Governor Scott Walker is rejecting a full expansion of Medicaid. Instead, Wisconsin will tighten up eligibility for the program. The expectation is that 87,000 current Medicaid recipients will get private insurance on a federal exchange.
Governor Walker is forgoing additional federal dollars for Medicaid expansion, instead deciding to use state money for only a partial expansion that will bring in fewer dollars from Uncle Sam. Wisconsin's Health Secretary Dennis Smith says there are concerns about the federal government's promise to fully fund the program the first 3 years, and then at 90 percent after that. "What the governor did was, I think, a bold decision to chart Wisconsin's course for itself and not be subject to uncertainty and changes in Washington."
Supporters of expanding Medicaid call the governor's argument about potential federal funding uncertainty a "smokescreen." Families USA director Ron Pollack says if Governor Walker is truly worried about future funding, he could opt out of Medicaid expansion at a later date.
"He could say, 'I'm just making a commitment for the first 3 years. I'll look at circumstances later on and make another decision. Additionally the governor could say, 'I am opting in to this expansion but if there is a modification of the federal government's generosity I'm going to withdraw the state's involvement in this expansion.' He could say exactly what Arizona Governor Jan Brewer said."
Arizona is one of 6 states with Republican governors that has decided to voluntarily expand Medicaid under the Affordable Care Act, even though they opposed health reform in general.