Baldwin, Georgia senators propose federal alternative for states that refuse Medicaid expansion

Hoping to do an end-run around state governments that have refused to expand Medicaid, senators from two such states want to offer a federal alternative that would not require state approval.

Sens. Tammy Baldwin (D-Wis.), Raphael Warnock (D-Ga.) and Jon Ossoff (D-Ga.) introduced a bill Monday that would create a federally run and funded Medicaid alternative for the 12 states that have not accepted Medicaid expansion under the Affordable Care Act.

Included in the ACA was a federally subsidized expansion of Medicaid that extended eligibility for the program to people with incomes up to 138% of the federal poverty guidelines. The regular Medicaid program is jointly funded by the state and federal governments, while the federal government subsidizes 90% of the additional cost for expanding the program under the ACA.

Georgia and Wisconsin have both so far refused to join the expansion program. In Wisconsin, Gov. Tony Evers included provisions in his proposed budgets for 2019-2021 and 2021-2023 to accept the federal expansion, but the Republican-controlled Legislature stripped those proposals from each budget.

Advocates for Wisconsin to accept the ACA Medicaid expansion estimate it would cover an additional 91,000 state residents who currently lack health insurance.

GOP leaders have also refused to take up separate legislation that would authorize the state to accept the $600 million federal Medicaid expansion. In forgoing the expansion, Wisconsin also lost the opportunity for an additional $1 billion incentive under the American Rescue Plan Act.

Baldwin, Warnock and Osoff call the bill they introduced Monday the “Medicaid Saves Lives Act.” The legislation would create a program parallel to Medicaid in the-non expansion states.

The new federally funded and administered program would provide the same benefits as Medicaid expansion offers, but without state involvement. The legislation also would include a financial incentive for states to expand their Medicaid program.

In their joint announcement of the legislation, the senators stated that because Congress has already appropriated funding for Medicaid expansion nationwide in the original ACA, their new proposal “has already been funded once and requires no additional offsets.”

Baldwin’s announcement of the legislation included endorsements for the measure from five Wisconsin activists and organizations that supported Medicaid expansion in the state.

Michele Mackey, CEO for Kids Forward, which advocates for children and families, especially those with low incomes and of people of color, said the legislation “will offer quality health coverage directly to Wisconsinites who, through the choices of our legislature, are stuck without access to affordable health care.”