Monday, June 24, 2019

Winnebago County committee endorses Medicaid expansion, citing potential gain of $104 million

The Evers administration says Medicaid expansion will bring these benefits to Winnebago County.
By Miles Maguire
After a spirited debate between Oshkosh’s two state representatives, a Winnebago County committee voted June 24 to endorse the idea of expanding Medicaid in Wisconsin, a move that could bring more than $100 million to the local community.

The vote was preceded by an extended exchange between Rep. Gordon Hintz (D-54th) and Rep. Michael Schraa (R-53rd). Hintz’s district encompasses most of the city of Oshkosh, while Schraa represents mostly surrounding communities such as Algoma, the town of Oshkosh, Omro, Black Wolf, Nekimi and Rosendale.

One of the few things they agreed on is that health care funding is a complicated issue that involves an array of tradeoffs, offsets and exceptions. Another thing is that health scare spending is taking up an increasingly large part of the state budget.

“Medicaid is an arrow up, and it is scaring everyone in state government,” Schraa said, gesturing with this hand to show how the cost is rising rapidly. “It takes up such a large portion of our state budget that there is less money to go into schools, to go into education, to go into everything else.”

Democratic Gov. Tony Evers had proposed accepting $324.5 million in federal Medicaid subsidies, which he said would help to trigger the availability of a total of $1.6 billion from Washington. Most other states have taken this kind of approach. But in Wisconsin the Republican-controlled legislature rejected this plan and is poised to vote this week on the next two-year budget without such a provision.

Advocates for expanding Medicaid in Wisconsin believe that the shift is inevitable. Republican opponents are equally adamant that the change will never happen as long as they control the legislature.

To try to sell his plan, Evers developed county-specific fact sheets to show how federal dollars would be spent. His administration estimated that Winnebago County would gain $104 million.

The beneficiaries would include 2,010 residents who would be covered under Medicaid, local physicians who would see $1.5 million in new funding and local hospitals that would see an additional $11.2 million.

Other programs that would be expanded include crisis intervention, lead poisoning prevention, postpartum coverage for new mothers, mental health consultation and cardiopulmonary resuscitation.

Bill Topel, the county’s human services director, said the Medicaid expansion would save the country several hundred thousand dollars. “But the larger piece is that our hospital systems, our dentists, our personal care workers, our nursing homes are all going to benefit greatly because Medicaid is a much better payment source than commercial markets have ever been.”

Schraa argued that the influx of new federal money would be offset by a loss of funds the state currently gets to help low-income residents purchase health insurance. He said the state can’t afford to continue to expand welfare programs.

“I would be willing to do it if it made financial sense,” Schraa said. “It’s an easy talking point--take the free money. But when you come down to it, the numbers just don’t make sense.”

One of the reasons why Wisconsin has been reluctant to accept the federal Medicaid money is a concern that it would be taken away at some point in the future, creating a major budget gap.

Hintz said the health care money would be like federal highway money, which may fluctuate over the years but has come to be a reliable part of transportation planning. He also discounted the idea that the federal Medicaid subsidy could be easily eliminated.

“Part of the reason it’s probably never going to go away is that if you have 36 or 37 states that have it cooked into their budgets, you’re going to have 72 senators in the United States Senate whose state that they represent have it baked into their budget,” Hintz said.

“And if you get rid of [the Medicaid subsidy], they are going to have to cut funding for schools or universities or other programs. Or they are going to have to raise taxes,” he added. “They would be hearing it from whoever their constituents are.”

The county Legislative Committee adopted the resolution in favor of accepting Medicaid money by a vote of 10-2. The measure now goes to the full Board of Supervisors.

Aaron Wojciechowski, who introduced the resolution, represents the UW Oshkosh campus and a nearby neighborhood. He said he realizes that the local Republican lawmakers remain adamantly opposed. “That’s why we are doing this--to hopefully put pressure on and to say this is something that we care about.”

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