The column below reflects the views of the author, and these opinions are neither endorsed nor supported by

Despite an all-out assault against the Affordable Care Act (ACA) by Trump and House Speaker Paul Ryan, the ACA has persisted. Enrollment in ACA private health insurance plans stands at 11.8 million, including over 200,000 Wisconsinites. “A slight dip in sign-ups for ACA plans” (Washington Post). Moreover, Medicaid expansion continues in 31 states, including 15 GOP-led states.

However, Trump and Ryan, supported by Wisconsin GOP Governor Scott Walker, are sabotaging the ACA. The Commonwealth Fund outlined how the Trump administration seeks to eviscerate the ACA: “… deep cuts in advertising and outreach during the … (ACA) open-enrollment …, a shorter open enrollment period, and other actions that collectively may have left people with a general sense of confusion… . Signs point to further erosion of insurance coverage in 2019: the repeal of the individual mandate penalty, included in the 2017 tax law, recent actions to increase the availability of (bare-bones) insurance policies … and support for Medicaid work requirements.”

Governor Walker’s cruel, inconsistent health policies show that he is trying to surpass Trump’s punitive lead. Walker applied for a federal waiver to restrict some childless adults to a lifetime limit on Medicaid coverage if they do not meet proposed work requirements. On Tuesday, the Trump administration denied a similar lifetime limit on Kansas Medicaid. Centers for Medicare and Medicaid Services Administrator Seema Verma said: “We’ve indicated we would not approve lifetime limits, and we’ve made that pretty clear to states.” Nonetheless, Trump and Walker continue in lockstep on Medicaid barriers.

Trump and Walker support work requirements to cut Medicaid coverage sharply. “The new policy would be attempting to solve a problem that doesn’t exist. About two-thirds of Medicaid beneficiaries are either seniors, disabled people or children. Of the remaining one-third, nearly 80 percent are in families with at least one working person and 60 percent have full- or part-time jobs, according to the Kaiser Family Foundation” (New York Times).

Walker also wants federal approval to require some Medicaid applicants to undergo drug-screening. An election year dog whistle. But Jon Peacock, research director at Kids Forward, said: “The goal of increasing the size and health of the Wisconsin workforce would be accomplished much more effectively by significantly increasing the state’s investment in drug treatment programs, rather than substantially increasing spending on BadgerCare (Medicaid) administration.”

Finally, Walker has asked Trump’s support for a Wisconsin ACA reinsurance program to help private insurers with high-cost enrollees. It has worked in Minnesota to limit rising premiums. However, Walker wants the state’s share of funding to come from unspecified Medicaid savings. With health insurers awash in new profits from the Trump-Ryan tax cuts, why not require Wisconsin insurers to pony up? Maryland GOP Governor Larry Hogan agreed to charge Maryland insurers to help pay for a Maryland ACA reinsurance program. Moreover, Walker and Wisconsin GOP Attorney General Brad Schimel must drop their frivolous election year lawsuit to have the ACA declared unconstitutional. And, why not expand Medicaid? It’s working everywhere across the nation. Cruel, inconsistent health policies.

— Kaplan wrote a guest column from Washington, D.C. for the Wisconsin State Journal from 1995 —2009.


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