Proposed Budget: Expanding Medicaid Coverage

Expanding Medicaid is good for our health and good for our workforce. Medicaid expansion will expand coverage access to an estimated 89,700 additional people in Wisconsin. It is expected to generate $1.6 billion in savings due to enhanced federal funds. As of currently, Wisconsin is one of only 10 states that have not chosen to expand their Medicaid programs, which is why this budget seeks to once again accept the federal Affordable Care Act’s provision for Medicaid expansion, ensuring affordable coverage to Wisconsinites with income up to 138 percent of the federal poverty level. This budget proposal is also good for Wisconsin’s workforce by increasing the number of people who can find and maintain full-time employment and helps prevent medical bankruptcies.

The significant savings from Medicaid expansion allows the Governor’s budget to expand the benefits available to members through the Medicaid program to better meet their needs.

Reinvesting savings to increase payments to providers and hospitals

The budget provides $626 million to increase payments to hospitals through a rate increase for hospital services, increased acute care hospital access payments, increased critical access payments, and increased pediatric supplemental payments. It also provides $250 million to increase Medicaid reimbursement rates for primary care services, physician services, autism treatment services, outpatient mental health and substance use disorder services, and child adolescent day treatment.

Gov. Evers' budget provides $46.5 million over the biennium to include the following benefits

• Doulas. Doulas provide physical, emotional, and educational support to mothers before, during, and following childbirth to help achieve better maternal and infant health outcomes. The Governor’s budget recommends providing funding to expand Medicaid benefits to include doula services.
• Community health workers. Community health workers serve as a liaison between health and social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. The Governor’s budget recommends providing funding to expand Medicaid benefits to include services provided by community health workers.
• Community health benefit. Nonmedical services such as housing referrals, nutritional mentoring, stress management, and other services positively impact a person’s economic and social condition. Gov. Evers’ budget provides $25.5 million over the biennium to fund a Medicaid community health benefit that would provide these nonmedical services to Medicaid members. Services would be delivered by various culturally competent organizations and would be adapted to the needs of members in each community.