MADISON — This week, as the country recognizes the 13th anniversary of the Affordable Care Act, Gov. Tony Evers will be visiting communities and providers across the state to highlight his 2023-25 biennial budget proposals to make significant investments to increase the access to and affordability of healthcare in Wisconsin.
“From supporting moms and babies to ensuring our kids have mental health supports at school to expanding BadgerCare and providing affordable coverage to tens of thousands of Wisconsinites, our budget works to expand access to quality, affordable healthcare across our state,” said Gov. Evers. “Not only will expanding BadgerCare help save lives, improve health outcomes, and bring more than a billion dollars of savings to our state but it will also enable us to reinvest those savings into our healthcare systems, our communities, and our people. That’s a win-win-win for Wisconsin, and it’s long past time we join red and blue states across the country and get this done.”
A key part of the governor’s proposal is expanding Medicaid, known as BadgerCare in Wisconsin, under the federal Affordable Care Act by covering all low-income individuals who earn incomes between 0 and 138 percent of the federal poverty level. As a result, the state would be able to provide affordable health insurance coverage to nearly 90,000 Wisconsinites, including approximately 30,000 individuals who are currently uninsured.
In addition to providing coverage to tens of thousands of individuals, the state would realize a savings of more than $1.6 million over the biennium and draw down and additional $2.2 billion in federal funds over the biennium. The savings are driven by an enhanced federal match rate the state would receive for childless adults covered by Medicaid and an additional incentive created by the federal American Rescue Plan Act that would increase the federal matching rate for the entire Medicaid program by five percentage points for two years when the state implements expansion. The governor is then proposing to reinvest those savings in improving the health and wellness of Wisconsinites with investments in telehealth, treatment for substance use disorders, and the state’s healthcare systems, among other initiatives.
Currently, with North Carolina expected to pass expansion in the coming weeks, Wisconsin is only one of 11 states in the country and the only state of its Midwest neighbors that has not yet expanded Medicaid.
Gov. Evers’ 2023-25 budget proposal also invests more than $50 million to support his “Healthy Moms, Healthy Babies” initiative, including expanding Medicaid postpartum coverage from 60 days to 12 months, investing more than $5.6 million for maternal and infant mortality prevention, and expanding Medicaid benefits to cover doula services, including childbirth education and emotional and physical support provided during pregnancy, labor, birth, and the postpartum period.
Finally, the governor previously declared 2023 the Year of Mental Health and announced his plan to invest $500 million to expand access to mental and behavioral healthcare, including veteran and school-based mental health services, suicide and crisis lifeline support, and efforts to bolster the mental and behavioral health workforce.
More information regarding the governor’s proposals to expand BadgerCare, support the state’s healthcare systems, infrastructure, and workforce, invest in his “Healthy Moms, Healthy Babies” initiative, and bolster mental and behavioral health supports is available below.
Affordable Coverage for Every Wisconsinite
Gov. Evers believes that every single Wisconsinite should receive high-quality care, regardless of their income. That is why Gov. Evers proposes overall Medicaid expansion and significant benefit creation and expansion to ensure a healthy and thriving population. His budget:
- Invests more than $380 million over the biennium to fully fund the Medicaid program and provide more than $527 million in each year of the biennium to restore base funding in the Medicaid program that was impacted by a one-time transfer included by the Legislature in 2021 Wisconsin Act 58;
- Expands Medicaid under the federal Affordable Care Act by covering all low-income Wisconsin residents who earn incomes between 0 percent and 138 percent of the federal poverty level, resulting in 89,700 low-income individuals becoming eligible for Medicaid while saving the state $1.6 billion and drawing down an additional $2.2 billion in federal funds over the biennium;
- Provides more than $40 million over the biennium to begin using state funding to pay the nonfederal share of the Medicaid Community Support Program that is currently paid by counties;
- Allocates more than $69 million over the biennium to expand Medicaid benefits to include psychosocial rehabilitation services provided by non-county providers, community health worker services, room and board costs for residential substance use disorder treatment, acupuncture services, doula services, expanded coverage of certified peer specialists, and coverage of continuous glucose monitoring devices and insulin pumps through the pharmacy benefit;
- Invests more than $25 million over the biennium for a Community Health Benefit, providing nonmedical services to reduce and prevent health disparities that result from the economic and social determinants of health, including housing referrals, nutritional mentoring, stress management, and other services;
- Invests $1.8 million over the biennium to support community dental health coordinators across the state and increase access to dental services by licensing dental therapists;
- Provides $1.8 million all funds over the biennium as a grant to conduct data analysis and identify low-value care in the Medicaid program and other healthcare coverage offered by the state, and more than $20 million to create a Medicaid incentive for non-hospital providers who participate in health information exchange;
- Invests more than $68 million over the biennium for a Medicaid rate increase for hospital services to increase hospital rates to approximately 85 percent of hospital costs, more than $531 million over the biennium to increase acute care hospital access payments, more than $7 million over the biennium to increase critical access hospital access payments, and $20 million over the biennium to increase pediatric supplemental payments; and
- Provides more than $189 million over the biennium to increase primary care service reimbursement rates, more than $32 million over the biennium to increase emergency physician services, more than $12 million over the biennium to increase autism treatment service reimbursement, and $17 million over the biennium to increase reimbursement rates for outpatient mental health and substance use disorder services and child-adolescent day treatment.
This budget also provides $529,200 to implement an easy enrollment program where individuals would be able to check a box on their individual income tax return indicating they would like the state to evaluate their eligibility for Medicaid or subsidized healthcare coverage on the exchange. This initiative aims to reduce the number of uninsured individuals in the state.
Bolstering Healthcare Infrastructure and Workforce
In addition to the rate increases and investments mentioned above, as previously highlighted, the governor is proposing $100 million to continue the Healthcare Infrastructure Capital Grant Program. This program provides grants for investments in healthcare infrastructure necessary to expand access to affordable healthcare, build facilities in areas of high need, and reduce disparities in healthcare outcomes and services statewide, among other key priorities. To date, more than $100 million in grants have been awarded to 27 projects statewide to address healthcare access needs in communities across the state, such as building a new critical access hospital of Marshfield Clinic Health System in Park Falls, helping HealthNet of Rock County expand their services at a new free and charitable clinic in Janesville, and establishing a new mental health outpatient Day Stabilization Services unit at SSM Health Ripon Community Hospital.
The governor is also proposing $150 million to address the healthcare workforce shortage across the state, including:
- $100 million through the successful Workforce Innovation Grant Program for fortifying the state’s healthcare workforce through long-term, regionally based solutions to the state’s workforce challenges;
- More than $1.5 million for the Qualified Treatment Trainee grant program, which facilitates the licensure and certification of those obtaining or already possessing a graduate degree in psychology, counseling, marriage and family therapy, social work, nursing, or a closely related field;
- $8 million for the WisCaregiver Careers program, which aims to address the shortage of certified nursing assistants in the state by supporting the recruitment, training, and retention of individuals to care for nursing home residents across Wisconsin;
- $10 million over the biennium for the highly successful nurse educators program, which provides incentives for nursing professors to stay in Wisconsin to teach the next generation of nurses; and
- $7 million over the biennium for a new psychiatry residency program through the Medical College of Wisconsin.
Supporting Maternal and Infant Health
In Wisconsin, two-thirds of maternal deaths occur post-partum, and the rate of pregnancy mortality for Non-Hispanic Black mothers is five times that of the rate for their white peers. Gov. Evers knows that maternal and infant health must be prioritized, and that is why he is investing:
- More than $34 million over the biennium to expand Medicaid postpartum coverage from 60 days to 12 months;
- More than $5 million over the biennium in funding for the Department of Health Services’ work on the Newborn Screening Program;
- $4.4 million over the biennium for the Wisconsin State Laboratory of Hygiene newborn screening operations, which screens infants born in Wisconsin for 48 disorders, hearing loss, and critical congenital heart disease; and
- More than $5.6 million and two positions to support grants for maternal and infant mortality prevention, technical assistance, expansion of fetal and infant mortality review teams, and a grief and bereavement resource for families who have lost a fetus or infant.
This budget also supports families by exempting from the sales tax basic family needs, including diapers, incontinence products, menstrual products, tampons, and breast pumps.
Investing in Mental and Behavioral Health
The governor is proposing an investment of $500 million to support mental and behavioral health services across the state, including more than $270 million to make his “Get Kids Ahead” initiative a permanent, ongoing program to ensure kids across Wisconsin have access to school-based mental health services and can bring their best, full selves to school.
Additionally, the governor’s budget proposes significant investments in developing robust prevention strategies to reduce suicide, self-harm, and other mental and behavioral health-related injuries, including providing more than $3 million for the 988 Suicide & Crisis Lifeline call center, creating a suicide prevention program to coordinate suicide prevention activities, develop educational materials, and conduct suicide prevention trainings, and increasing support for peer-run and community-based services across the state.
A full list of Gov. Evers’ $500 million in mental and behavioral investments by state agency is provided here.
An online version of this release is available here.