Will Wisconsin see BadgerCare expansion in 2025?

The state’s legislative leaders are outlining their priorities ahead of the next legislative session, but questions remain over Medicaid expansion.

Wisconsin Republicans have held gerrymandered control over the state legislature for over a decade, during which they blocked Medicaid (also known as BadgerCare) expansion – a move that could save the state billions of dollars and provide stable health insurance to tens of thousands of families. 

But when the legislature kicks off the new session in January, they’ll be doing so with fewer Republicans in tow – a result of the fall’s election with more representative maps. 

Many will be watching to see if the change in representation leads to more compromise in the Assembly and Senate, which could yield movement on Medicaid expansion, as has been done in 40 other states, including many with Republican majorities who voted to accept the federal funds that let them cover more people.  

But during a WisPolitics luncheon previewing the upcoming session and state budget, BadgerCare expansion appeared to be low on the list of priorities for Senate President Mary Felzkowski (R-Tomahawk). 

“Why would we take people off of private insurance to put them on government insurance and put our hospitals, who are already suffering, into a worse position with a lower reimbursement rate,” Felzkowski said.

Private insurance may not be working for Wisconsinites, however. 

Assembly Minority Speaker Greta Neubauer (D-Racine) shared, “We know some people that are able to stay on private insurance, but it is a huge strain on their families and they frankly are not able to afford it. They are cutting in other areas to be able to afford insurance.”

Neubauer added, “We should continue to invest in healthcare, including raising [Medicaid] reimbursement rates for hospitals.”

According to a 2024 report from the nonpartisan Wisconsin Policy Forum research group, expanding BadgerCare during the next biennium state budget could save taxpayers $1.7 billion. The cited savings include a $1.3 billion federal sign-on bonus, designed to raise the reimbursement rate that Medicaid pays healthcare providers. 

Not only can Wisconsin taxpayers benefit from expansion, but in those 40 states that have expanded Medicaid through the Affordable Care Act, uninsured rates have dropped, leading to documented improved health for residents.

There may be another factor to this debate however: the incoming Trump administration.

“What if under the Trump presidency along with Congress, decide to turn it into a block program?… Every state that has adopted [Medicaid expansion] is going to have to revamp the entirety of their program, ” said Keith Gilkes, Republican strategist and former chief of staff to former Gov. Scott Walker.

“You have a Department of Government Efficiency headed by Elon Musk and Vivek Ramaswamy,” Gilkes told the WisPolitics forum audience. “And you don’t know what’s coming out of that, and you don’t know what of that is going to pass. It could be significant reform.”

The unknown could ultimately lead to “some bigger conversations than we ever expected in ‘25 and ‘26,” said Gilkes. Though to this point —and for the entirety of Trump’s political career— the once and future president has repeatedly promised but never presented an actual healthcare plan to replace the Affordable Care Act or a reform of Medicaid that keeps coverage and costs the same or better. Trump has only claimed to have “concepts of a plan.”