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- There are more than 1.2 million Medicaid recipients in Wisconsin, and an estimated 310,000 people are uninsured.
- Former President Donald Trump and Vice President Kamala Harris said little about Medicaid policy during the campaign, but their records paint a very different picture of the program after the election.
- The former Trump administration proposed tightening eligibility oversight, allowing states to add work requirements, and cutting about $1 trillion from the federal Medicaid budget over 10 years. It was not passed by Congress.
- In 2019, Harris was a co-sponsor of the failed Medicare for All bill that would have given Americans universal coverage to replace private insurance and Medicaid. She has since distanced herself from the proposal, which received record levels of coverage during her administration with President Joe Biden.
At 4:55 p.m. on a recent Monday, five minutes before it opened, a family stood outside the door of the St. Francis Community Free Clinic.
Volunteer receptionists turned on the “open for business” sign at the clinic in Oshkosh, Wisconsin, and welcomed them inside. Within minutes, more patients filed into the waiting room. Volunteers brought people back to meet Dr. Weston Radford on a first-come, first-served basis.
Although the clinic technically closes at 7 p.m. on Mondays, Radford, who volunteers here weekly, said he often stays past 8 p.m. to treat patients. That is, 14 hours after he started work as an internist at a nearby private clinic.
Still, free clinics during limited hours cannot reach everyone who needs them, including many who do not have adequate health insurance.
“Health care remains a huge need that we’re not really meeting,” Radford said.
Ahead of the November election, many Wisconsin residents are concerned about health care.
Over 20 people responded WPR’s America Amplified Project They said they want politicians to prioritize access to health care. The eight called for expanding access to Medicaid, a joint state and federal aid program that helps low-income residents access health care.
There are more than 1.2 million Medicaid recipients in Wisconsin, and an estimated 310,000 people are uninsured.
Voters weighing their presidential options have heard little about Medicaid policy from former Republican President Donald Trump or Democratic Vice President Kamala Harris. Still, the chances of a program after November vary widely depending on their past records and party affiliations, the newspaper reported. Medical policy research company KFF.
“Medicaid, its future, and whether it faces an existential threat depends on the outcome of this fall’s federal election,” said Edwin Park, a public policy professor at Georgetown University.
President Trump has previously pushed for Medicaid cuts.
Experts say more low-income adults will become dependent on busy clinics like St. Francis if President Trump succeeds in reviving past proposals to scale back the program. , says residents could lose access to Medicaid.
Project 2025, a plan for the second Trump administration published by the far-right Heritage Foundation, includes chapters written by former Trump administration officials and calls for deep cuts in federal Medicaid spending and stricter eligibility requirements. is proposed.
These proposals are consistent with President Trump’s record. The administration has proposed tightening oversight of eligibility, allowing states to add work requirements, and cutting about $1 trillion from the federal Medicaid budget over 10 years, a cut that Congress passed in 2017. It was not passed.
Despite this, President Trump has sought to distance himself from Project 2025.
Daniel Alvarez, a senior adviser to the Trump campaign, said in a statement to WPR and Wisconsin Watch that “President Trump and his campaign alone represent policy in his second term, and not other organizations or former officials.” said.
The campaign did not respond to questions about whether President Trump supports Project 2025, which would limit state Medicaid funding through block grants and impose lifetime limits on benefits.
“President Donald J. Trump remains steadfast in his mission to reduce costs for seniors and protect Social Security, Medicare, and Medicaid,” Jacob Fischer, the Trump campaign’s Wisconsin spokesman, told WPR and Wisconsin Watch. I’m taking a stance,” he said.
President Trump’s 16-page policy proposal promises protections for Medicare, the government’s health insurance for seniors and adults with disabilities, but makes no mention of Medicaid.
Harris touts high Medicaid enrollment numbers with few details
Meanwhile, Harris’ 82-page campaign document touts record-high levels of coverage under President Joe Biden’s administration, but does not specify specific Medicaid policies.
A spokeswoman for the Harris campaign did not directly respond to questions about the specific Medicaid proposal.
“Donald Trump campaigned on a promise to repeal the Affordable Care Act, which would see costs skyrocket under his extreme Project 2025 agenda, but he also said he would “This stands in stark contrast to Vice President Kamala Harris’ plan to reduce health care costs for families across Wisconsin,” Brianna Johnson, the campaign’s Wisconsin spokeswoman, said in an emailed response.
Harris ran in the Democratic presidential primary in 2019, pushing for more dramatic health care reform. She co-sponsored the failed “Medicare for All” bill, which would have given Americans universal coverage to replace private insurance and Medicaid.
Harris has since tried to distance herself from Medicare for All. President Trump went viral, attacking Harris for “upsetting” what his campaign called a “socialist” proposal. misleading claims About what it means for immigrants who entered the country illegally.
Harris does not mention Medicare for All in her current platform. Instead, she outlined plans to strengthen Medicare and the Affordable Care Act, commonly known as Obamacare, a law that President Trump has repeatedly called for repeal.
What does Medicaid policy mean for Wisconsin?
Wisconsin has a lower percentage of uninsured residents than most states, but no state has expanded Medicaid to cover adults below 138% of the federal poverty line (approximately $20,800 per adult per year). It remains in only 10 states.
The Wisconsin Policy Forum estimates that the expansion would allow Wisconsin to expand government coverage to up to an additional 90,900 adults, generating a net benefit of $1.7 billion over two years. That’s what it means.
President Trump’s efforts to repeal the Affordable Care Act would have ended Medicaid expansion nationwide. The federal government cannot force states to expand coverage, but Congress under the Biden-Harris administration approved financial incentives to encourage expansion.
The Republican-led Wisconsin Legislature rejected the latest expansion proposal. Lawmakers argue this will make more residents overly dependent on the government and increase private insurance premiums, costing future taxpayers.
Republican critics of expansion point out that among states that have not expanded Medicaid, Wisconsin is the only one without so-called coverage disparities.
That’s because the state’s Medicaid program targets low-income adults who meet the federal poverty level. This is the same point at which a subsidized plan becomes eligible in the federal health insurance market.
However, Medicaid is considered more comprehensive coverage than marketplace options. Wisconsin’s Medicaid program covers dental care. However, Marketplace enrollees may be required to pay additional fees for dental insurance.
In a KFF poll of non-expansion states, including Wisconsin, two-thirds of respondents said they supported expansion.
Voters in six Republican-led states have approved Medicaid expansion through ballot initiatives since 2020, but voters in Wisconsin lack the ability to put the referendum on the ballot.
Some experts see Wisconsin’s new electoral map as a potential expansion.
This is the first election since the Wisconsin Supreme Court ordered lawmakers to draw new state House and Senate district lines. The new maps make districts more competitive and could give Democrats a majority in the state Legislature.
Philip Rocco, an associate professor of political science at Marquette University, said that while it remains unlikely that Democrats will control the Senate, expansion discussions could still move forward if they control one chamber.
“Even if victory isn’t immediate, there may be political momentum toward eventual victory,” Rocco said.
Radford doesn’t know why Wisconsin won’t expand Medicaid, but he’s still hopeful.
It will relieve some of his day job duties at his private clinic. If more people use Medicare and Medicaid, they may be less worried about denials and high out-of-pocket costs.
“Hopefully we can provide them with the treatment that we think is best for them medically,” Radford said.
Even under the expansion, many Wisconsin residents will need to visit free clinics like St. Francis.
“We just take care of them.”
Each week, Radford sees patients who don’t have adequate private insurance, those who are in the middle of insurance coverage, and those who cannot qualify for Medicaid because of their citizenship status.
These needs are not new. Mr. Radford’s father volunteered at St. Francis Church for nearly 30 years, spanning multiple presidential administrations.
Although health care policy has changed over time, the clinic’s mission has remained the same. No one at the front desk asks about insurance or other types of payments. No one can be turned away.
“People need to be noticed,” Radford said. “So we just take care of them.”
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