Wisconsin Democrats are poised to control the governor's office and both houses of the Legislature after the Nov. 3 election, but expanding Medicaid eligibility under the Affordable Care Act may not follow. The issue had been a centerpiece of the party's agenda and appeared in all four budget requests from Democratic Gov. Tony Evers since 2019.
Wisconsin is one of 10 states that have not expanded Medicaid to adults earning up to 138% of the poverty level, which is $22,025 for an individual and $45,540 for a family of four. Expansion first became available to states in 2014, and the Republican-led Legislature rejected repeated proposals, most recently leaving expansion out of the two-year state budget.
Democrats now say the math has changed. Shortly before his election as governor, Democrat David Crowley's campaign said expansion is no longer viable, pointing to restrictions in President Donald Trump's One Big Beautiful Bill, and suggested the administration would revisit the question if Congress and a future president reversed those restrictions.
The federal law removed the one-time incentive bonus for states newly expanding Medicaid and placed restrictions on provider taxes, one of the tools states use to fund their programs. It kept the higher federal match for expansion enrollees, 90% instead of the typical 60%, but an analysis by the Wisconsin Department of Health Services concluded expansion had become fiscally and operationally unfeasible for the state.
Other Democratic voices have echoed that caution. State Sen. Kelda Roys called expansion not feasible in April, and state health department head Kirsten Johnson said in June that it did not make financial sense right now. Legislative Democratic leaders have not listed expansion among their priorities; Assembly leader Greta Neubauer of Racine declined to comment, and Senate leader Dianne Hesselbein did not respond to a request for comment. Crowley's campaign said his administration would instead focus on a state-run health insurance exchange with a public option, while preparing for a possible expansion later.
