Wisconsin has long walked an unusual and even singular path on the issue of health care coverage. In the 1990s and 2000s, the state played a leading role in expanding public health insurance coverage to more individuals who could not otherwise afford it. The state’s elected officials also protected Wisconsin’s popular state Medicaid prescription drug plan at a time when other such plans around the country were being shut down in the wake of a prescription benefit being added through the federal Medicare Part D plan. In many respects, Wisconsin has been a leader among states in ensuring access to coverage for low-income and vulnerable populations.
With the passage in 2010 of the federal Affordable Care Act (ACA) and the expansion nationally of Medicaid health programs for low-income recipients, Wisconsin has fallen out of the vanguard but remained out of the ordinary. Today, Wisconsin is one of just three states outside of the South that have not fully expanded Medicaid – a source of pride for the opponents of expansion, consternation for its supporters, and perpetual conflict for both.
Given the many national developments on this issue, now is an opportune moment to revisit it in Wisconsin. With support from the American Cancer Society Cancer Action Network, The Leukemia and Lymphoma Society, Community Care Inc., Jewish Family Services, Lutheran Social Services of Wisconsin and Upper Michigan, and the Wisconsin Medical Society, we examine here the history of Medicaid in our state and the possibility of extending the health program to tens of thousands of additional recipients. Our research questions include:
- What has been the history of the Medicaid program in Wisconsin – both before and after the passage of the ACA? What are the characteristics of those already being served by the program?
- Who are the individuals who would benefit from a potential Medicaid expansion? Where do they live and what are their characteristics?
- What are the potential impacts of expansion in Wisconsin and how might they differ from other states? What would be the impact of maintaining the status quo?
- What lessons can we learn from other states and how they have expanded their programs?
- What are options for pursuing an expansion in Wisconsin, if policymakers choose to do so?
As with all our reports, in this study we neither advocate for or against expanding Medicaid. We have striven to do more than simply recapitulate the heated national debate on this topic that often fails to address the unique circumstances here in Wisconsin. Instead, we have sought to approach the topic with a steadfast focus on our state, its particular features, and its full range of stakeholders including patients, health care providers, insurers, and taxpayers. We hope that this study will serve the public and leaders from across the political spectrum as they consider how to proceed.