WASHINGTON, DC – Today, Derrick Van Orden (WI-03), Congressmen Bryan Steil (WI-01), Scott Fitzgerald (WI-05), Glenn Grothman (WI-06), Tom Tiffany (WI-07), and Tony Wied (WI-08), applauded the Center for Medicare and Medicaid Services’(CMS) proposed rule 91 FR 46562, ensuring Wisconsin receives fairness in the Medicaid reimbursement formula and delivering historic Medicaid funding to WI.
Van Orden led the delegation in working directly with CMS and the Trump Administration to ensure that Wisconsin providers receive the same treatment in the Medicaid reimbursement system as providers in other states. Recent changes resulted in an additional $1 billion in federal healthcare funding for Wisconsin. This funding will help ensure high-quality care for patients in Wisconsin.
“For years, Wisconsin providers have been reimbursed at a lower rate than other states. Under the Working Families Tax Cuts, Wisconsin will now be treated fairly, protecting Medicaid for the people it was designed for - children, pregnant women, and disabled Americans,” said the Representatives. “Wisconsin’s Republican congressional delegation worked closely with the State Legislature and Centers for Medicare and Medicaid Services to guarantee fair treatment, implement meaningful reforms, and deliver affordable, high-quality healthcare for families and seniors.”
During CMS Administrator Dr. Oz’s visit to Eau Claire, he stated, "We're going to make sure the Badger State is taken care of and that the funding that's required to improve rural healthcare is at the level that it should be at," and praised Van Orden for ensuring that Wisconsin’s provider tax rate was aligned with other states across the nation.
Background:
Wisconsin will receive historic Medicaid funding under the Working Families Tax Cuts (WFTC), the 2025 Wisconsin Biennial Budget, and CMS proposed rule 91 FR 46562.
o Wisconsin will receive an estimated $9.6 billion in federal Medicaid funding, a $1 billion increase over FY25.
Wisconsin’s Republican delegation worked directly with CMS and the State Legislature to ensure that Wisconsin providers receive the same treatment as providers in other states under the Medicaid reimbursement system.
o Wisconsin hospitals have historically received a lower reimbursement rate for care provided to Medicaid patients, passing on costs to private insurers and potentially reducing additional service offerings.
o In addition, states impose provider assessments to increase funding for state Medicaid programs. Previously, Wisconsin’s provider assessment was less than 1.8%.
o Wisconsin’s lower Medicaid reimbursement rate, combined with its responsible provider assessment rate, puts Wisconsin at a funding disadvantage compared to other states.
o The WFTC, Wisconsin biennial budget, and CMS proposed rule 91 FR 46562 brings Wisconsin closer to parity with other states in federal Medicaid funding.
For a fact sheet on this rule, click here.