Wisconsin Department of Health Services (DHS) 2027-29 State Budget Requests
The Wisconsin Department of Health Services is requesting an additional $1.795 billion GPR funds in the 2027-29 biennial state budget just to continue funding Medicaid program operations.
All state agency budget requests for the 2027-29 biennial state budget were due to the Wisconsin Department of Administration by September 15.
The total biennial cost to operate the Medicaid program in the 2027-29 biennium is projected to be $20.339 billion All Funds ($5.696 billion GPR, $1.561 billion SEG, $1.430 billion PR, and $11.652 billion FED) in FY28 and $21.153 billion All Funds ($6.114 billion GPR, $1.423 billion SEG, $1.496 billion PR, and $12.120 billion FED) in FY29. It is projected that $688.1 million GPR in FY28 and $1.107 billion GPR in FY29 is needed to fully fund projected costs in the Medicaid program. This sums to a request for additional funding of $1.795 billion GPR in the 2027-29 biennium for cost-to-continue for the Medicaid program.
Wisconsin Department of Health Services 2027-29 Biennial State Budget Request
Major Factors in the Medicaid GPR Cost-to-Continue Related to Assisted Living Providers (Page 322):
FY27 Base GPR Expenditure Levels. Higher than budgeted costs are projected across most Medicaid benefits and programs in FY 27, and the Medicaid program is expected to enter the 2027-29 biennium at an expenditure level higher than its FY27 base budget level. The projected difference between base funding and FY27 adjusted base costs is an increase of $748.5 million GPR in the next biennium, before considering any further adjustments due to intensity, enrollment, or other trends expected to occur in FY28 and FY29. This represents 42% of the total GPR cost to continue.
Federal Medical Assistance Percentage (FMAP). The federal matching rate for Medicaid benefits, or FMAP, is projected to be more favorable in the coming biennium. FMAP projections for both FY28 and FY29 are expected to be higher than the FY27 FMAP assumed in the 2025-27 Biennial Budget. It is currently projected that FMAPs impacting the 2027-29 biennium will be higher than the base FMAP by 0.76 percentage points in FY28 and 0.85 percentage points in FY29, resulting in savings of $192.7 million GPR in the next biennium. This contributes savings equal to 11% of the total GPR cost to continue.
2027-29 Intensity and Caseload Adjustments. Intensity is a composite adjustment representing expected changes in the level, frequency, or quantity of service utilization. FY28 and FY29 service lines are adjusted for expected changes in intensity above adjusted base funding. Intensity adjustments are expected to cost $787.8 million GPR over the 2027-29 biennium, or 44% of the cost to continue.
Medicaid Enrollment. In FY26, Wisconsin Medicaid served an average of 1,190,100 members per month, representing a 3.6% net decrease in average monthly enrollment compared to FY25. As of July 2026, Medicaid enrollment totals 1,179,560 members, comprised of 1,116,420 full-benefit members and 63,140 limited-benefit members. Accompanying this lower overall enrollment is a substantial shift toward a higher intensity, higher cost case mix.
Long-Term Care. The largest share of projected cost growth in the next biennium is related to Medicaid long-term care (LTC) programs and services, including fee-for-service (FFS) nursing homes (NHs), Family Care, PACE, Partnership, IRIS, CLTS and FFS personal care. These services are expected to cost an additional $816.2 million GPR over base funding in the next biennium, which is a 15% increase to base GPR funding for LTC services. These costs make up 45.5% of the total GPR cost to continue.