Nov. 8, Wisconsin Health News

Gov.-elect Tony Evers is poised to dramatically alter Wisconsin’s approach to Medicaid and the Affordable Care Act, a move that could reshape parts of the state’s healthcare market.

Gov. Scott Walker, a longtime foe of Obamacare, conceded Wednesday afternoon to Evers, the state superintendent who ran a campaign focused on healthcare and expanding coverage under the ACA.

“The results of this election in Wisconsin are very consequential with regard to health policy,” said Donna Friedsam, health policy programs director at the University of Wisconsin Population Health Institute. “There’s going to be a number of substantial changes.”

Evers will have to work with a Republican-controlledLegislature. He told reporters Wednesday that he wants to meet with legislative leaders to discuss moving forward on healthcare and other issues.

“I would really like to talk to them about how we can kind of set the stage going forward so we can find common ground,” he said.

Assembly Speaker Robin Vos, R-Burlington, said in a statement that he’d work to find “common ground when possible.”

“While yesterday was a win for Gov.-elect Evers, it cannot be seen as any kind of mandate for change,” he said. “Assembly Republicans will continue to deliver on our conservative promises to our constituents and won’t allow Wisconsin to slide backward.”

Dr. Bud Chumbley, Wisconsin Medical Society CEO, said that divided government at the state level could lead to gridlock and slow efforts to reduce the uninsured rate.

But he noted that the divided federal government, with Democrats controlling the House and Republicans controlling the Senate, will likely halt efforts to repeal and replace the Affordable Care Act, protecting people who gained coverage under the law.

“It’s hard to say,” he said. “A lot of things are said in campaigns. It’s hard to sort out what people are going to do."

The Wisconsin Hospital Association sees a bipartisan way forward on increasing the number of healthcare workers to meet demand and promoting use of telemedicine.

“We are confident that all of us will remain focused on enacting bipartisan public policy that maintains Wisconsin’s high-quality healthcare system,” WHA CEO Eric Borgerding said in a statement.

Medicaid expansion could come with the next budget

Healthcare experts expect Evers will propose expanding Medicaid in his first biennial budget.

While Republican lawmakers have long opposed accepting federal money for expansion, they may have a difficult time filling a hole that could amount to more than $200 million.

There’s also enthusiasm among voters nationwide to take the money. Idaho, Nebraska and Utah voters all approved expanding Medicaid Tuesday.

“Yesterday’s election results substantially increased the chances of expanding BadgerCare,” Jon Peacock, Kids Forward research director, wrote in an email. “The approval of referendums to expand Medicaid in three very red states shows how popular that policy is.”

Also at stake are the state’s efforts to require that some childless adults work, pay premiums and take a health risk assessment to qualify for BadgerCare. Wisconsin received approval on the waiver last week.

According to the Centers for Medicare and Medicaid Services, governors may decide not to implement Medicaid waivers. If states choose to change how their Medicaid program operates, they would need to renegotiate with federal officials.

“Although the state now has authority to make these changes, the new governor could potentially withdraw, amend or not implement the waiver,” the Kaiser Family Foundation noted in a brief released Wednesday.

State could shift attitude toward Affordable Care Act

Evers vowed during his campaign that he’d withdraw Wisconsin from a lawsuit seeking to invalidate the ACA on his first day in office.

Democratic Madison attorney Josh Kaul declared victory in the state’s attorney general race Wednesday morning. Republican Attorney General Brad Schimel acknowledged Kaul’s lead but didn’t concede, saying he’ll wait until every vote is counted.

Peacock expects that Evers and Kaul will “put some muscle” into the campaign rhetoric around coverage of pre-existing conditions. He predicted that Wisconsin will “switch sides by backing the state attorneys general that are defending the law.” 

Friedsam of the UW Population Health Institute said that Evers’ pick for insurance commissioner could take a different approach to regulating insurance in Wisconsin, particularly around the individual market.

That could have an impact on how plans that don’t comply with the ACA are promoted or to the degree that they’re offered in the state. And the state could end up playing a greater role in outreach and promoting enrollment, she said.

Friedsam also said there’s “opportunities to use the purchasing power of the state” through Medicaid and the state employee health plan “to try to help control healthcare prices generally.”

“The new governor has an opportunity now to think creatively,” she said.