The Wisconsin Hospital Association traveled to Washington, D.C. Thursday, February 2 for a round of meetings with Wisconsin’s congressional delegation. The sole purpose for the trip was to advance the Wisconsin perspective on changes to the Affordable Care Act and what those mean for Wisconsin’s patients and providers.
“This is about treating Medicaid expansion and non-expansion states in an equitable manner,” Eric Borgerding, WHA president/CEO said in several of the meetings. “Our request is that Wisconsin’s so-called ‘partial expansion’ of Medicaid, which added nearly 130,000 childless adults at a cost of roughly $280 million in state dollars, also receive enhanced federal matching dollars.”
At issue with proposals to repeal and replace the Affordable Care Act, as Borgerding discussed in all the meetings, is the unique route Wisconsin took to reduce its uninsured by some 38 percent since 2013. This was accomplished by Gov. Scott Walker and the Wisconsin Legislature through an interconnected approach whereby individuals below 100 percent of the federal poverty level (FPL) became eligible for Medicaid coverage, and individuals above 100 percent of the FPL were moved off Medicaid and onto the federal health insurance Exchange. This approach has allowed over 130,000 individuals to gain Medicaid coverage and 235,000 more individuals to access affordable coverage now on the federal exchange.
Because Wisconsin took a “partial” approach to Medicaid expansion—moving eligibility to 100 percent FPL rather than 138 percent—the Obama Administration denied Wisconsin the same level of Medicaid funding that other “full expansion” states received.
“Wisconsin clearly, and substantially, expanded Medicaid,” Borgerding said. “As Congress moves forward, all we’re asking for is recognition for what we did here and to be treated fairly.”
This matters significantly in the larger picture of how Congress may potentially reform the Medicaid program and how baseline Medicaid funding amounts may be determined.
Also during the meetings WHA highlighted the fact that 235,000 Wisconsinites now access affordable coverage on the federal exchange, with roughly 85 percent receiving a subsidy to reduce their premium costs. Preserving premiums assistance for lower-income populations has been an integral component of Wisconsin’s hybrid approach to expanding coverage. Preserving these subsidies will be critical to sustaining the coverage gains achieved in Wisconsin. WHA also discussed the value-focused payment reforms that are a part of the ACA and the impact those have had in moving both Medicare and commercial health insurance toward more outcomes-focused reimbursement.
“We greatly appreciated the opportunity to meet with Speaker Ryan and our Congressional Delegation on these important matters,” Borgerding said. “Our issues and our messages were well received, it was a productive trip and the latest of what I am sure will be many more to our Nation’s Capital in the coming months as we advocate on behalf of Wisconsin’s hospitals and health systems.”