Thousands of Wisconsin jobs at risk from potential Medicaid cuts

As Republicans search for ways to cut federal funding, experts and advocates are worried they could include funding for Medicaid, which could put the jobs of thousands of workers across Wisconsin — from home health aides to dentists to grocery store clerks — at risk.

Medicaid is a joint federal and state program that helps cover medical costs for low-income residents. More than a million Wisconsinites use Medicaid, including children, people with disabilities, and older adults, and it helps cover costs for dentist visits, therapy, doctor visits, medication, transportation to the doctor, pediatric care, long-term disability and aging care, childbirth and midwife services, and more.

Republicans in the U.S. House of Representatives passed a budget resolution on Feb. 25 that calls for cutting $2 trillion in federal funding over the next decade. That includes at least $880 billion to be found by the House Energy and Commerce Committee. That committee oversees Medicaid, which costs more than $600 billion a year to fund, leaving experts to believe it would be impossible to avoid making cuts to the program.

Advocates in Wisconsin are sounding the alarm about the economic impact any cuts to Medicaid could have.

In 2023, $11 billion in Medicaid funding supported local economies and jobs across the state, according to the Wisconsin Medicaid Coalition, a new advocacy group that Wisconsin organizations formed in response to the possible Medicaid cuts. The coalition said that 39,250 Wisconsin businesses received some of their funding from Medicaid reimbursements.

Thousands of jobs across the state could be at risk if Medicaid is cut, said Erin Smith, the CEO of Disability Service Provider Network, a group that supports organizations that provide services to people with disabilities and a member of the Wisconsin Medicaid Coalition.

DSPN represents organizations that employ roughly 4,500 employees total, from the service providers that work with patients to front desk workers. And there are many more organizations and health care facilities that employ people that rely on Medicaid funding, from hospitals to nonprofits, Smith said.

It also affects the people on Medicaid and their own ability to work, she said. Someone who works at a grocery store or a restaurant may rely on Medicaid to get to work or stay healthy enough to work.

“It just has such a far reach when you think about the number of people that are reliant on Medicaid in Wisconsin to be a healthy, working, contributing person in the economy,” Smith said.

If Medicaid-supported workers lose their jobs, it could exacerbate existing issues with access to health care in communities across Wisconsin, especially rural ones, said Richelle Andrae, the associate director of government relations for the Wisconsin Primary Health Care Association. WPHCA works with Wisconsin’s 19 community health centers, federally funded health care facilities that provide preventive care such as annual physicals, dental work and mental health support to underserved communities.

Community health centers in Wisconsin served 287,000 patients in 2023, of which 55% were enrolled in Medicaid, Andrae said, and they employed about 2,800 individuals.

In rural Wood County, more than 29% of residents are enrolled in Medicaid, and 244 businesses rely on its funding, according to a map created by the Wisconsin Medicaid Coalition. In southern Rock County, nearly 26% of the population is enrolled in Medicaid, and there are 784 businesses that rely on the funding. And in northern Sawyer County, more than 30% of residents are eligible for Medicaid, and 76 businesses rely on its funding.

Job losses in the medical field due to Medicaid cuts could deter people from living in rural communities out of concern over a lack of access to care, Andrae said. She said the employees at their clinics have recently felt like they were on “shakier ground” because of the potential funding cuts.

“Especially in rural areas of Wisconsin, it’s probably a local health care provider that’s employing a lot of folks, delivering care, serving as a cornerstone for that small rural community to thrive,” Andrae said.

Counties across the state also rely on Medicaid to fund hundreds of jobs that provide behavioral health support and long-term care to children and adults, according to John Tuohy, the executive director of the Wisconsin County Human Service Association, which represents directors of human service departments in all 72 Wisconsin counties.

Cuts to this funding would likely mean reduced services and longer waitlists for patients. It could also limit who qualifies for Medicaid, Tuohy said, meaning a behavioral health case manager, for example, could lose some of their clients that are covered by Medicaid, and in turn some of the revenue that pays their salary, and their position may have to be cut.

“If there’s cuts to the amount of reimbursement that would come down through the state to counties, that would put counties in a really tough situation,” Tuohy said. “How do you absorb those cuts?”

All of this is leaving workers across the state worried. Smith said while it may seem like a cost-saving measure to make these cuts, they will cause local services to be more expensive and limit access to quality care for community members across Wisconsin.

“It might seem like, Oh, we’re going to cut all this money out of there. It’s going to actually exponentially be more expensive to serve people if the current types of services and businesses go out of business because of cutting of the funds,” she said. “And then in the end of it, the people that are going to be hurt the most are the ones that need the service, because they’re going to get a lesser quality of service for a higher price.”