3 ways Medicaid expansion would help Wisconsin families

Expanding Medicaid in Wisconsin would allow tens of thousands of people to gain health care coverage, and would help alleviate hospital closures as well as address staffing shortages.

Over the last decade, Wisconsin Republicans have blocked Medicaid expansion time and time again. 

Blocking Medicaid expansion–known in Wisconsin as BadgerCare–means the state has been missing out on billions of dollars that could have been used to provide more stable health insurance to Wisconsinites that have no access to affordable coverage through their employer.

Things may be changing, however. 

Former State Senator Janet Bewley (D-Bayfield) told UpNorthNews last month that expansion could be possible now thanks to the state’s new legislative maps—voters could finally oust the Republican majority. Assembly Minority Leader Greta Neubauer (D-Racine) has also said that expanding Medicaid is one of the top priorities of Wisconsin Democrats.  

So, what exactly would expanding Medicaid mean for Wisconsin’s families? Here’s what you need to know. 

Tens of thousands would gain health care coverage

To date, Wisconsin remains one of only 10 states that have not expanded Medicaid under a provision made available through the Affordable Care Act (ACA), according to the Kaiser Family Foundation. 

The ACA expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level. For an individual living in 2024, that’s $20,783 per year.

As such, enrollment in Wisconsin’s current Medicaid program stands at 1.47 million. According to a May 2023 survey, an estimated 372,636 Wisconsin residents were uninsured for at least part of the year–that’s about 6.5% of the state’s population. 

According to last year’s Wisconsin Consumer Healthcare Experience State Survey, 81% of Wisconsinites worry they won’t be able to afford their health care costs. Nearly half of all uninsured respondents cited the cost of insurance as their primary reason for lack of coverage. Of those that did receive care, 39% struggled to pay the associated costs. This led to depleted savings accounts, maxed out credit cards, and forgoing key necessities such as heat and food.

“The survey data should be a wake up call to state policy lawmakers who have not prioritized reforms that would slow the health care cost crisis gripping Wisconsin,” Executive Director of Citizen Action Robert Kraig told The Daily Cardinal last year. 

Research has shown that “expanding Medicaid helps low-income families’ health and financial well-being.” This is because “physical health and financial health are inextricably linked.” Because expanding the program would make it easier for these families to afford care, both their bodies and pocketbooks would feel some relief. 

Would help alleviate hospital closures

Although rural hospital finances improved during the COVID-19 pandemic as a result of government relief funds, they’ve begun to struggle again as those funds have gone away. 

In fact, more than 600 rural US hospitals are at risk of closing due to financial instability, according to the Center for Healthcare Quality and Payment Reform. That’s more than 30% of the entire country’s rural hospitals.

Just this past March in Wisconsin, two hospitals that served their respective communities since the 19th century closed their doors due to financial challenges: Sacred Heart Hospital in Eau Claire and St. Joseph’s Hospital in Chippewa Falls.

According to data from the Wisconsin Office of Rural Health, over 250,000 Wisconsinites now live beyond 15 miles from the closest hospital. Local officials said that these most recent closures would make it more difficult for patients like these to access care. 

Research has shown that expanding Medicaid, however, reduces hospitals’ uncompensated care and thus could keep more hospitals open. 

The medical community has traditionally used the term “uncompensated health care” to describe one of two things: “charity care,” also known as community or indigent care, and “bad debt.” The former refers to care for which a hospital does not expect payment because it’s been determined that the patient simply cannot afford the care they need; in other words, the hospital writes off the bill. 

While this helps patients in the short-term, hospitals take a loss whenever they write off a bill, making them all the more likely to close. If Medicaid were expanded in the state of Wisconsin, hospitals will by default be providing less uncompensated health care since patients would be more able to afford their bills. 

For example, after Michigan expanded its Medicaid program in 2014, uncompensated care was cut in half. The same could happen in Wisconsin. 

Would help address staffing shortages

In addition to financial challenges that have made it all the more difficult to keep hospitals in rural areas open, the health care field has been dealing with an unprecedented outflux of employees in the past several years. 

By the end of 2022, a total of 145,213 health care providers and 34,834 nurse practitioners left the profession nationwide. According to a report from the Wisconsin Hospital Association (WHA) released earlier this year, the state continues to need many more nurses and health care professionals than are currently working. 

“We have to grow our workforce faster,” Ann Zenk, WHA senior vice president for workforce and clinical practice, told the Wisconsin Examiner earlier this year. Without new policy interventions inside the industry as well as outside it, “it is not going to grow fast enough to keep up with the increasing health care demand.” 

One of those policy interventions could be expanding Medicaid.

According to a study published in Health Services Research, a medical journal, Medicaid expansion has in the past been “associated with gradually improved…nurse staffing ratios and hospital‐wide readmission rates.” 

Medicaid expansion has also been “associated with improved access to outpatient and preventive care and self‐reported quality of care.” Plus, high nurse staffing ratios have been “associated with shorter length of stay and lower rates of adverse outcomes.”