In his effort to be the "not Chris Christie" of the Republican 2016 race, Wisconsin Wisconsin Gov. Scott Walker is attempting to not expand Medicaid while still keeping the state's low income residents insured. In February, when he announced that the state plan to not accept federal funds to expand the program, Walker said the plan was "to get more people out into the workplace, more people covered when it comes to health care and fewer people dependent on the government, not because we've kicked them out, but we've empowered them to take control of their own destiny." The state's Republican-led legislature approved the budget in June.
So what's his game plan?
Currently, Wisconsin's Medicaid program — BadgerCare — accepts people making 200 percent of the poverty level, though the program caps how many people are in the program, creating a waiting list. Walker's plan undoes that cap, which will open up BadgerCare to 83,000 people, but he'll lower the income level to 100 percent of the poverty level, or $11,490. That kicks out 77,500 people, forcing them on to the exchanges.
The good news is that, unlike a few other states that declined to expand Medicaid, that 77,500 wouldn't be caught in the limbo of being too "well off" for Medicaid but too poor for subsidies on the exchanges.
Well that's good, right?
Kinda. The bad news is that's a lot of people who'll have to use the exchanges, a system that's not designed for people at their income level (they should be on Medicaid). Wisconsin will also bear the honor of having kicked more people off Medicaid that any other state in the country. Also, some estimate that Wisconsin would save $460 million between now and 2020 by expanding under Obamacare, but he could be president by then so what does it matter?
Walker, meanwhile, gets the best of both worlds. He's turning down taxpayer handouts from Big Government, while also keeping people insured. Walker also postponed the January 1 BadgerCare cuts and the close of the state's high risk insurance pool for three months, till April 1, because of problems with the federal exchange. (The state legislature will vote on the expansions next month.) He made the announcement hours after President Obama announced his plan to allow insurers to continue offering plans that don't comply with the Affordable Care Act.
Basically it gave him a chance to gloat about Obamacare.
Walker definitely didn't mince words about the rollout. “The whole reason we’re here today is because the federal government couldn’t get its act together,” he said during a Thursday press conference. Another good sound bite:
We’re talking about real people’s lives. I’m not going to let the failures of the federal government bring down people who are caught in between systems that just aren’t working right now.
At the same time, Walker is advocating restraint. During a chat with the National Review on Friday, he said Republicans can't be seen “spiking the football” or bragging about Obamacare. His job is to help the people who "slip through the cracks" because they lost their old insurance.
That's very presidential of him.
Well, Walker is the sort of cool guy you might want to have a beer with, as Time notes. And to paraphrase the general conservative consensus, "as long as it's not Christie, am I right?" If, three long years from now, Obamacare is a success, Walker won't be the guy who left thousands of his constituents uninsured. Well, he'll have kicked over 70,000 people out of BadgerCare, and have failed to provide Medicaid to those in the 100 percent to 133 percent of the poverty level bracket, but there are the exchanges. If they can't get insured there it's Obama's fault.
If Obamacare doesn't go well, he won't be the guy who drank the Obamacare Kool-Aid and took federal money. Plenty of policy decisions could come back to haunt him, but with Republican voters, Medicaid probably won't be one of them.