Ensure equitable and flexible Medicaid funding for Wisconsin in any Medicaid restructuring plan. Whether Medicaid funding changes include block grants, per capita caps, or some other formula, it is imperative that Wisconsin is not be penalized under any new Medicaid funding formula. Wisconsin expanded Medicaid by taking a unique approach to expanding Medicaid by using state dollars to cover everyone under 100% of the federal poverty level. Setting the baseline for Medicaid funding under a new formula should take into account Wisconsin’s fiscally sound approach which, at the same time, increased access to health care for its neediest citizens.
Maintain positive results from federal health care reform. Under the ACA, approximately 225,000 new individuals in Wisconsin gained health care coverage through the health insurance exchanges and Medicaid expansion. These coverage gains must be sustained under any ACA replacement. Losing this coverage would result in increased uncompensated care provided by hospitals, and reduced access to essential health care.
Preserve and strengthen Wisconsin’s competitive insurance market. Federal reforms should support and strengthen market competition in states like Wisconsin that have a healthy and competitive environment for insurers.
Assure fair competition and a level playing field for hospitals and other safety net providers. Any changes under health care reform that may change financing structures and/or coverage requirements should recognize the role that hospitals perform as safety net providers in their communities for persons with little or no health insurance. Reforms should not encourage “cherry picking” of the most profitable patients.
Ensure a realistic pace and transition of any ACA repeal and replacement. The health care delivery system has undergone significant structural changes since the implementation of the ACA. Any plan to replace the ACA must be adopted and ready to implement before the repeal of the ACA. Otherwise, massive disruption in insurance markets, and the health care system in general, could result.
Health Care Reform in the 15th Congress