Since taking office in 2019, Wisconsin Gov. Tony Evers has consistently pushed for expanding BadgerCare Plus, the state’s Medicaid program, to cover more low-income residents and bolster health care access. His 2025-27 budget proposal continues this focus, emphasizing Medicaid expansion and mental health investments.

However, the Republican-controlled Senate and Assembly have repeatedly rejected these plans, favoring limited spending and alternative approaches to health care coverage. This article examines the differences between Evers’ Medicaid proposals and the Legislature’s stance, alongside a year-by-year breakdown of Wisconsin’s Medicaid budget from 2013 to 2024.

Evers’ 2025-27 Medicaid Proposals

Evers’ budget, introduced on Feb. 18, centers on expanding BadgerCare Plus to cover adults with incomes up to 138 percent of the federal poverty level ($21,563), up from the current 100 percent. This would extend coverage to approximately 95,800 additional Wisconsinites, leveraging $1.3 billion in federal funds over two years while saving the state $1.9 billion through higher federal reimbursement rates.

The expansion aims to lower out-of-pocket costs, improve access to care, and support economic stability by allowing enrollees to afford essentials like food and housing. Evers argues this aligns with 40 other states that have expanded Medicaid under the Affordable Care Act, citing benefits like reduced hospital closures and job growth.

Additionally, Evers proposes $300 million for mental health initiatives, including funding for school-based mental health professionals, peer-to-peer suicide prevention programs, and enhanced crisis services. These investments target rising rates of anxiety, depression, and self-harm among youth, building on prior efforts to strengthen Wisconsin’s mental health infrastructure.

The budget also includes $3.2 billion to increase hospital reimbursements, $15 million for pediatric hospitals, and $15 million to address care access in Western Wisconsin after recent hospital closures. Other provisions cover community health workers, doulas, and postpartum Medicaid extension to one year.

Senate and Assembly Counteroffers

The Republican-led Legislature has consistently opposed Medicaid expansion, viewing it as an unsustainable expansion of government-funded health care. In 2021, they rejected Evers’ special session on expansion in under a minute, dismissing $1 billion in federal incentives. GOP leaders, including Assembly Speaker Robin Vos and Senate Majority Leader Devin LeMahieu, argue that individuals just above the poverty line can access affordable private insurance through the federal marketplace, and expansion risks future state costs if federal funding decreases. They also express concern about shifting people from private plans to BadgerCare, potentially increasing taxpayer burdens.

Instead of expansion, Republicans have prioritized targeted Medicaid funding increases. In the 2019-21 budget, they approved $322 million more in state funding for Medicaid than Evers proposed, focusing on hospitals serving high numbers of uninsured or Medicaid patients, but rejected his $1.3 billion expansion plan.

The 2023-25 budget saw Republicans strip 545 items from Evers’ proposal, including Medicaid expansion, and revert to a baseline budget with modest increases for provider reimbursements and rural hospitals. They argue this approach avoids long-term fiscal risks while addressing immediate health care needs.

On mental health, Republicans have supported some initiatives but at lower funding levels. For example, the 2023-25 budget included funding for crisis services and suicide prevention but fell short of Evers’ $675 million request for 2024 and $698 million for 2025. The Legislature has also resisted broader systemic changes, such as postpartum coverage extensions, citing concerns over cost and scope.

Key Differences

Medicaid Expansion: Evers’ cornerstone proposal to expand BadgerCare to 138 percent of the poverty level is a non-starter for Republicans, who reject federal funds to avoid future liabilities and prefer private insurance options. This divide has persisted since 2019, with the Legislature forgoing billions in federal savings.

Funding Scope: Evers’ budget proposes transformative investments, including $3.2 billion for hospitals and $300 million for mental health, leveraging federal expansion funds. The Legislature opts for incremental increases, such as $157 million for hospitals in 2019-21, prioritizing fiscal restraint over systemic overhaul.

Mental Health Priorities: While both sides support mental health, Evers’ $300 million plan is far more ambitious than the Legislature’s targeted allocations, which focus on existing programs without significant expansion.

Policy Approach: Evers ties provider reimbursement increases to expansion, aiming to maximize federal support. Republicans fund providers directly with state dollars, avoiding reliance on federal subsidies.

Analysis and Outlook

Evers’ push for Medicaid expansion reflects a broader Democratic strategy to reduce uninsured rates and address health disparities, particularly in rural areas where 6-8 percent of residents fall in the 100-138 percent poverty range. The Wisconsin Policy Forum notes rural counties would benefit most from expansion, yet Republican resistance persists, rooted in ideological opposition to government-led health care and skepticism about federal funding reliability.

The Legislature’s incremental approach has maintained BadgerCare’s core functions but left Wisconsin as one of only 10 states without Medicaid expansion, forgoing significant federal savings. This standoff has cost the state an estimated $1.6 billion in potential savings since 2014, according to Legislative Fiscal Bureau memos.

As the 2025-27 budget process unfolds, Republicans, who control the Joint Finance Committee, are likely to again reject Evers’ expansion and scale back his mental health proposals. Assembly Speaker Vos has called Evers’ budget “dead on arrival,” signaling a continuation of the GOP’s budget-stripping strategy. However, bipartisan support for targeted measures, like hospital funding or crisis services, could emerge if framed outside the expansion debate.

For Wisconsinites, the outcome will determine whether 95,800 low-income residents gain coverage and whether mental health services see transformative investment. With a projected $4 billion surplus, the state has resources to bridge divides, but political will remains the sticking point.