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What is it? Under the Affordable Care Act, states could expand Medicaid to people who make up to 133 percent of the federal poverty level, with the federal government paying 100 percent at first and later 90 percent. Walker and the Republican-controlled Legislature opted instead to limit coverage to people at or below the poverty line. That shifted about 63,000 adults with higher incomes off Medicaid. It also allowed about 130,000 childless adults onto the program, with the state paying its regular 40 percent share for them.

What’s new? The Democratic challengers in the governor’s race say they would take federal funding for Medicaid expansion. They also support BadgerCare for All, which would let people with incomes above the poverty line purchase the state’s main Medicaid coverage at full price, about $7,200 a year for an adult. The federal government would have to approve such a “public option.”

What’s the debate? Wisconsin is one of 18 states that didn’t adopt the Medicaid expansion. Among them, it’s the only one with no gap in coverage for residents below the poverty level. Medicaid programs in the other states, including Florida, Georgia and Texas, don’t cover adults up to the poverty line. But Wisconsin shifted people with incomes just above the poverty level to the Affordable Care Act marketplace, which wasn’t designed for them. According to the Legislative Fiscal Bureau, the state could have saved $1.1 billion in 2014 to 2019 by taking the Medicaid expansion. This year, the savings would be $187 million.

What’s next? Medicaid expansion likely will be discussed during the gubernatorial campaign. If Walker wins, he likely won’t change his stance, though some Republican governors have supported Medicaid expansion.

Medicaid expansion and work requirements

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Medicaid expansion