FILE - Wisconsin State Capitol

The dome of the Wisconsin State Capitol in Madison, Wisconsin.

The Republican-led Joint Finance Committee (JFC) is recommending a record $1.63 billion two-year budget for the state’s Department of Health Services – an increase of $588 million in state General Purpose Revenue (GPR) than under former Gov. Scott Walker.

The cornerstone of Gov. Tony Evers’ budget proposal, Medicaid expansion, was squashed.

Medicaid expansion was one of the first non-fiscal policy items the JFC nixed, at the bewilderment of Democrats. State Rep. Evan Goyke, D-Milwaukee, said Republicans were “screwing over” his city.

“The Medicaid expansion is intimately tied to the Democrat’s proposal and how it plays with federal funding,” he said.

Republicans disagreed.

“We have said all along expanding Medicaid wasn’t necessary based on where we were,” JFC co-chair Rep. John Nygren, R-Marinette, said.

“The Republican legislative leadership acted in the best interest of the state of Wisconsin when it rejected, once again, the effort to expand Medicaid,” CJ Szafir, executive vice president at the Wisconsin Institute for Law and Liberty (WILL), told The Center Square.

A WILL study concluded that Medicaid expansion would result in increased costs to Wisconsin families with private insurance by $177 per year, up to $700 for a family of four, and cost Wisconsin nearly $1 billion per year.

More than one million, or about 20 percent of Wisconsinites, receive Medicaid or a Medicaid related program.

“It is unfortunate that the Evers administration and his allies are obsessively pursuing Medicaid expansion when Wisconsin has no coverage gap, one of the lowest rates of uninsured, and the cost of the expansion will raise the cost of care for those with private insurance,” Szafir added.

Despite Democratic complaints, the GOP budget surpasses Democrat Gov. Tony Evers’ spending proposal, raising the eyebrows of fiscal hawks.

The Omnibus motion funding the Health Services department passed last week by a vote of 11-4. Nygren and co-chair Sen. Alberta Darling, R-River Hills, said their plan uses the benefits of conservative tax and regulatory reforms that were implemented over the past eight years.

“Medicaid reimburses lower than private insurance,” Darling said. “While Evers' budget would have switched tens of thousands of Wisconsinites from private insurance to MA, Republicans invested to help providers recoup some of the losses they are already incurring from Medicaid.”

“We made real investments into our hospital systems, our rural providers, and increased reimbursement rates,” Darling added.

In nearly every measure, the base funding for programs was increased. Rural critical care hospitals will have their funding increased by $4.9 million each year; Physician and Behavioral Health Services (provider reimbursements) increased by $12.3 million each year; base funding for Nursing Home Reimbursement increased by $36.9 million in the first year and $37 million in the second; Personal Care Reimbursement Rates increased by $37.6 million in 2019-20 and $53.3 million in 2020-2021. It also increases the Department of Children and Families biennial budget by more than $125 million, and added $60 million for hospitals that treat higher populations of poor patients.

“We made record investments into our long-term care workforce,” Darling said. “We more than doubled Evers’ investment into Family Care and nursing homes. We invested over 5 times more than Evers into our personal care workers.”

The budget funds new programs like the Child Psychiatry Consultation Program and the Qualified Treatment Trainee Program.

“These investments will strengthen our mental health provider workforce and increase access to care for all Wisconsinites,” Darling added.

And it retains welfare reforms, including drug testing for FSET (FoodShare Employment and Training) and mandatory FSET participation for able-bodied adults without dependents.

“Instead of encouraging people to depend on the government for health care, policymakers in non-expansion states should promote affordable alternatives to traditional health care,” Will Flanders, director of research at WILL, said. “One great example of such alternatives are Short Term Limited Duration (STLD) plans, which were made far more viable with changes in policy by the Centers for Medicare & Medicaid Services (CMS) under President Trump.”

Evers has threatened to veto any budget that excludes Medicaid expansion.