Everything Wisconsin needs to know about Trump’s cuts to Medicaid and BadgerCare

BadgerCare is what Wisconsin calls its Medicaid program, so let’s learn why Medicaid is so important to more than 1 million people in the state and what Trump/Republican budget cuts would do to it.

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If you are not familiar with Medicaid, it may be because you get your health insurance through your job or you’re fabulously wealthy. In either case, congratulations!

For roughly 1.3 million people in Wisconsin, that’s not the case. They know a thing or two about Medicaid because it’s the only way they can have stable and affordable healthcare coverage to prevent illnesses, treat injuries, and other address maladies that can bankrupt someone without insurance.

Despite Medicaid’s success and the ongoing need to provide coverage for constituents, President Donald Trump and congressional Republicans want to make drastic cuts to its programs to offset the cost of massive tax cuts for corporations and the very wealthy. 

Why? Let’s break it down.

What is Medicaid?

Medicaid is healthcare coverage provided by the federal and state governments when the private sector can’t or won’t cover some Americans. Without Medicaid, these folks often put off necessary care in order to avoid sky-high medical bills. Some get much sicker than they would have if they’d had coverage. Others would die. People who try to go without health insurance can rack up big emergency bills that they can’t afford and don’t pay. Healthcare providers then have to make up for that uncompensated care by raising prices for everyone else who can afford their coverage. Covering more Americans is common sense fiscal policy.

Medicaid is also used to cover long-term care for older adults and people with disabilities. Altogether, about 83 million Americans rely on some form of Medicaid to ensure they get care.

What is BadgerCare?

Medicaid coverage is primarily funded by the federal government (65% in Wisconsin), but it is administered at the state level. Many states choose to give their unique programs their own branding. In Wisconsin, it’s called BadgerCare. In Indiana, it’s called Hoosier Healthwise. In Oklahoma, it’s SoonerCare. You get the idea. The federal government sets minimum eligibility and coverage standards, then each state determines how it will tailor the program to the needs of its people, its providers, and its state budget. 

Didn’t the Affordable Care Act Ensure Universal Coverage?

No, and it was never meant to cover every American. For that, you would need “universal coverage”—something offered in many other countries, but not here. The Affordable Care Act (ACA, sometimes referred to as ObamaCare) was designed for—and has succeeded at—greatly reducing the number of uninsured Americans by offering financial assistance to purchase coverage from private sector insurers through an online marketplace. 

There were 45 million uninsured Americans when the ACA marketplace ramped up operations. By 2022, the number fell to 26 million. This increase in coverage has led to improved health outcomes and massive savings, as expected.  

But many Americans are trapped in gaps. For example, their incomes, while meager, may be too high to qualify for Medicaid, but are low enough to make ACA premiums out of reach even with financial assistance. Republicans have consistently refused to make improvements to the ACA that would close those gaps and allow more people to buy coverage from private insurers in the marketplace.

So Who’s on BadgerCare?

KFF (formerly the Kaiser Family Foundation) used state data to determine there are 1,278,000 children and adults using Medicaid services in Wisconsin. BadgerCare covers 35% of all births in the state, 55% of Wisconsin’s nursing home residents, and nearly half of all working-age adults with disabilities. 

Is Medicaid a Form of Welfare That Lets People Not Work?

Hardly! Three-fourths of Medicaid adults are currently working! The others fall into several categories: they’re sick or disabled, they are caregivers for someone else, or they’re furthering their education. 

Why Do Republicans Insist They’re Not Cutting Medicaid?

Using the well-worn claim that they’re fighting waste, fraud, and abuse, Republicans have written legislation that increases the Medicaid work requirements. State-level experiments have found these requirements to be nothing more than intentional hurdles. The recipients already working find themselves filling out more and different forms. Their coverage is at risk of being cut off for missed deadlines or for arbitrary reasons. 

In short, the work requirements don’t work. But if deserving recipients lose their coverage or walk away from it because of the frustration, politicians can claim they weren’t the ones who actually cut off their coverage.

What’s Next?

President Trump is trying to pass the entire federal budget in one “big, beautiful bill” as a way to get around a more deliberative process in Congress, where budgets are usually broken up into smaller, more manageable pieces. House Republicans passed a single-bill budget by the narrowest possible margin and sent it to the US Senate, where there is genuine division among GOP senators. 

Some, like Sen. Ron Johnson (R-Wisconsin), want even more cuts to Medicaid and other services to fund tax cuts. Others recognize the political peril of cutting healthcare coverage for the people who got them elected. 

The bill faces a rough road as more people learn about what’s in it. In Wisconsin, for example, the cuts to Medicaid coverage and to benefits in the Affordable Care Act could strip health insurance from 82,000 people, while another 235,000 would see their premiums rise, leading some of them to become uninsured. Under the bill, an estimated 144,000 Wisconsinites would also be at risk of losing food benefits through SNAP, the Supplemental Nutrition Assistance Program that covers 12% of the state’s population.

But at the heart of it all are the cuts proposed for Medicaid, which, next month, will mark its 60th anniversary of improving the lives of tens of millions of American children, giving workers the stability to stay in the workforce, and saving taxpayers from the costs of uncompensated care, more sick days, and lives lost to preventable illnesses. Not that every member of Congress appreciates that.

Confronted with the knowledge that cutting Medicaid would lead to premature deaths, Sen. Joni Ernst (R-Iowa) could only scoff.“Well,” Ernst remarked bluntly, “we’re all going to die.”