From a short‐​term budgetary perspective, Medicaid expansion seems like a great deal for Wisconsin. The federal government covers 90% of the costs for providing medical care for individuals in the expansion population compared to 60.66% (in 2024) for those currently eligible for Medicaid and 0% for BadgerCare Plus members who are ineligible for Medicaid.

Further, the American Rescue Plan Act of 2021 gave states an additional incentive to expand their Medicaid programs. If Wisconsin accepts the expansion, the Federal Medical Assistance Percentage (FMAP) on its existing beneficiaries would rise by 5% (from 60.66% to 65.66%) for two years. This extra funding would likely offset Wisconsin’s state budgetary cost of the program while it is available.

But what about the longer term? Wisconsin Manufacturers & Commerce (WMC) opposes Medicaid expansion because “federal Medicaid dollars will decline over time, leaving state taxpayers responsible to pay for a large unfunded entitlement.”

[Not to mention that the entire entitlement edifice is likely to collapse at the federal level not too far out from now. This isn’t a safe bet for states that will get left holding an extremely large bag. — Ed]