LA CROSSE, Wis. — Twenty Wisconsin counties want to circumvent the state and its rejection of the federal Medicaid expansion and deal directly with the federal government for low-income health care dollars.

The counties have sent a letter to state health Secretary Kitty Rhoades asking that the state be only the conduit for the federal funds.

"This is an attempt to approach the issue from another avenue," La Crosse County Supervisor Monica Kruse told the La Crosse Tribune (http://bit.ly/15tktzu ). "It's an attempt to have the counties negotiate directly with the federal government."

The Wisconsin counties point to a demonstration project in Cuyahoga County, Ohio, in which federal Medicaid money will pass through the state to the county and the MetroHealth Medical Center in Cleveland to provide health care for low-income residents. Like Wisconsin, Ohio rejected Medicaid expansion under the Affordable Care Act.

Robert Kraig, executive director of Citizen Action of Wisconsin, said the 20 counties want Wisconsin to follow Ohio's example.

The state can say, "We're not going to take the money, but we'll enable you to get it," Kraig said.

The Wisconsin Department of Health Services did not immediately return an Associated Press call seeking comment from Rhoades on Tuesday.

The Republican Legislature accepted Gov. Scott Walker's budget proposal to reject $12 billion in federal money over 10 years. Instead, the income eligibility for the BadgerCare program in Wisconsin was reduced to the federal poverty level. Walker said his plan would cut the number of uninsured by almost 225,000. But opponents said the plan will adds tens of thousands to the roles of the uninsured.

Kruse said Walker's plan will cut about 35,000 people from BadgerCare in the Western Region for Economic Assistance consortium, which includes La Crosse, Buffalo, Clark, Jackson, Monroe, Pepin, Trempealeau and Vernon counties.

"They will be kicked off of BadgerCare because they earn too much" under Walker's guidelines, Kruse said.