Which Candidate’s Plan Expands Obamacare?

Monday, September 29, 2014 at 5:54 PM by

A Walker campaign ad that criticizes Mary Burke for her stance relating to the Affordable Care Act (aka the ACA or “Obamacare”) is based on a false premise. It incorrectly equates supporting the expansion of BadgerCare with supporting an expansion of “Obamacare.”

Although I don’t think one can say that either candidate supports “expanding Obamacare,” I believe a strong case can be made that the Governor’s plan relies more heavily on a key part of the Affordable Care Act. For reasons I’ll explain below, his changes to BadgerCare do more than Burke’s alternative to expand the reach of the core part of the ACA – the new federal Marketplace for health insurance and the substantial federal funding to subsidize Marketplace insurance plans.

One of the major problems with the ad is that implementing part of a federal law and taking advantage of federal funding is not the same thing as supporting expansion of that law. Ask any of the nine Republican Governors who have expanded their Medicaid programs and taken the federal funding, which is financing the full cost of covering newly eligible adults. I have no doubt that every one of them would argue very strongly and convincingly that their support for expanding their state Medicaid programs does not equate to supporting an expansion of “Obamacare.”

Even if you think that implementing a part of the ACA is in some way equivalent to supporting its expansion, there’s another substantial problem with applying that reasoning in this case. That problem is summed up by the headline for an MSNBC story that succinctly and accurately described the changes that the Governor incorporated into his last budget bill, “Scott Walker finds an alternative to Medicaid: Obamacare.”

Rather than expanding BadgerCare coverage for childless adults to 138% of the federal poverty level (FPL) and qualifying Wisconsin for full federal funding of newly eligible adults, the Governor’s budget cut in half the eligibility ceiling for parents – reducing it to 100% of the poverty level. His budget uses those savings to partially offset the cost of ending the BadgerCare waiting list for childless adults below 100% of the poverty level. The following table compares the Governor’s plan with prior Wisconsin law and the alternative endorsed by Burke.  

Comparison of Alternative Approaches to BadgerCare and Marketplace Eligibility

 

Prior WI law

Governor’s budget

Burke proposal

BadgerCare eligibility for parents

Up to 200% of FPL

Up to 100% of FPL

Up to 138% of FPL

BadgerCare eligibility for childless adults

Up to 200% of FPL, but long waiting list

Up to 100% of FPL, no waiting list

Up to 138% of FPL, no waiting list

Eligibility for subsidized Marketplace coverage

NA

Adults between 100% and 400% of FPL

Adults between 138% and 400% of FPL

The Governor justifies the decision to knock about 60,000 people out of BadgerCare on the basis of moving them into Marketplace insurance plans. As the MSNBC article put it, “To avoid expanding Medicaid, he is handing off Medicaid patients to another federal program.” As the table helps illustrate, the Governor’s plan puts more people into the “Obamacare” Marketplace, whereas the Burke plan is the closer of the two to prior Wisconsin law. 

A recent PolitiFact article reviewed the claim in the Obamacare ad that Burke “supports Obamacare unequivocally and wants to expand it.” After stating that there is no evidence that Burke unequivocally supports the ACA, the PolitiFact article nevertheless calls the ad “half true” because it buys into the premise that expanding BadgerCare is equivalent to expanding ObamaCare. 

I often disagree with PolitiFact ratings, but I usually think that they do a good job of laying out the relevant facts and making readers better informed about the subject of the disputed claim. However, in this instance there is absolutely no discussion of the reasons why many people, including nine GOP Governors, would vehemently disagree with the assessment that supporting an expansion of Medicaid (or BadgerCare) can be likened to expanding Obamacare, while making more people eligible for subsidized Marketplace coverage is not. 

It’s very important for the public and policymakers to understand how Wisconsin’s BadgerCare choices relate to the ACA. Next year state lawmakers are going to have to figure out how to fill a $760 million hole in the budget for Medicaid and BadgerCare. And as they are grappling with that, some members of Congress will again be trying to repeal the ACA, including the funding that subsidizes Marketplace insurance plans. Thus, I was surprised and disappointed that PolitiFact failed to mention that Wisconsin is now relying on the Marketplace to provide insurance for thousands of parents previously covered in BadgerCare.  

Jon Peacock

 

 

 

Categories: BadgerCare Plus, Blog, HEALTH & HUMAN SERVICES, health care reform, Medicaid | Comments Off on Which Candidate’s Plan Expands Obamacare?

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