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The State Health Plan currently covers over 720,000 members. The State Health Plan currently covers over 720,000 members.

The State Health Plan currently covers over 720,000 members.

Eric Litke
By Eric Litke November 20, 2018

U.S. Rep Gwen Moore correctly says that fewer are insured after Medicaid expansion turned down

Outgoing Republican Gov. Scott Walker has drawn repeated fire from Democrats for turning down a Medicaid expansion in 2014.

With Democrat Tony Evers poised to take over the governor’s mansion, U.S. Rep. Gwen Moore said in a Nov. 8, 2018 interview that she expects Wisconsin will now take those federal dollars. And she expanded on a common claim about the cost of Walker’s decision.

"We have lost over $1 billion in not taking the Medicaid expansion money, only to insure fewer people," Moore said in an the interview on Milwaukee’s WTMJ-TV (Channel 4).

So the Milwaukee Democrat says the decision not only cost Wisconsin $1 billion, but it resulted in fewer people being insured.

We’ll dig into both points.

Walker declined $1 billion in federal funds

We checked a similar $1 billion claim in June, when then-gubernatorial candidate Dana Wachs said Walker "has turned down $1 billion of Medicaid money." We rated that Mostly True.

That item examined an April 2017 memo from the Wisconsin Legislative Fiscal Bureau, which detailed the federal funds Wisconsin could have received if the state did a full Medicaid expansion in April 2014.

Under that expansion, anyone earning up to 138 percent of the federal poverty level would have been eligible for Medicaid. Wisconsin would have gained enough additional federal funding to reduce state spending an estimated $1.07 billion on Medicaid from 2014 to 2019, according to the fiscal bureau memo.

But since that period has not yet ended, the state has not yet missed out on the full $1 billion.

With seven months remaining in the 2018-’19 fiscal year, about $114 million of that has not yet been "lost," said Jon Dyck, supervising analyst at the fiscal bureau. He noted, though, that it’s not really possible  to "un-lose" that money at this point since the state would be unlikely to reverse that policy by the end of the fiscal year.

Walker, who has criticized the full expansion as essentially a new form of welfare, did institute a partial Medicaid expansion, so for the first time everyone in Wisconsin living below the federal poverty level was eligible for Medicaid.

(As an aside, we should note the Medicaid coverage limit in various publications is reported as 133 percent or 138 percent of the federal poverty level. The official limit is 133 percent, but there is a 5 percent "disregard," which means the functional limit is 138 percent, so that is how we’re referring to it.)

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Medicaid move decreased number of people covered

The second part of Moore’s claim is that the decision to pass on the full Medicaid expansion caused the state "to insure fewer people."

The Wisconsin Department of Health Services found nearly 63,000 adults lost their coverage that year through BadgerCare Plus, which administers Medicaid in Wisconsin.

The agency attempted to track the insurance status of those adults and could establish that 58 percent of them obtained other insurance coverage or regained BadgerCare coverage. Most of the rest — about 26,000 — were presumed to be uninsured.

The state’s nonpartisan Legislative Fiscal Bureau has also analyzed the impact a change would have today.

If Wisconsin accepted the Medicaid expansion now — increasing the allowable threshold in the state from 100 percent of the federal poverty level to 138 percent — the number of childless adults and parents enrolled in BadgerCare would grow an estimated 25 percent, or by about 70,000 people, the agency said.

Dyck said it’s reasonable to assume a good number of those new enrollees would be moving from uninsured to BadgerCare, given the number of people near poverty who are uninsured.

The U.S. Census Bureau’s 2017 American Community Survey estimated 38,000 people are uninsured in Wisconsin and have an income between 100 percent and 138 percent of the federal poverty level.

Those are the people not currently covered by BadgerCare that would be covered if Wisconsin accepted the Medicaid expansion.

Our rating

Moore said Wisconsin has "lost" over $1 billion from Walker’s decision to turn down the full Medicaid expansion and that Wisconsin is insuring fewer people as a result.

That figure is based on an estimate that runs through 2019, so the actual funds missed have not yet topped $1 billion, though they’re not far off. And it’s not quite right to say Wisconsin "lost" the money — it just spent that much more due to not receiving federal funds.

Meanwhile, a state study confirmed that fewer people were being insured after the 2014 decision. And to add additional support, it’s clear more people would be covered if Governor-elect Evers were to accept a Medicaid expansion in the future.

We rate Moore’s claim Mostly True.

Our Sources

Email exchange with Libbie Wilcox, spokeswoman for U.S. Rep. Gwen Moore, Nov. 15-16, 2018

Email exchange with Jon Dyck, supervising analyst, Legislative Fiscal Bureau, Health Services and Insurance division, Nov. 15-20, 2018  

WTMJ-TV, Congresswoman Moore talks about her plans as Democrats prepare to take control of the House, Nov. 8, 2018

Kids Forward, The Wisconsin Approach to Medicaid Expansion, December 2017

Interview with Jon Peacock, research director, Kids Forward, Nov. 19, 2018

Wisconsin Legislative Fiscal Bureau, Medicaid expansion memo, April 3, 2017

U.S. Census Bureau, 2017 American Community Survey, accessed Nov. 19, 2018

PolitiFact, How Scott Walker's rejection of Medicaid expansion under Obamacare cost Wisconsin $1 billion, June 15, 2018

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U.S. Rep Gwen Moore correctly says that fewer are insured after Medicaid expansion turned down

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