could lose access to Medicaid coverage. These patients would be put into a health insurance exchange that has yet to form and they would face expensive premiums, copays, and deductibles that would limit their access to quality, preventive health care services. This unnecessary barrier to health care will come with a significant cost to our hospitals, providers, and ultimately, Wisconsin taxpayers.”

The Rand Corporation is a nonprofit, nonpartisan global think tank that provides research about issues such as health, education, national security, international affairs, law and business and the environment.

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