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Shell game with OUR state budget very confusing! Part I - Medicaid.

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John Eyster
June 5, 2013

Shell game with OUR state budget very confusing!

I have been trying to sort through the decisions made by the Joint Finance Committee of our WI State Legislature THROUGH LAST NIGHT. Can YOU figure out the SHELL GAME?

The budget manipulations of the JOINT FINANCE COMMITTEE of our WI state legislature which has been going on now for days, continued through last night. I see the situation as SHELL GAME/Timblerig/Three shells and a pea game. Have YOU been able to keep track of the dollars? I confess, in spite of close attention, I have NOT been able to keep track of the dollars! In fact, this morning, I am the MORE confused.

Just think: The Joint Finance Committee convened about 1:25ish early this morning! Do legislators make optimal decisions through an all-night session? Are legislators making these decisions in the DARK OF NIGHT to avoid the SUNLIGHT of transparency?

If you want to review the votes through last night, you can use this link to read Jason Stein’s “All Politics Blog” on the Milwaukee Journal Sentinel website posted at 3:48 am today, “Tax cut, voucher expansion clear hurdles on way to final vote.”

To my mind, some of the decisions are healthy public policy and others are unhealthy public policy. I would cite the shell game with the MEDICAID PLAN in WI as VERY EXPENSIVE for WE THE PEOPLE of WI! There is an ongoing NATIONAL discussion about the MEDICAID PLAN which is part of the Affordable Healthcare Act.

If you want to learn more about that national discussion, I suggest you read the article published by the Washington Post last Sunday, June 2, “GOP governors’ endorsements of Medicaid expansion deepen rifts within party.”

I noted that three Republican governors — Jan Brewer of Arizona, John Kasich of Ohio and Rick Snyder of Michigan — are trying to persuade their Republican-controlled legislatures to go along. The governors are unwilling to turn down Washington’s offer to spend millions, if not billions, in their states to add people to the state-federal program for the poor.

What about Scott Walker of Wisconsin? He has chosen to turn down the millions of federal dollars and increase the costs to WI taxpayers. And, last night, the Joint Finance Committee added $30 million of OUR WI TAXPAYER DOLLARS to help hospitals manage the costs of giving care to persons who need medical care and do not have insurance. HELP!

To gain information and perspective on the Committee’s action, I read Associated Press’ Scott Bauer’s article, “Committee Votes to Reject Medicaid Expansion” which I found online published by the Green Bay Press Gazette online.

The article provides the valuable perspective that ttwenty-four states have agreed to the expansion. Wisconsin is one of 15 states not planning on expanding, while another 11 have not yet made a decision. WHY NOT WISCONSIN?!

Jason Stein provided valuable analysis of the Medicaid plan for WISCONSIN in his article published by the Milwaukee Journal Sentinel last Saturday, June 1, “Unreasonable assumptions may threaten Medicaid plan.” I encourage you to read and evaluate it. Forewarned is forearmed!

Stein summarizes, “The Republican governor's plan for dealing with the looming federal health care law involves shifting nearly 90,000 people from the state's BadgerCare Plus program into a new federal online insurance marketplace, where the participants are supposed find replacement coverage. But a detailed analysis of the plan by the Legislative Fiscal Bureau finds that many of the people now receiving state Medicaid coverage would likely not buy the more costly insurance through the federal program."

He noted that GOP lawmakers were considering making state payments to some hospitals to help cover the costs of emergency room visits by the uninsured. They voted $30 million for that purpose during last night.

I continue to be baffled by Governor Walker’s ideological stance against the expansion of Medicaid under the Affordable Healthcare Act. Stein analyzes, “In doing so, Walker is passing up a federal offer that would allow the state to cover 84,700 more people in Medicaid than his plan and receive enough additional federal tax money over the next two years to boost the state budget by $119 million even after covering the cost of those additional people, according to the fiscal bureau. If the federal government delivers on its legal commitments, accepting the federal Medicaid expansion would save the state an additional $340 million through 2021, the fiscal bureau said.”

Stein notes, “Walker says he wants fewer people on government coverage and is concerned that the federal government won't be able to keep its commitment of the higher Medicaid funds over the long term.”

One gains political perspective as Stein writes, “Walker's plan has drawn loud criticism from Democrats but praise from GOP lawmakers who control the Assembly and in general support from Republicans in charge of the Senate.”

Very significant issues are raised by the Legislative Fiscal Bureau – the highly respected and credible NON-PARTISAN source of fiscal evaluations in our WI State Government – as reported by Stain, “The Legislative Fiscal Bureau analysis raises questions about that assumption. The report notes that the administration put in effect similar premiums last year for people in BadgerCare with slightly higher incomes.

“In the first month alone, nearly 18% of those BadgerCare recipients with the new premiums failed to pay them and were dropped from Medicaid, the fiscal bureau report found. In the light of that, the Walker administration's assumption ‘appears unreasonably optimistic,’ the report found.

“The state's Smith said that the projection by the Department of Health Services took into account factors not in play for the BadgerCare case such as the federal mandate that people purchase coverage and outreach efforts that will be conducted by the state and federal government.”

Stein continues to report on the Legislative Fiscal Bureau’s report, "’Taking all of the above information into account, we don't believe we will see as big a drop in those currently enrolled in BadgerCare Plus as we did when the policy changes went into effect in July 2012,’ Smith said.”

It is very important to note the report that Stein cites, “Rep. Jon Richards (D-Milwaukee), a member of the Joint Finance Committee taking up the Medicaid proposal Tuesday, said the fiscal bureau report revealed the problems with the governor's plan.

"’It just shows that the administration is living in a fantasyland that is going to result in fewer people insured, the state losing nearly $100 million and the hospitals seeing more people in the emergency room,’ Richards said.”

So, NOW, IF I UNDERSTAND THE SHELL GAME, WISCONSIN will NOT expand Medicaid coverage taking advantage of federal funding under the Affordable Healthcare Act and income eligibility for Medicaid has been INCREASED meaning that more people will be denied Medicaid coverage and the Committee spent $30 million of our WI TAXPAYER MONEY to help hospitals manage costs for these people denied Medicaid coverage who do NOT have healthcare insurance. What YOUR calculation?

Here we go…

Mr. E.



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