A new report released Wednesday by the Wisconsin Institute for Law & Liberty warns that expanding Medicaid in Wisconsin could lead to higher costs and reduced quality of care, challenging Governor Tony Evers’ push for the policy.
The report, titled “Wisconsin & Medicaid Expansion: A Prescription for Failure,” argues that while the policy offers short-term financial incentives, “the long-term fiscal and systemic costs outweigh these benefits.” It arrives as debates over Medicaid expansion intensify in states that have yet to adopt it under the Affordable Care Act.
“Expanding Medicaid is a Trojan horse for higher costs without the promise of improved care,” said Miranda Spindt, policy associate at WILL. “Wisconsin would be better off finding ways to lower health care costs by reducing government intervention, and by allowing innovation to improve the quality of care for all Wisconsinites.”
The analysis points to several potential downsides. It finds that “Medicaid expansion is positively correlated with higher per capita healthcare expenditure,” with expansion states spending an average of $215.59 more annually per person—a 2.1% increase compared to non-expansion states like Wisconsin.
Access to care could also suffer, the report suggests. “There is also no guarantee that Medicaid recipients will receive the care they need,” it states, noting that 96.1% of doctors accept new private insurance patients, while only 74.3% accept new Medicaid patients. This gap, WILL argues, could shift people from private insurance to Medicaid, potentially worsening health outcomes.
The report also highlights a shift in priorities, claiming that “expansion states have shifted spending away from children, the elderly, and the disabled in favor of childless adults,” spending a third less on these vulnerable groups compared to non-expansion states.
Fiscal risks loom large as well. With federal deficit reduction efforts underway, the report warns that “the current 90% match could drop to 60%, leaving Wisconsin responsible for an estimated $285 million in new costs.” It also cites rising improper payments in expansion states, growing from $35 billion in 2018 to $90 billion in 2020, a figure likely to increase as more data emerges.
WILL concludes that “Medicaid expansion, often touted as a solution, is just not right for Wisconsin,” especially given the state’s relatively low uninsured rate. The organization hopes the findings serve as “a warning to policymakers looking for actual solutions to Wisconsin’s health care problems.”
Evers has long advocated for Medicaid expansion, arguing it would extend coverage to more low-income residents and bring in federal funds. Wisconsin is one of 10 states yet to fully expand Medicaid under the ACA, though it provides partial coverage up to 100% of the federal poverty level without the enhanced federal match.
Republicans have resisted expansion.
