Why one state lawmaker continues to fight to expand health care coverage

Wisconsin is one of 10 states that haven't accepted a full expansion of the Medicaid program offered by the federal government. Photo courtesy Shutterstock

By Salina Heller

May 13, 2024

Affordable, comprehensive health care coverage is the most important protection against medical debt. The biggest gaps of coverage remain in states that have chosen not to expand Medicaid. Wisconsin is one of those states.

“Democrats don’t think anyone should have to choose between paying medical bills or paying rent or putting food on the table,” Rep. Daniel Riemer said.

Over the last decade, Rep. Riemer, a Democrat from Milwaukee, is used to laying out his argument for expanding BadgerCare, which is Wisconsin’s version of Medicaid. After all, he’s introduced plenty of plans to expand the program since he’s been elected.

“These arguments have failed to persuade Wisconsin Republicans in the 15 years since the Affordable Care Act was passed,” he said. “Believe me, I know.”

“I have authored and introduced legislation to expand BadgerCare every session since I was first inaugurated in 2013. Republicans have rejected the proposal every single time.”

Wisconsin is missing out

In 2010, President Obama set in place a way for people to have secure, stable, and affordable health insurance. The Affordable Care Act (ACA) ushered in the biggest health insurance coverage expansion in the US health care system since the creation of Medicare and Medicaid in 1965.

People without health insurance are a lot more likely to end up with significant serious medical debt—it’s the nature of what health insurance is for—it’s to prevent you from the major fiscal financial shock of a medical bill,” Riemer said.

Under the ACA, Medicaid expansion extends health insurance coverage to nearly all adults with incomes up to 138% of the federal poverty level, and President Joe Biden’s administration is providing enhanced funding to help cover new populations of parents, caretakers, and other adults without dependent children.

In Wisconsin, Medicaid expansion would give affordable access to an estimated 90,000 additional people and generate an estimated $1.6 billion in medical savings. It’s up to each state to decide if they want to opt in or leave the money on the table. Wisconsin is one of only 10 states that have not opted in. Republicans have controlled the state Legislature during all of that time.

This has been absurd!” Riemer said. “We could have done this sessions ago.”

“The state of Wisconsin missed out on billions—literally billions of dollars because of an ideological opposition, in particular from the [Assembly] Speaker [Robin Vos] who characterizes Medicaid expansion as welfare.”

Benefits for Wisconsin’s residents

After having argued about why BadgerCare expansion is right for Wisconsin over the course of six legislative sessions, Riemer is well-versed in his points. He said the 40 states that have chosen expansion have seen lower maternal mortality rates. They also have increased early-stage cancer diagnoses and improved health outcomes in everything from depression to diabetes.

And he said, “There’s widespread long-term benefits of increased access to preventative care, such as early screenings and regular immunizations, that expanding BadgerCare would offer to Wisconsinites.”

Riemer recently announced he isn’t running for re-election for another term, but he said he’ll continue to advocate for this expansion because it’s too important for the state.

“So people don’t have to sell their home or do something more drastic to try and get out of medical debt,” Riemer said. “Do you want people to have a future?”

“All of us are well-served by expanded coverage because we all are better off when people are healthy and people are financially secure.”


RELATED: What you need to know about medical debt in Wisconsin


  • Salina Heller

    A former 15-year veteran of reporting local news for western Wisconsin TV and radio stations, Salina Heller also volunteers in community theater, helps organize the Chippewa Valley Air Show, and is kept busy by her daughter’s elementary school PTA meetings. She is a UW-Eau Claire alum.



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