Like other Republican-led states, Wisconsin is at a crossroads over health reform. The partisan cries for Congress to repeal health reform have died down with the re-election of President Obama. But how the Affordable Care Act proceeds is still up in the air. Wisconsin is among the 25 states which will not run an online marketplace for health insurance. Instead, the federal government will. It's a huge, complicated undertaking. Sarah Goodell writes about it in a recent policy brief for the journal Health Affairs. She says the federal exchange, or online marketplace, could lead to unstable insurance markets in some states...like Wisconsin. "You could get adverse selection, where the people who are sicker choose to buy a more comprehensive plan from the exchange. But maybe the young single people -- [who] may not qualify for a federal subsidy -- would choose to buy coverage outside the exchange, leaving the sick people in the exchange." Recently, a national conference on health reform took place in Washington D.C. Wisconsin Citizen Action director Robert Kraig was there and said Medicaid expansion was a big topic of discussion. "It's the most consequential decision for low-income Americans that we've had in 40 years. [Democratic U.S. Senator] Tammy Baldwin in her speech here promoted Medicaid expansion. But in Wisconsin we do not yet know what's going to happen." Advocates say expanding Medicaid is the right thing to do. They point out that initially, much of it would be paid by the federal government. But Wisconsin is still assessing the cost of insuring more people. Governor Walker will reveal his decision in his budget address later this month.
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