Here & Now

Jon Peacock On Wisconsin's Affordable Care Act Participation

IN WISCONSIN’S LATEST ACTION, IT JOINS TEXAS AND FOUR OTHER STATES CHALLENGING A FEE IMPOSED ON FOR-PROFIT INSURANCE COMPANIES THAT’S PASSED ON TO STATES UNDER THE LAW. THE FEE HAS COST THE STATE AN ESTIMATED $23 MILLION SO FAR. FOR HIS PART, GOVERNOR SCOTT WALKER SAYS, QUOTE, THIS LAWSUIT IS MEANT TO ENSURE WISCONSINITES ARE NOT LEFT PAYING THIS UNCONSTITUTIONAL AND COERCIVE TAX, WHICH COULD RESULT IN A LOSS OF MILLIONS OF DOLLARS TO WISCONSIN’S MEDICAID PROGRAM. THE LEGAL ACTION REMINDS PEOPLE THAT WISCONSIN REJECTED FEDERAL MEDICAID EXPANSION DOLLARS AND ITSELF MOVED FORMER BADGERCARE RECIPIENTS WHO WERE OVER THE POVERTY LEVEL INTO FEDERALLY-SUBSIDIZED MARKETPLACE PLANS THROUGH THE AFFORDABLE CARE ACT. AT THE SAME TIME, MEDICAID IN WISCONSIN NOW COVERS MANY MORE PEOPLE AT THE POVERTY THRESHOLD. BUT AGAIN THE WALKER ADMINISTRATION HAS REJECTED EXPANSION ABOVE THAT AND THE FEDERAL DOLLARS THAT GO WITH IT. ADVOCATES OF THE HEALTH CARE LAW ARE SCRATCHING THEIR HEADS OVER THE LATEST LAWSUIT. JON PEACOCK OF THE WISCONSIN COUNCIL ON CHILDREN AND FAMILIES IS HERE. THANKS VERY MUCH FOR BEING HERE.

JON PEACOCK:

THANKS FOR HAVING ME.

FREDERICA FREYBERG:

WE JUST DESCRIBED THAT YOU’RE SCRATCHING YOUR HEAD OVER THE LAWSUIT ON THE FEES. WHY?

JON PEACOCK:

WELL, I HAVE A NUMBER OF REASONS WHY I THINK THE LAWSUIT’S MISGUIDED, BUT THEY REALLY FALL INTO TWO GENERAL CATEGORIES. THE FIRST AND MOST OBVIOUS ONE IS THAT THE STATE’S FOCUSED ON THIS $23 MILLION WHEN WE’RE LEAVING ALMOST TEN TIMES THAT MUCH ON THE TABLE BY NOT EXPANDING BADGERCARE A LITTLE FURTHER AND QUALIFYING FOR FEDERAL FUNDS THAT WE COULD DRAW DOWN. BUT EVEN IF THAT WEREN’T AN OPTION, THE OTHER PROBLEM I HAVE WITH THE LAWSUIT IS THAT IT FOCUSES ON JUST ONE ASPECT OF THE AFFORDABLE CARE ACT, OF HOW IT AFFECTS MEDICAID. THERE ARE MANY OTHER WAYS THAT IT DIRECTLY AND INDIRECTLY SAVES THE MEDICAID PROGRAM MONEY. ONE EXAMPLE IS THAT IT SUBSTANTIALLY INCREASES THE FEDERAL REIMBURSEMENT RATE FOR MANY OF THE KIDS IN BADGERCARE, WHICH IS SAVING THE STATE TENS OF MILLIONS OF DOLLARS EVERY YEAR. AND, SECONDLY, IT DOES A LOT IN TERMS OF INCREASING ACCESS TO PREVENTIVE CARE AND MAKING OTHER CHANGES THAT ARE HELPING TO SLOW THE GROWTH OF HEALTH CARE COSTS.

FREDERICA FREYBERG:

NOW, BACK TO THE MONEY THAT YOU DESCRIBE AS BEING KIND OF LEFT ON THE TABLE. THE FISCAL BUREAU REPORTS THAT WISCONSIN COULD GET $678 MILLION IN FEDERAL MONEY THROUGH JUNE, 2017 IF WE EXPANDED MEDICAID TO INCLUDE ADULTS WITH INCOME UP TO THAT 138% OF POVERTY. HOW MANY PEOPLE WOULD THAT BE?

JON PEACOCK:

ACCORDING TO THE FISCAL BUREAU, WE’D COVER ABOUT 83,000 MORE ADULTS IN BADGERCARE BY MAKING THAT EXPANSION AND THAT FIGURE WAS THE NET SAVINGS TO STATE TAXPAYERS.

FREDERICA FREYBERG:

AND YET BECAUSE OF THE CHANGES THAT WISCONSIN MADE TO COVER THE PEOPLE AT 100% OF POVERTY, A LOT MORE OF THOSE PEOPLE ARE BEING COVERED.

JON PEACOCK:

OH, YEAH. NO. WHAT THE STATE DID WHILE I THINK IT COULD BE A WHOLE HECK OF A LOT BETTER, IT IS A COMPROMISE OF SORTS. IT’S BETTER THAN SOME OF THE OTHER STATES THAT HAVE TOTALLY REFUSED TO DO ANYTHING TO HELP COVER CHILDLESS ADULTS. WE ARE COVERING CHILDLESS ADULTS UP TO THE POVERTY LEVEL AND THAT’S GREAT. BUT BECAUSE WE ARE, WE HAVE WAY MORE TO GAIN FINANCIALLY BY GOING A LITTLE FURTHER.

FREDERICA FREYBERG:

NOW, THE WALKER ADMINISTRATION, AS YOU KNOW, REJECTS THE FEDERAL DOLLARS AND THE EXPANSION, SAYING THAT THE U.S. GOVERNMENT MIGHT NOT BE GOOD FOR THE PROMISED AMOUNT OF MONEY IN THE FUTURE. WHAT’S YOUR RESPONSE TO THAT PREMISE?

JON PEACOCK:

I HAVE A LOT OF PROBLEMS WITH THAT, BUT THE TWO BIGGEST OF WHICH, ONE, WE’RE ACCEPTING LOTS OF OTHER FEDERAL MONEY FOR TRANSPORTATION PROJECTS, HIGHWAYS, NOTWITHSTANDING THE FACT THAT THE HIGHWAY TRUST FUND IS IN REALLY BAD SHAPE. AND WE’RE EVEN TAKING MONEY UNDER THE AFFORDABLE CARE ACT. THE MONEY FOR KIDS THAT I TALKED ABOUT EARLIER. AND BESIDES THAT, IF YOU’RE WORRIED ABOUT THE FEDERAL MONEY GOING AWAY, DO WHAT SOME OTHER REPUBLICAN GOVERNORS HAVE DONE, WHERE YOU STRUCTURE YOUR EXPANSION IN A WAY THAT IT’S CONTINGENT UPON THE FEDERAL MONEY BEING THERE. IT GOES AWAY IF IT ISN’T.

FREDERICA FREYBERG:

DO YOU KNOW WHETHER OR NOT ANYONE LIKE ADVOCATES LIKE YOURSELF OF THIS LAW HAVE TALKED WITH THE ADMINISTRATION ABOUT THAT?

JON PEACOCK:

OH, YEAH. YES. YEAH. I CERTAINLY — I KNOW THERE HAVE BEEN LOTS OF CONVERSATIONS WITH LEGISLATORS ABOUT THAT. THUS FAR, THAT HASN’T GONE ANYWHERE. I HOPE MAYBE WHEN THE DUST SETTLES AFTER THE ELECTIONS. MAYBE NEXT TIME AROUND WE CAN GET A LITTLE FURTHER ON THAT.

FREDERICA FREYBERG:

ALL RIGHT. JON PEACOCK, THANKS VERY MUCH.

JON PEACOCK:

THANKS FOR HAVING ME.