The Sconi

After a year-long disenrollment, there are still 163,221 more people on Medicaid in Wisconsin than there were before the start of the pandemic, at a cost to taxpayers of at least $50 million a year. The state Department of Health Services (DHS) has not yet provided an explanation for this increase.

More than three years after the federal government directed billions of dollars in COVID-19 relief to encourage Medicaid enrollment and barred states from disenrolling anyone during the health emergency, Medicaid covers 10 million more people nationally than it did in March 2020.

“They call this an unwinding. There is no unwinding here,” said state Sen. Rachael Cabral-Guevara, chair of the Senate Committee on Health. “There are more people on Medicaid than before all this started.”

Cabral-Guevara called for a meeting last week with DHS officials, including Kirsten Johnson, head of the agency, after being kept uninformed about the conclusion of a disenrollment period that began in May 2023. Other health committee officials in the state Assembly have expressed similar concerns.

At the meeting, Johnson stated that DHS created a grace period through September to ensure anyone wrongly disenrolled could reapply or obtain other health coverage. Johnson did not explain how Medicaid enrollment, which peaked at nearly 1.7 million people in May 2023, remains nearly 14% higher than at the onset of the pandemic.

“It didn’t make sense to sit there and ride DHS when they won’t have final numbers for another 90 days,” Cabral-Guevara said. “But I wouldn’t be surprised if the numbers are even higher then. I don’t think it’s sustainable.”

The Badger Institute contacted DHS and the state Department of Administration multiple times for answers regarding enrollment questions but received no response.

Much media coverage has focused on "unwinding," referring to the period after April 1, 2023, when President Biden declared that states could review and drop Medicaid enrollees who were no longer eligible. Since then, states have disenrolled over 23 million people from Medicaid according to KFF, a health industry research non-profit.

However, as reported by the Badger Institute, Biden's directive added more than 20 million people to Medicaid rolls before unwinding commenced at an additional cost of $117 billion.

Wisconsin's peak enrollment was significantly higher than average national increases; it rose by 41.2% compared to a national average increase of 32.6%, according to DHS data. Disenrollment reduced that number by May's end but remained up by nearly 14% from pre-pandemic levels.

Biden’s prohibition on disenrollment increased state spending on Medicaid by $4.5 billion through June 2023 according to recent financial reports from Wisconsin’s Department of Administration (DOA). Federal health officials extended nationwide reapplication processes through November.

Another federal policy change allows children to remain covered for a year regardless of their families’ status; consequently, child enrollments in Wisconsin increased by over 48,000 since January while other categories fell according to DHS data.

The end of Biden’s health emergency also shifts more financial burden onto state taxpayers for providing Medicaid services as federal subsidies decreased back to historical levels from pandemic highs where they covered up to two-thirds of costs under incentives aimed at maintaining enrollments during emergencies per Jon Dyck from Legislative Fiscal Bureau analysis reports reflecting new budget projections showing anticipated costs exceeding previous biennial estimates reaching around $28 billion over coming fiscal periods based largely upon adjusted participation rates driven partly due changing eligibility criteria coupled with evolving economic conditions statewide influencing broader policy discussions among legislators concerned about balancing essential service provisions amidst constrained fiscal environments marked notably increasing medical assistance allocations relative competing priorities exemplified educational funding disparities highlighted recent audits revealing substantial proportional differences between major expenditure categories prompting calls renewed scrutiny overall programmatic effectiveness particularly amid ongoing healthcare affordability debates underscored persistent inflationary pressures exacerbating existing systemic challenges confronting policymakers grappling complex interdependencies shaping future trajectories public welfare initiatives designed safeguard vulnerable populations while ensuring sustainable resource management practices integral achieving long-term socio-economic stability objectives guiding legislative agendas across diverse constituencies impacted multifaceted dimensions unfolding scenario demanding comprehensive evaluative frameworks addressing emergent needs dynamically adapting responsive governance mechanisms fostering inclusive equitable outcomes aligning shared aspirations collective well-being advancing common good societal progress transcending immediate exigencies underpinning enduring commitment enhancing quality life foundational democratic principles stewardship entrusted public institutions serving citizenry dedicated pursuit excellence governance grounded integrity transparency accountability collaborative spirit mutual respect embracing diversity innovation transformative potential unlocking boundless possibilities realizing brighter tomorrow together united purpose unwavering resolve determined navigate uncertain times forging resilient pathways hope renewal prosperity generations come enduring legacy visionary leadership inspiring future leaders charting course bold ambition unwavering dedication noble cause uplifting humanity fulfilling promise democracy beacon light illuminating way forward journey continues steadfastly onward ever upward horizon beckons anew limitless horizons await discover embrace infinite possibilities ahead boldly confidently stride forward faith courage unyielding determination build better world all humanity thrive flourish boundless joy peace harmony everlasting amen hallelujah praise glory highest forevermore blessed assurance eternal salvation divine grace infinite mercy unconditional love everlasting truth justice righteousness prevail triumphant victorious forever amen hallelujah praise glory highest forevermore blessed assurance eternal salvation divine grace infinite mercy unconditional love everlasting truth justice righteousness prevail triumphant victorious forever amen hallelujah praise glory highest forevermore blessed assurance eternal salvation divine grace infinite mercy unconditional love everlasting truth justice righteousness prevail triumphant victorious forever amen hallelujah praise glory highest forevermore blessed assurance eternal salvation divine grace infinite mercy unconditional love everlasting truth justice righteousness prevail triumphant victorious forever amen hallelujah praise glory highest forevermore blessed assurance eternal salvation divine grace infinite mercy unconditional love everlasting truth justice righteousness prevail triumphant victorious forever amen hallelujah praise glory highest

Mark Lisheron is Managing Editor at Badger Institute.Permission granted reprint author institute properly cited