While much media coverage has been rightly given to Gov. Scott Walker’s decision to defer to the federal government regarding health insurance exchanges under the Affordable Care Act, I’m concerned that there is virtually no conversation on another major issue of this legislation — expanding BadgerCare in Wisconsin.

I have worked in health care my entire professional career, often serving people who seek care and do not have insurance. Frequently these people work two or three jobs, none of which offer insurance, or lose their jobs because of illness or some event over which they have little or no control.

Whether they lose insurance or never had it, Medicaid is an important safety net.

Walker has not yet announced whether he will support eligibility expansion of BadgerCare, but he should.

It’s estimated that accepting federal Medicaid revenue from the Affordable Care Act could save Wisconsin’s economy

millions of dollars, allow 211,000 low- to moderate-income citizens access to BadgerCare, create jobs in the health sector and prevent increased taxes on Wisconsin businesses.

(16) comments


Good letter and excellent point. A universal single-payer plan would be better, but the ACA is the best we have to provide wider healthcare coverage to the most citizens and, as the Congressional Budget Office says, actually save money. Those who subscribe to "let everyone take care of him or herself" -- do away with Medicare, Medicaid and SS rugged individualism can always refuse to pay their federal taxes and pay out of pocket for all medical expenses; then, when they are bankrupt and in the final days do what Inuit elders used to do; lay down on an ice floe in the Big River and drift away.


great; the Inuit's have the right idea. Beats laying in a nursing home kept alive for what reason? So, your family can visit you once in a while and make themselves feel good? End of life is just that; the end of your life, why prolong the agony? If there is a reasonable chance of recovery to lead a somewhat normal (for your age) life, then treat me through medicare/ medicaid by all means' if not, let me go. I would prefer to die sitting on a stump in my beloved woods and marsh than lay for weeks/ months/ years in a care center. Just my humble opinion.

The Veteran

lostinparadize Could not agree more,well said. You have a good day!

Seven Reasons States Should Just Say No To Medicaid Expansion

1. Medicaid Is Bad Coverage — Medicaid is the worst health insurance coverage in the country, and yet ObamaCare did nothing to fix its many problems. Take access to physicians. The Texas Medical Association published a survey showing that the number of Texas doctors willing to accept new Medicaid patients has declined from 42 percent in 2010 to 31 percent in 2012, in large part because Medicaid pays doctors so little. For various reasons Medicaid beneficiaries often go to the emergency room instead of a family doctor. In addition, Medicaid drug formularies limit the poor’s access to many beneficial drugs.

The problem highlights a serious misunderstanding among Democrats pushing the legislation: Access to health insurance is not the same as access to health care. ObamaCare goes to great strides, and even greater expense, to ensure people have coverage. That does not mean they will be able to get care.

While Medicaid is better than having no insurance, expansion only exacerbates Medicaid’s many problems. Coverage for the poor should not be synonymous with poor coverage.

2. The Exploding Medicaid Population — Medicaid currently covers more than 70 million Americans, and ObamaCare increases that number by an estimated 17 million almost immediately.

In addition, those designated as disabled are eligible for Medicaid, and that population has grown at unprecedented levels since Obama became president, from 7.5 million to 8.8 million.

Since Medicaid is a welfare program, ObamaCare becomes the biggest expansion of the welfare state since Lyndon Johnson’s War on Poverty. And considering the growing numbers, we apparently lost that “war.”

3. The Woodwork and Crowd-Out Effects — Those Medicaid growth projections are likely low, as eligible people “come out of the woodwork” to join the program. For example, an estimated 25 percent of the uninsured are eligible for Medicaid but not enrolled.

More importantly, employers with a large number of low-income workers who offered some type of basic coverage may drop it or shift some employees to part time, making them eligible under Medicaid’s new eligibility standards. That’s known as the “crowd-out effect.” Wal-Mart, the country’s largest employer, recently announced that it would take that step. And a small number of low-income workers buy their own coverage. They will likely drop it and shift to “free” Medicaid.

4. The Cost to State Budgets — Medicaid spending has been growing at about 8 percent a year, compared to economic growth of 1 percent to 2 percent. But ObamaCare puts Medicaid on growth hormones. Total Medicaid spending (state and federal) is projected to grow from about $400 billion to about $900 billion by 2020.

At 23.5 percent, Medicaid has become the biggest budget item for most state budgets, surpassing K-12 education. We are already at the point where other state priorities are suffering because of money being sucked up by Medicaid; and that problem will only get worse.

Expansion advocates claim that the federal government will absorb most of the cost of the newly eligible Medicaid enrollees—100 percent for a few years, dropping to 90 percent by 2020. That’s much larger than the average 57 percent share the federal government now pays. What a deal!

But those advocates sound like the spendthrift spouse after a shopping spree who boasts about all the money that was saved; what the fiscally responsible spouse wants to know is how much money was spent. Expanding Medicaid will still cost states billions of dollars, even at the reduced state share. And taxpayers are still paying for the coverage; the taxes—actually, borrowed money—are just coming from the feds rather than the state.

5. Federal Controls — While a bipartisan coalition of governors has asked Washington for more flexibility over their Medicaid program; ObamaCare doubles-down on federal control. If states thought federal mandates and restrictions were suffocating under traditional Medicaid, they will be gasping for air under the expanded portion.

6. Rampant Fraud — Medicaid fraud is rampant and will only get bigger under expansion. No one knows for sure how big the Medicaid fraud problem is, but estimates put it in the range of $60 billion a year.

For example, Texas spent $1.4 billion on Medicaid pediatric orthodontics—more than every other state combined! Some unscrupulous dentists have been making millions of dollars putting braces on low-income children’s teeth who did not need the work. But it wasn’t the state or federal government that identified the scam; it was the Dallas-based ABC affiliate.

States have been rapidly shifting their Medicaid populations to private sector managed care companies, which helps to reduce costs and fraud. But the government has yet to figure out how to cut the waste, fraud and abuse.

7. Loss of State Sovereignty — Medicaid is supposed to be a federal-state program. But the Medicaid expansion is one more effort by the federal government to micromanage the states and what they do. That effort is fundamentally breaking down our federalist system, a system in which the federal government has its sphere of authority, as do the sates—and individuals, for that matter.

Democrats claim that Republicans should work with them to implement the Medicaid expansion. But the time for “working together” was when the legislation was crafted, and Democrats rejected that option. Considering all the problems that will come with Medicaid expansion, states would be wise to reject it now.


NO He should NOT. Badger Care should NOT be expanded under any circumstances.


There should be NO Badger Care or any other other government funded health care. Get off your duff and get a job - pay for your own care. Retirees - if you werent smart enough to put money away you can go without as well. Why should working taxpayers pay for their own care plus that of people too lazy to get a job ?


I'm not a fan of expanding badger care, and perhaps there is a good argument to get rid of it entirely.

But, as far as Retirees go, I don't think you can say, you're on your own. Decades ago, Insurance companys would LITERALLY RAPE their seniors with outrageous premiums. They knew that these customers could not find coverage anywhere else, and so they were considered captive customers. I think profit is important but not off the backs of seniors. So programs to cover them in their later years are needed and beneficial.


"Retirees - if you weren’t smart enough to put money away you can go without as well."

That is so dumb. If seniors didn't have Medicare they would still be treated in hospitals and the cost would be passed onto all of us. Leave the seniors alone. AND you say there should be no "government funded health care” so we send our limbless veterans home and drop them on their doorstep and not give them the treatment they deserve? You are something else.


Time for a true nationalized health care system: Medicare for everybody. The states are too mired in right-wing ideology to care about people dying from lack of proper health care.

We spend public money on football stadiums, on corporate-welfare TIFs for rich locals... we spend trillions on corporate welfare nationwide, therefore we've got the wealth to spend on our citizens' health too.

Why is spending public money on rich people not taboo while spending it on ordinary people is considered shameful?

"AIG, saved by US bailout, now considers suing US government"

"AIG may join a lawsuit alleging that the terms of the US government bailout were unfair to investors, but such a move risks infuriating the taxpayers whose money saved it from ruin."


Seven Reasons States Should Just Say No To Medicaid Expansion


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