HHS official touts Medicaid, mum on Walker choice

MADISON, Wis. (AP) - Expanding Medicaid under President Barack Obama's health care law is a good deal for any state, a top federal health official who previously served a long stint in Wisconsin government said Monday.

Ken Munson, regional director of the U.S. Health and Human Service department, carefully avoided any direct comments on Gov. Scott Walker's decision to reject the expansion. But Munson said: "I just don't want to underestimate the importance of Medicaid coverage."

Munson also did not discuss Walker's decision to turn down a chance for the state to operate a new private marketplace for people to purchase insurance.

Walker made the moves saying he was concerned over how much it would cost the state in the future both to manage the insurance marketplace and to pay its share of the additional people put on Wisconsin's BadgerCare Medicaid programs.

But health care advocacy groups, Wisconsin hospitals and others that pushed for Walker to go in the other direction have said it makes sense to have the state control the insurance marketplace and also accept full federal funding to expand Medicaid for the next three years.

Munson stressed that states can change their minds at any point both on expanding Medicaid and operating the private health insurance marketplace and anyone with an opinion should make it known.

"This is not just something I say in Wisconsin," Munson said at the HealthWatch Wisconsin conference, a gathering of policy makers, consumer advocates, and health care industry representatives.

The meeting was organized by ABC for Health, a Madison-based public interest law firm that works with making sure children and families get health care benefits and services.

ABC for Health director Bobby Peterson said before Munson spoke that Walker's plan rejecting the Medicaid expansion didn't make sense.

Walker proposed lowering the state's Medicaid income-eligibility rate from 200 percent of the federal poverty level to 100 percent. That would make the Medicaid income cutoff for a single person $11,490 a year instead of $22,980. He would also remove a cap on a program for childless adults.

The net effect - between new people coming into the previously capped program and those leaving Medicaid because they earn too much - would be a 5,000-person decrease. But Walker also said because of people purchasing insurance through the marketplace known as an exchange, the number of uninsured in the state would drop by 224,580.

Critics have said that number is inflated and people who would lose Medicaid coverage won't be able to afford premiums and other charges under the coverage plan they would receive through the exchange.

"This is not right. This is not a good plan," Peterson said Monday. "This plan is grounded in political ambition because it makes no sense from a practical, moral or fiscal sense."

Munson said it's understandable that the changes taking place under President Barack Obama's health care law, like establishing the private marketplaces and expanding Medicaid, would result in lawsuits and states diverging in what approaches to take.

"When you have this big of a societal change, it's not surprising we have these kind of struggles and fights," said Munson, who served three times as deputy secretary of the Wisconsin Department of Health Services, most recently in 2010 and 2011.

Wisconsin is one of 26 states that have deferred to the federal government to set up their health insurance exchanges, the online marketplace for consumers to buy government-subsidized private insurance. Twenty-three states plus the District of Columbia said they would run their own exchanges or partner with the federal government. Utah's status is unclear.

The new exchanges are scheduled to go into operation in October, with insurance coverage beginning in January 2014. They are a key part of the Affordable Care Act, the health care law championed by Obama that is reshaping how Americans buy insurance.

Munson said 27 states have chosen to expand Medicaid as allowed under the law, a move he said will help save lives and provide needed preventative care. States that had been against the health care overhaul law - including Michigan, Arizona and Florida - are now recognizing that expanding Medicaid as allowed under the law is the best approach, he said.