Legislative Democrats want Gov. Scott Walker to expand Medicaid to cover up to 175,000 more adults through federal money and $66.7 million in state spending through the 2019–20 budget cycle.
Of course, Democrats want to embarrass Walker and Republicans by introducing a bill so they can get GOP legislators on the record voting against federal "free money" and being opposed to health care for the poor. Politics ain’t beanbag, said Finley Peter Doone. Democrats are for expanding government’s role in health care anyway even beyond where it is now.
The Milwaukee Journal Sentinel quotes Rep. Jon Richards (D–Milwaukee) as saying, "It’s about knowing a good deal when you see one. And this is a good deal." Why anyone should trust legislative Democrats’ view on fiscal matters is an excellent question given how Democrats left state finances when they last controlled state government, but never mind that.
Republican Governors Torn
GOP governors elsewhere have voted in both directions. Arizona Gov. Jan Brewer and Ohio Gov. John Kasich approved their state’s Medicaid expansions. Texas Gov. Rick Perry, Louisiana Gov. Bobby Jindal and Mississippi Gov. Phil Bryant did not.
Brewer and Kasich basically said the same thing, that if their states didn’t approve Medicaid expansions, that money would go to other states. That, you’ll recall, was the rationale behind accepting millions of federal dollars for the half-fast Madison-to-Milwaukee train.
That kind of rationale ignores the inconvenient truth that Washington is sending money to the states that Washington doesn’t have. You have heard of the federal budget deficit. You may also have read projections that entitlements including health care spending will consume an increasing amount of the federal budget.
Walker’s Lose-Lose Proposition
To think the Democrats’ won’t find some way to demagogue Walker and Republicans for supporting Medicaid expansion is naïve. Recall how well Democrats praised Republicans for supporting the Medicare Part D expansion. (You don’t? That’s the point.) The cynic would be correct in asking whether the Obama administration is proposing this to make Republicans at the state level look bad whether or not they choose to take the federal money.
Where the Obama administration is concerned, there is no such thing as a "good deal." Remember, before Obama, Bill Clinton’s 100,000 police officers? The feds started funding a vast expansion of police officers (to appear tough on crime), but stopped, leaving local governments with the choice of raising taxes (or cutting budgets elsewhere) to fund those officers, or cutting the positions. There are numerous other examples of Washington’s (and, even more numerous, Madison’s) saying it will fund something and then deciding otherwise, or reducing funding, leaving lower levels of government holding the bag.
It is exceedingly unlikely that Washington will have the money to make the commitments it’s enticing the states to make. And what happens then? That’s the problem of any state that accepted the federal money in the first place. The obligation to provide Medicaid to the larger population will far outlive the federal money. That won’t just increase the state budget; growing Medicaid spending will crowd out other spending priorities as Medicaid grows as a percentage of state spending, in the exact same way entitlements are crowding out the rest of the federal budget.
Thanks to Badgercare and the fact that most people work for a living, this state has one of the highest percentages of people with health insurance anyway. Free money would be nice, but there is no such thing as free money. Walker knows this and should act accordingly.
Steve Prestegard lives in Platteville where he serves as Editor of the Platteville Journal. He has been a journalist for more than two decades. He also writes at his blog,