Friday, July 22, 2011

WI Ranks #4 In States That Pay Higher Taxes

Taxes paid by residents as pct. of income: 11%
Total state and local taxes collected: $41.7 billion
Pct. of total taxes paid by residents: 77.9%
Pct. of total taxes paid by non-residents: 22.1%
According to the Milwaukee Journal Sentinel, Wisconsin relies more on income and property taxes for its revenue than most states. In fact, both are approximately 25% higher than the national averages. The state receives a smaller portion of federal money than most others, leaving little room for this money to offset state spending. Worst still, taxes on industrial property owners rank among the bottom half, and often the bottom third, of the country, while residential taxes are among the greatest. According to a study by the Institute on Taxation and Economic Policy, Wisconsin's middle class pays a bigger share of government spending than any other state, except for New York.

The Walker Admin. is biting the hand that feeds them. The push to alienate the very people that pays for their employment and benefits, should think long and hard about what they are doing. They need the middle class to support their lifestyles, unless ALEC and the Koch brothers will pick up the slack when the middle class is gone.

Tuesday, July 19, 2011

Feds halt Illinois Medicaid reform

July 18, 2011
By Benjamin Yount      Illinois Statehouse News
CHICAGO — The federal government says Illinois cannot ask Medicaid recipients to prove how much they earn or where they live.

The federal Centers for Medicare and Medicaid Services, or CMMS, which manage these programs, told Illinois' Medicaid managers in June that two of 15 reforms violate federal rules that prohibit states from changing criteria for those seeking Medicaid.
The reforms, passed earlier this year and signed by Gov. Pat Quinn, require Medicaid recipients to prove that they are earning within 300 percent of the federal poverty level — $67,050 for a family of four — and live in Illinois.
U.S. Sen. Mark Kirk, R-Ill., said Illinois' verification requirements are designed to prevent fraud.
"We are worried, because this will now cost the state of Illinois $800 million over (six) years," said Kirk. "This is the fastest growing part of the Illinois budget."
President Barack Obama's health-care reforms prohibit states from tightening Medicaid eligibility requirements that existed in March 2010. Illinois' Medicaid reforms were passed in January.
Kirk said at a Monday news conference that he is asking CMMS, based in Washington, D.C., to reconsider, because the state lawmakers' intent was not to alienate people from seeking Medicaid. If his efforts fail, Kirk said he is willing to push Congress for legislation to change the rules.
State Rep. Patti Bellock, R-Hinsdale, who helped write the Medicaid reform package, said stopping fraud is the first step Illinois must take to contain the skyrocketing costs of Medicaid.
"Fifty percent of all births in Illinois (are) on Medicaid," Bellock said. "One out of every three children in Illinois is on Medicaid, and one out of every five Illinoisans is on Medicaid."
Bellock said that in 2006, Illinois spent $7 billion on Medicaid. This year, Illinois is poised to spend $15 billion, nearly half of the final $33.4 billion budget.
U.S. Rep. Judy Biggert, R-13th District, said that with all of the recent focus on federal debt and federal spending, the government should jump at any chance to save hundreds of millions of dollars.
"The state and the federal government have a partnership," said Biggert. "It should not be a dictatorship."
Biggert said she wants the Obama administration to reverse the ruling.
"I don't think this is something that just happened," Biggert said. "The other side of the aisle wants to make sure that everyone can be on these programs."
Bellock added that Republicans and Democrats supported Illinois' Medicaid reform laws, which were signed by a Democratic governor.
Mike Claffey, a spokesman for the Illinois Department of Health Care and Family Services, which runs the state's Medicaid program, said, "While we are disappointed by the denial, we are pressing ahead to implement these reforms through other means that we believe will receive approval."
Claffey said the state will use electronic databases to verify income and residency information.
But Bellock said she's waiting for the other shoe to drop.
"We just have to wait and see about the rest of the reforms," said Bellock.
Lawmakers passed a series of additional Medicaid reforms, namely increasing the amount that Medicaid recipients pay, this past spring. Quinn signed the reforms in June. The federal government has not yet weighed in on those changes.

Healthwatch News Letter July 15th

I had to break the newsletter up into sections, they are listed below, sorry for the delay in posting them.
CKSN Corner
Covering Kids with Special Needs
Wisconsin's CYSHCN Program is made up of a significant network of collaborators who work together to ensure access to care and coverage for children and youth with special health care needs.
The National Youth Leadership Network announces their new curriculum: Reap What You Sow: Harvesting Support Systems Curriculum Training Packages. Reap What You Sow brings youth and adults together to build support systems. For more information, click here.
July 25-27. Leadership, Legacy, and Community: A Retreat to Advance Maternal and Child Health (MCH) Scholarship and Practice. Hyatt McDonald's Lodge, Oak Brook, IL. Learn more information here, or register here.
September 21. Making Connections: Care in the Community Conference. Radisson Hotel, Wauwatosa, WI. Topics will include advocacy, mental health, transition and a health benefits update. For more information, visit
September 22. Did you know? Now you know! Aging and Disability Resource Center of Manitowoc County, Manitowoc, WI. 5:30-8:30 p.m. Topic: Parents and partners on a journey; public support systems available to assist you and your child; private insurance and your provider. To register, call 877-568-5205 or email
October 1. Did you know? Now you know! Aging and Disability Resource Center of Manitowoc County, Manitowoc, WI. 9 a.m.-noon. Topic: More about Medicaid; advocating for systems change. To register, call 877-568-5205 or email

Ops Memos
On July 1, DHS issued an Operations Memo 11-35, effective July 1, 2011, instructing that Tribal members and close family relatives are EXEMPT from paying application processing fees and premiums. (See Table 51.1 in the BadgerCare+ Eligibility Handbook to see which recipients are receiving Medicaid-funded benefits.) This applies to:
  • Individuals receiving Title 19-funded BadgerCare Plus if they are a Tribal member, the son or daughter of a Tribal member, the grandson or granddaughter of a Tribal member, or they are otherwise eligible to receive Indian Health Services
  • Children who are Tribal members or who are the son or daughter of a Tribal member and eligible for Title 21-funded (separate CHIP program) BadgerCare Plus. (Previously, only children who were tribal members were exempt from premium payments.)
  • Anyone meeting the Medicaid definition of ‘Indian’ is also exempt from paying the processing fee for a Core Plan application or renewal.
  • These Title 19 premium exemptions do not apply to Medical Assistance Purchase Plan (MAPP) premiums, cost share amounts for Long Term Care Medicaid and patient liability for Institutional Medicaid.
Retroactive: Members who paid premiums between July 2009 and August 2011, who should have been exempt as a Tribal member, or son or daughter of a Tribal member, will be identified through a central process and the premiums will be refunded. The member must have verified that he or she is a Tribal member or son or daughter of a Tribal member to be considered exempt.

State & National News
Analysis and Comment

Building (and Governing) the Insurance Exchange

On Monday, July 11, Department of Health and Human Services Secretary Kathleen Sebelius announced the long anticipated proposed regulations governing how states should set up and run the health insurance exchanges envisioned in the Affordable Care Act. Wisconsin's Department of Health Services issued their own notice--a call for vendors to build Wisconsin's exchange, signaling that the state may abandon the progress made before the changing of administration.
The Affordable Care Act, (health reform) requires states to set up their own health insurance exchange or "marketplace" by 2014. Exchanges are new organizations or agencies that offer consumers "one stop shopping" for a variety of health insurance plans for individuals insurance marketplace consumers, small businesses and public benefits--potentially Medicaid, BadgerCare Plus, FoodShare and Wisconsin Shares in Wisconsin.
Health reform favored exchanges to increase the number of Americans covered by health insurance. The exchange was determined the best a means to create a more organized and competitive market for health insurance by:
  • Offering a choice of health plans,
  • Establishing common rules regarding the offer and pricing of insurance, and
  • Providing information to help consumers better understand their options.
A key component to the success of this model is a system of offering consumer assistance. Wisconsin eliminated that option in March 2011 when it sent back the over $500,000 remaining on the federal grant to create a Consumer Assistance Project in Wisconsin--meant to go hand-in-hand with helping consumers use exchanges. Wisconsin however held onto the "start-up" money HHS injected into 49 states to get the initial planning off the ground. Wisconsin applied for and received this first planning grant of $1 million and then an additional $37 million in an "Early Innovator Grant." Beyond meeting the benchmarks required in these two grants, Wisconsin will be evaluated on their progress in 2013. It is at this time that HHS will determine if it needs to step in and take over the exchange.
New Rules
On July 11, 2011, the U.S. Department of Health and Human Services (HHS) published two Notices of Proposed Rulemaking related to health insurance exchanges giving guidance to the states on what benchmarks they need to reach for their exchanges. The first proposed rule outlines how states can build insurance exchanges, while the second addresses standards related to reinsurance, risk corridors, and risk adjustment to assure stability in these newly established markets.
HHS published the proposed rule in the Federal Register on July 15 and will accept public comments for the next 75 days. HHS will also convene a series of "regional listening sessions and meetings" on the proposal to get additional public feedback.
Calling All Exchange Builders
Released July 8, 2011, the Office of Free Market Health Care issued a "Request for Information," to all "interested parties to demonstrate their product offerings." The Office is interested in learning "more about health insurance exchange systems and applications that serve the non-group and group health insurance markets." The demonstrations of products will take place August 1 & 2, 2011, and only those products with fully functional enrollment and plan comparison features need apply. Not required, but encouraged is functionality that shows health insurance education tools as they relate to purchasing health insurance and customer support--the "consumer assistance" pieces to the exchange. The same consumer assistance elements that Commissioner of Insurance Ted Nickel defunded on March 12, 2011. Curious whether the exchange built in autumn 2010 under the Doyle administration and debuted at the HealthWatch Wisconsin "The Changing Landscape" Health Reform Conference on October 28, 2010 will be among those demonstrated.

Walker administration reverses course, now backs health grants
David Wahlberg, Wisconsin State Journal, 14 July

"Public health advocates seeking federal grants to prevent chronic diseases now have the state’s support, after Gov. Scott Walker’s administration reversed its opposition to the grants."
37 Democrats urge feds to deny Gov. Walker's Family Care freeze
Rep. Richards to HHS Secretary Sebelius, 14 July

"Family Care empowers some of Wisconsin's most vulnerable residents, and their families, by giving them choices about the services they need to remain independent and maintain a high quality of life."
AARP: Fewer plans will make exchanges easier to use
Sam Baker, The Hill, 14 July

"A new AARP report on state insurance exchanges says consumers will have an easier time comparing health plans if they're not presented with too many options. AARP analyzed several existing Web portals for insurance to help states figure out the most effective designs for their exchanges' websites. The exchanges are envisioned as one-stop shops for individuals and small businesses to compare and purchase insurance policies."
State reverses course, supports city's bid for federal health grants
Guy Boulton, Milwaukee Journal Sentinel, 13 July

"Reversing its position, the state Department of Health Services has cleared the way for the City of Milwaukee and others to apply for federal grants totaling roughly $30 million over five years for public health initiatives to stop smoking, reduce obesity and promote healthier lifestyles."
Officials say the exchange rule includes flexibility for states
Kaiser Health News, 11 July

"Insurers want states to be granted great flexibility in how they design their exchanges – and don't want to be barred from seats on oversight boards. Consumer groups, however, would prefer that insurers not be allowed on the boards or, if they are, to meet strict conflict-of-interest rules."
Click here for more health care news!
HealthWatch Public Hearings: The Human Impact of Medicaid/BadgerCare Cuts in Wisconsin
HealthWatch Wisconsin has posted the complete video footage of public testimony on the impact of proposed BadgerCare+ and Medicaid cuts that will affect 1.2 million Wisconsinites covered by these programs. In March, HealthWatch Wisconsin sponsored two days of public hearings during the HealthWatch Wisconsin Annual Conference, drawing hundreds of people to listen, learn, and for some, to share their stories and the stories of loved ones. HealthWatch Wisconsin staff was on hand to record participants' testimony.
View the public testimony footage online.
Member Profile
Jon Peacock, Wisconsin Council on Children and Families
By Katie Foran-McHale

Jon Peacock serves as the Research Director for the Wisconsin Council on Children & Families. The WCCF focuses on an intersection of health and fiscal policy, providing timely, credible and reliable analysis. “We work on providing information that reporters and policymakers will be able to trust,” he said. Jon keeps track of state legislation, approaching analysis from the perspective of how the issues affect low-income families. “We don’t have all the answers, but we potentially have more knowledge about the state’s fiscal challenges and opportunities, and we try to share that with other advocates and nonprofits to enable them to do their legislative advocacy more effectively,” he said.
Like many health care advocates, Jon is concerned about threats to Medicaid programs that were passed in the state budget July 1. These threats include significantly increasing premiums that may lead families to drop out of the program; changing crowd-out policies that will disallow enrollment if an applicant has any access to private insurance, regardless of whether he or she can afford it; more frequent reviews and verifications for eligibility; and a reduction of eligibility for adults to 133% FPL, which cuts 63,000 people from receiving Medicaid.
“Policymakers are placing a much lower priority than we do on protecting programs for low-income families,” he said. “It’s a very challenging time to be convincing policymakers that we need to maintain Wisconsin’s long tradition of serving disadvantaged families.”
Jon thinks balancing the budget shouldn’t come exclusively from cuts—that the legislature could use different combinations of approaches, including taxing the rich. “We need reforms that make the system more efficient, not ones that shift costs and leave more people uninsured,” he said.
Having been a HWW member since its inception and a member of the HWW Council for three years, Jon joined for the potential of expertise from a broad range of providers, advocates and others in the health care system who see what’s going on in the front lines. He is also collaborating with HWW to document detailed stories of families whose lives are greatly affected by BadgerCare or a lack of insurance.
“Story banking puts a human face on the more abstract arguments that we make,” he said. “For instance, a lot of legislators who have government insurance and comfortable incomes have no idea how difficult it is for low income families to come up with what may sound like a modest amount for premiums.“
He also wants to work with HWW to help identify barriers to enrolling, renewing and accessing health services that people need.
In today’s climate, Jon thinks the public realizes that although the state government said they could reduce spending without harming important public services, this isn’t the case. “I’m very frustrated that the state appears to be moving backwards and reversing the progress that we’ve made in improving access to coverage, but I’m also guardedly optimistic that most of the public is still on our side,” he said. “We can win on these issues if we can get everything onto the table, if we can avoid the budget decisions being made in a way in which caps are put on spending and boxes are created that tie the hands of policymakers…Conservative lawmakers want to change the rules of the game and make it impossible to balance spending and taxes at the same time.”
Dependent Coverage in Wisconsin: 26 or 27?
Even as the Affordable Care Act was being unveiled, Wisconsin was ahead of the curve in terms of dependent coverage, allowing adult children on health plans governed by state law to remain on their parents' health insurance up to age 27. Recently, a bill was circulated in the Wisconsin legislature to repeal dependent coverage and adopt, instead, federal law to exclude from an employee’s income payments certain payments from an employer related to medical care. Essentially, the bill would scale back the insurance mandate and permit dependent coverage only to age 26. At the same time, language was inserted into the state budget bill (tucked into the General Fund Tax Omnibus) to do the same. The budget bill was signed by Governor Walker on June 26, and so the rollback of dependent coverage became law. Please note: while the budget changed the rule on dependent coverage, this particular change will not be effective until January 1, 201

LogistiCare Could Be A Real Problem
Reports are still coming in that LogistiCare's administration of non-emergency medical transportation in Wisconsin is having a serious issues. In just two weeks since the start of its contracted services, HealthWatch has heard reports of people being denied rides to appointments that should be covered, kids not being able to go with their parents to appointments, and urgent care appointments being mishandled. As stories continue to pour in, HealthWatch Wisconsin will be tracking this important issue.
If you've been personally affected by dealings with LogistiCare and would like to share your story, positive or negative, please contact HealthWatch staff.
For more information on LogistiCare and the status of their contract, be sure to check out Shawn Doherty's July 10 Vital Signs Blog and July 6 Vital Signs Blog.

DHS Secretary Smith's "Good" 180 on Public Health Funding

After intense pressure on the Department of Health Services, Secretary Dennis Smith has changed his mind, and will now support the City of Milwaukee and other applicants as they apply for over $30 million in public health federal grants. The prevention grants were initially deemed "duplicative" and a "waste of taxpayer money." Sound familiar? See "Commissioner of Insurance's 'Bad' 180" below. The grant proposals are targeting smoking and obesity while promoting healthier lifestyles.
DHS Budget Summary
On July 8, 2011, Wisconsin's Department of Health Services posted a summary of the "Major Provisions for DHS" in the state's new biennial budget in the form of a PowerPoint presentation.  The slides begin with an overview of the budget process, from submission of the agency's request through the Governor's partial vetos and signature. The following sampling of slides provides an overview of the major policy provisions addressed in the budget while giving a sense of the justifications accompanying the changes:
  • Slide 5: Authority granted to DHS to reform Medicaid and BadgerCare Plus (called "implementing efficiencies" on the slide)
  • Slide 5: Eliminate maintenance of effort requirements:
    • DHS is to request a waiver of maintenance of effort requirements.
    • "If waiver is not granted by January 1, 2012, DHS must 'comply' with federal requirements under ACA and instead end enrollment for non-disabled, non pregnant adults above 133% of the federal poverty level."
  • Slide 13: Reform Income Maintenance
    • Counties will form up to 10 consortia
    • Counties will contribute county funds to consortia at least CY 09 levels.
    • DHS will issue contracts based on caseload
    • DHS will operate a statewide document processing center
  • Slide 16: End Family Planning Only Services for Men
    • Directs DHS to apply for federal waiver to continue coverage for women.
Stay tuned for future editions of the HealthWatch Update and HealthWatch Reporter where the DHS PowerPoint presentation will be broken down and discussed in more detail.

Commissioner of Insurance's "Bad" 180 on Consumer Assistance

On July 14, Public Interest Law Firm ABC for Health, Inc. (ABC) filed a supporting brief related to a claim for $176,250 plus expenses against the Wisconsin Commissioner of Insurance Ted Nickel. The claim arises from the termination of the Consumer Assistance Grant contract between the Commissioner of Insurance (OCI) and ABC. Also mentioned in the claim filed with the State Claims Board, are Deputy Commissioner of Insurance Dan Schwartzer, Department of Health Services Secretary Dennis Smith, Deputy Secretary Kitty Rhoades, and Governor Walker’s Deputy Chief of Staff Eric Schutt.
The brief claims that newly appointed Commissioner Ted Nickel and his Deputy Dan Schwartzer’s decision to terminate a carefully crafted and unduplicated consumer assistance program that included ABC was unlawful and inequitable. Bobby Peterson, Public Interest Lawyer at ABC, said, “Commissioner Nickel thoughtlessly terminated a promising program to help consumers navigate the maze of health insurance. In January 2011, OCI recklessly pivoted 180 degrees and shunned opportunities to support consumer assistance and instead pandered to the insurance industry and a mean spirited political ideology that is out of step with the people of Wisconsin.”
Read the full press release here.
Read the brief and attached exhibits online.

Premium Hike for BadgerCare Plus Basic Plan

Wisconsin's Department of Health Services announced in an Operations Memo dated July 15 that premiums for the BadgerCare Plus Basic Plan would once again be increasing, this time to $250 per month. The first premium payment reflecting the increase will be due August 5, 2011 for September coverage.
DHS is relying on the language in a Wisconsin Statute to justify the increase, saying that the revenue collected through premium payments is not sufficient to cover the cost of the program. Recall, premiums for Basic were increased from $130 to $200, with the first $200 premium payment due May 5, 2011 for June coverage. (Note, this July 15 operations memo incorrectly stated that the May premium was for “July” coverage instead of June coverage.)
The premium increases may help explain the drop of approximately 950 individuals from April through June (the most recent data available from DHS). An individual on the BadgerCare Plus Basic Plan with an income at 100% FPL will easily be paying 27.5% of his annual income in Basic Plan premiums.
The increased premium will be reflected on the premium payment slip sent in July. Members who made advanced payments will not be required to pay an increased amount until the months for which they have prepaid have ended. To see a sample of the notice Basic members will receive in the US Mail announcing the premium change, see pages 3 & 4 of the attachment.

Monday, July 11, 2011

Questions For DHS Secretary Smith

The following list of questions have been drafted based on your input so far.  If you have additional questions, concerns or myths you'd like brought forth to DHS Secretary Smith, please send an email to by noon on Monday, July 11th.  Thank you. Sara 
1)      What changes do you plan to make to BadgerCare+ eligibility and benefits?

a.       Will BadgerCare+ premiums be increased?

b.      Will the scope of benefits for BadgerCare+ enrollees be

c.       Will BadgerCare+ enrollees have higher prescription costs?

d.      Will BadgerCare+ enrollees still be able to see specialists?

e.       How will changes to BadgerCare+ specifically affect children?

f.       Will and if so, what changes will be made to FPL eligibility levels?
2)      If there are changes to BadgerCare+ eligibility and an individual no longer qualifies, what other health care coverage and access options will there be?

3)      Will changes to BadgerCare+ be indicative to changes to other benefits such as FoodShare?

4)      What are future plans for the BadgerCare+ Core Plan? With the waiting list?  How soon and in what way will individuals be notified of changes?

5)      Are there anticipated changes to the BadgerCare dental plan?
6)      If plans to change BadgerCare+ are unknown at this time, is there a timeline in which we can expect to learn of changes?

7)      Will and how will DHS to keep patients and providers abreast of changes being made?
8)      What will the State Health Insurance Exchanges look like? How and will it integrate with the current BadgerCare+ program? Are you planning to move people from the BadgerCare+ Core Plan and its waiting list into the exchanges at any point?

9)      What is the process of developing the State Health Insurance Exchange and how can consumers, advocates and providers contribute ideas and concerns?

Sunday, July 10, 2011

The Ryan Medicaid Plan

A Threat to Middle Class Security

By Scott Lilly

The Medicaid changes in the Ryan budget plan would have extraordinary implications not only for poor individuals but for a very broad swath of middle-class families, as a very big share of Medicaid benefits protects middle class families from financial disaster in the event of severe accidents, catastrophic illness of prolonged infirmity in old age.
If Medicaid benefits are cut as outlined under the Ryan plan, the majority of middle class families will be at significantly greater risk of facing financial catastrophe at some point in their lives.
Cutting eligibility for those who are neither elderly nor disabled would be more problematic than is generally recognized. For example, Medicaid is at least partially responsible for the dramatic decreases in miscarriages and infant mortality that have taken place in this country. Cutting Medicaid would also dramatically reduce the number of children who arrive at school ready to learn, while placing the broader population at risk from the stand point of public health.
Changes to this critical safety net program should be made with extreme caution and not before the public has a clear understanding of the consequences those changes might have on their lives and the lives of their neighbors.
Read more and download this report here.

Joel McNally: Walker administration hazardous to health

With his administration launching an unprecedented assault on education and public health throughout the state, Republican Gov. Scott Walker’s political agenda literally appears to be to keep Wisconsin fat and dumb.
Far more needs to be written about the slashing of funding for public education by nearly a billion dollars, the largest gutting of public schools in state history. Hundreds of teachers in Milwaukee and around the state will be thrown out of work as children suffer.
But, for now, let’s consider Walker’s opposition to public health programs, something that shows just as clearly how mean-spirited and extreme this administration really is.
Some sour tightwads have always been shortsighted enough to believe education doesn’t matter to them if they don’t have any kids in school. But health matters to absolutely everyone, doesn’t it? And no sighted person in Wisconsin can go out in public these summer days without becoming aware the public health epidemic of obesity is massive in this state.
What sort of state public health official would refuse to apply for federal funds to combat adult and childhood obesity, reduce diabetes and other chronic diseases, promote healthier lifestyles and eliminate avoidable deaths from smoking and alcoholism? The answer is a public health official who cares absolutely nothing about public health.
Walker did not appoint Dennis Smith as his secretary of health services because Smith had any expertise or training in public health. Walker appointed Smith because he was a right-wing ideologue who opposed public health programs.
In the administration of President George W. Bush, working for Health and Human Services Secretary Tommy Thompson, Smith threatened to kill Wisconsin’s popular SeniorCare prescription drug program. Only a last minute amendment by Wisconsin Sen. Herb Kohl saved it.
Before Walker appointed him, Smith was a senior fellow at the right-wing Heritage Foundation, where he advocated states drop out of Medicaid, the federal-state program that provides health care for the poor, elderly and disabled.
Now, unbelievably, Smith is trying to prevent the Milwaukee Health Department and University Health Services in Madison from applying for about $27.5 million in federal funds that could save lives and prevent serious health problems in the state. The grants are available under President Obama’s federal health care reform law, which both Smith and Walker oppose. The programs cost the state nothing, but the applications require a letter of support from the state.
Smith has an absolutely incredible explanation for refusing to provide even that token support. He thinks the state already saves enough lives.
“Why are we asking for taxpayers’ money for stuff that we are already doing?” he asks rhetorically.
Well, if a state is already saving some lives and sparing some folks from debilitating disease, doesn’t it make sense to prevent even more disease and save even more lives?
Clearly, they aren’t the lives of Smith’s loved ones.
What many people don’t realize is that right-wing ideologues such as Walker and Smith really don’t believe in government doing good things for the citizens of their state. It’s not a financial issue. It’s an ideological issue.
As a tax and financial issue, conservatives should be in favor of federal health care reform and preventive health care that keeps medical problems from becoming far more serious and expensive to treat.
Hard as it may be to believe, right-wing extremists simply don’t believe government should play any role in either saving lives or making the lives of citizens any better. This is the outdated, extreme, right-wing philosophy I grew up with in Indiana. Many people do not realize Indiana, not the deep South, was the longtime national headquarters of the Ku Klux Klan, which had a powerful influence on Hoosier politics.
During the 1960s, an Indianapolis mayor bragged his city had never had a race riot because it had never accepted any federal funds. Federal funds, he claimed, came “with strings attached” requiring equal rights for minorities, which only leads to trouble.
That ignorant political philosophy ended with the election of a moderate, intelligent Republican, Richard Lugar, as mayor of Indianapolis in 1968. Lugar became known as “Richard Nixon’s favorite mayor” and accepted federal development funds hand over fist, transforming Indianapolis into a dynamic, modern city.
Proving such enlightened leadership is no longer in fashion as Republicans move back into the political dark ages, the Indiana tea party is targeting Lugar, now the state’s senior Republican senator, for defeat in 2012.
Under Walker, millions of dollars to improve public health and save lives are no more welcome in Wisconsin than nearly a billion dollars in federal transportation funds to create thousands of jobs and make the state a key link in a modern, national, high-speed rail network.
We can’t recall these dangerous political throwbacks fast enough.
Joel McNally of Milwaukee writes a regular column for The Capital Times.

Thursday, July 7, 2011

Medicaid Makes A Difference

Medicaid supporters are abuzz about a National Bureau of Economic Research (NBER) study on the benefits of Medicaid, as well as a series of articles on the often ignored voices of enrollees who enthusiastically support the program.  The NBER study was recently featured on National Public Radio (NPR) and in the New York Times.  It examined an October 2008 Medicaid expansion opportunity for 10,000 adults without disabilities in Oregon with incomes below the poverty line.  Because it was expected that many more than 10,000 Medicaid-eligible individuals would apply, the state decided to hold a lottery to determine who could get coverage.  The study provided a rare randomly selected sample of individuals who obtained Medicaid coverage and a sample of people who remained uninsured. 

Some of the (not so startling, but “we told you so”) results were: 
·         Medicaid enrollees were 35% more likely to go to a clinic or see a doctor, 15% more likely to use prescription drugs, and 30% more likely to be admitted to a hospital.
·         Women enrolled in Medicaid were 60% more likely to have mammograms.
·         Medicaid enrollees were 40% less likely to say that their health had worsened in the past year than the uninsured.

More details on the NBER study can be found at: 

Second, NPR featured the experiences of new Medicaid enrollees and how the program has assisted them in obtaining maternity care.  One of the articles, “Medicaid Helps Uninsured Couple Pay for Pregnancy Care,” details the soon-to-be first time mother’s Medicaid enrollment process and her experience seeking prenatal and related health care, as well as the misperceptions about Medicaid. For the complete article, see

Last, but by no means least – our friends at the Coalition on Human Needs have issued an action alert to protect Medicaid from deficit reduction plans and budget cuts that include block grants, federal caps, and blended Medicaid rates.  In addition, more friends from
Caring Across Generations, the PICO National Network, Alliance for a Just Society, Community Catalyst and the Campaign for Community Change have organized a “Medicaid Matters” day of action on July 12.  For details on both of these activities, and to voice your support of millions of people who know that Medicaid is a safety-net program. . .please see the information below:

Calls needed NOW:
Targets:  President Obama (toll-free comment line, call from 9-5 EST:   1-888-245-0215 – this number is being used by several other coalitions for budget advocacy)

Toll-free number for the targets in the House and Senate - 1-888-907-1485, which directs callers to the Capitol switchboard:
Senate - Reid (NV), Baucus (MT), Warner (VA), Durbin (IL), Conrad (ND), Collins and Snowe (ME)
House -Van Hollen and Hoyer (MD), Clyburn (SC), and Pelosi (CA)

Messages:  Families and communities of color would be disproportionately impacted by cuts to critical safety net programs, like Medicaid.  Medicaid is a lifeline for millions of people and the building block of improvements passed in health reform.  Proposals to cut Medicaid – from block grants to blended rates – only shift costs to states, providers and beneficiaries, and harm a lot of people along the way. They would take us a giant step backward just as we need to be taking steps forward to implement health reform and help people hit by the recession to get back on their feet .  Medicaid and other programs for low-income families and individuals must be protected, and revenues must be included in the final budget deal. 

Budget Advocacy Tools:
Coalition on Human Needs – scroll down the page on this helpful website for a Toolkit for Advocates – includes archived webinars on budget issues and other helpful resources. 
Center on Budget and Policy Priorities – lots of great data and analysis.  Including an analysis of Medicaid blended rates
Georgetown Center for Children and Families also has a great blog on Medicaid blended rates.

Other activities:
July 12 – “Medicaid Matters” events –

Dear Partner, 
On Tuesday July 12th, Caring Across Generations, the PICO National Network, Alliance for a Just Society, Community Catalyst and the Campaign for Community Change will join Senator Rockefeller and other champions to stand up for the millions of seniors, children, people with disabilities and working families who depend on Medicaid and Medicare.  
Please RSVP here to join us at the event. 
Despite overwhelming public support, Medicaid faces continued threats from policymakers who are willing to make a deal that sacrifices heath care for those who need it most while billionaires get tax breaks and rich CEOs enjoy tax loopholes. We need a plan for deficit reduction that reflects our values, that protects the most vulnerable, and that doesn’t shift the burden onto middle class families and states. 
Together, faith and community leaders will raise our voices to demand a fair, balanced and principled approach to the deficit that does not pay our country’s bills by inflicting crushing costs on seniors, families, children and people with disabilities while asking nothing of those who can most afford to pay their fair share. 
On July 12th raise your voice and tell the Senate that “Medicaid Matters!”
  • Come to DCJoin us for a rally from 2:30-3:30 in the Dirksen Senate Building
  • Sign up for a call to action so your grassroots network across the country has the opportunity to tell their Senators “Medicaid Matters!”
We need you to help send a message to Washington: Medicaid matters! Americans want Washington to stop playing politics with our health care! 
Community Catalyst

Deborah A. Reid
 Senior Attorney
National Health Law Program (NHeLP)
1444 Eye Street, N.W., Suite 1105
Washington, DC  20005
"Securing health rights for those in need"

Misleading Medicaid Statistics

In spite of what's being spun about how much states spend on Medicaid, that cost is not the primary driver of state spending.  In fact, a recent Washington Post article (found below) took a closer look at some of the statistics being used in the legislative debate to justify possible cuts to the Medicaid program, and dispelled some of the myths that we've heard about the cost of Medicaid. 
Regardless of the hype in the debate -- the fact still remains that millions of low-income individuals, people with disabilities, and individuals in long-term care facilities who depend on Medicaid coverage would be negatively impacted by cuts in eligibility and services to this essential health program.

 Washington Post
Posted at 06:00 AM ET, 07/05/2011
A well-used but misleading Medicaid statistic

Witnesses at a hearing on Medicaid legislation in Florida last month (Lynne Sladky/AP)

“Cash-strapped states are also feeling the burden of the Medicaid entitlement. The program consumes nearly 22 percent of states’ budgets today, and things are about to get a whole lot worse.”
— Sen. Orrin Hatch (R-Utah), June 23, 2011, at a hearing of the Senate Finance Committee
 “Medicaid is the lion’s share of that spending burden as it now consumes about 22 percent of state budgets now and will consume $4.6 trillion of Washington’s budget over the next ten years.”
— Former Kentucky governor Ernest Lee Fletcher (R), June 23, 2011, at the same hearing
 “Across the country, governors are concerned about the burgeoning cost of Medicaid, which in fiscal 2010 consumed nearly 22 percent of state budgets, according the National Association of State Budget Officers. That’s larger than what states spent on K-12 public schools.”Washington Post front page article, June 14, 2011

When a statistic is universally tossed around as a certified fact, it’s time to get suspicious.
Such is the case with this oft-cited statistic that 22 percent of state budgets is being gobbled up by Medicaid, the state-federal program that provides health coverage for the poor and the disabled. Medicaid supposedly is even dwarfing what is spent on educating children and teenagers.
But note the phrase “state-federal.” There’s billions of dollars in federal money involved, and the “22-percent” statistic obscures that fact. Let’s dig a little deeper into the numbers. 
The Facts
Medicaid was a central part of President Lyndon Johnson’s “Great Society” initiative in the mid-1960s. Each state administers its own Medicaid program, but with federal oversight, federal requirements—and plenty of federal dollars. On average, the federal government provides 57 percent of Medicaid funds.
Initially, Medicaid was focused low-income Americans, but elderly nursing home care has also become a big part of it. The new health care law would also greatly expand eligibility to people up to 133 percent of the official poverty line.
There’s no question that the recession has put pressure on Medicaid spending, as more people lost jobs or income and so became eligible for coverage. The new requirements of the health care law also will boost Medicaid spending.
The assertion that Medicaid is 22 percent of state spending, and thus now exceeds education spending, comes from an annual survey of the National Association of State Budget Officers (NASBO). But if you dig into the report — if you just go to page one — you will see that this number includes the federal contribution, in what is known as “total funds.” 
If you want to see what states themselves are spending on Medicaid —“general funds” — you have to use another set of statistics.
As NASBO says on page one, “For estimated fiscal 2010, components of general fund spending are elementary and secondary education, 35.7 percent; Medicaid, 15.4 percent; higher education, 12.1 percent; corrections, 7.2 percent; public assistance, 1.9 percent; transportation, 0.8 percent; and all other expenditures, 27.0 percent.”
In other words, without the federal dollars included, Medicaid falls to second place, far behind education. It turns out that on average, states spend 15.4 percent of their funds on Medicaid — not 22 percent.
Brian Sigritz, NASBO’s director of state fiscal studies, said, “You are correct that there are several different ways of looking at Medicaid spending that you can use. If you consider just general funds, K-12 easily remains the largest component of general fund spending, as it historically has been.”  
Indeed, when you look at NASBO’s historical data (table three of this report), it becomes clear that Medicaid spending, as a proportion of general funds, has remained relatively consistent since 1995 — about 15 percent — in contrast to the popular image of being a drain on state budgets.
Sigritz said that the two figures provide a different picture of state spending. “General funds gives you a sense of spending deriving from state revenue, while total funds gives you a sense of total state expenditures,” he said.  “Typically when you discuss overall state budgets you examine the various funding sources that go into them including general funds, other state funds, bonds, and federal funds.”
The Office of the Actuary for Medicare and Medicaid makes this distinction. The 2010 Actuarial Report for Medicaid notes the broad figure, but then takes pains to add: “This amount, however, includes all Federal contributions to State Medicaid spending, as well as spending from State general revenue funds and other State funds (which for Medicaid consists of provider taxes, fees, donations, assessments, and local funds).” The report concludes: “When only State general revenues are considered, however, Medicaid spending constitutes an estimated 16.2 percent of expenditures in 2009, placing it well behind education.” 
Antonia Ferrier, a spokeswoman for Hatch, defended the 22-percent figure, noting its wide use. “It is part of their budgets, and there are many different streams of funding that fund those state budgets (including federal funding, taxes, etc.) that fund their many programs,” she said.
But Colleen Chapman, a spokeswoman for the Georgetown University Center for Children and Families, a policy and research center, said, “In the current budget debate, the data are being misused to argue that the Medicaid program in states is out of control and needs to be cut dramatically, when in fact, Medicaid is still much less of state spending than education and has not grown, as a portion of state budgets, in any way close to the mammoth way that others argue it has.”

Interesting Stories From Huffpost

Orrin Hatch ticks me off! How about you?

Van Jones And The American Dream Movement

Look what we started! I have been hearing some of Van Jones comments about this movement, he makes sense and reflects what the American people have been saying about taxes and the deficit. I appreciated this comment about Republicans and collective bargaining: "If a foreign power conspired to inflict this much damage on America's first responders and essential infrastructure, we would see it as an act of war.
And if a foreign dictator unilaterally announced that his nation's workers no longer had a seat at the bargaining table in their own country, the U.S. establishment would rightfully go bananas.
If Republicans would oppose that kind of thuggery abroad, how can they champion it here at home? How can they accept for the American people what they would denounce for the people of any other nation on Earth?"

His comment about a tight family budget is, "if the budget is tight we don't starve Grandma, junior goes out and gets a paper route". So simple yet so true! It will be interesting to see how many people join this movement and if it will have an impact for the good.

Important News On BadgerCare

This link explains the status and availability of BadgerCare programs.

Monday, July 4, 2011

Healthwatch Newsletter July 1st

A New Direction for Wisconsin

Friday, July 1 is the first day of the new fiscal year for the state of Wisconsin--and the first day under Governor Walker's new biennial budget. In this edition of the Update newsletter, we recap some of the changes most likely to impact the health care and coverage of the people of Wisconsin.
Wisconsin's new budget, together with select sections of Act 10 (a.k.a. "Budget Repair" or "Collective Bargaining Bill") resuscitated by the Wisconsin Supreme Court, Wisconsin's Department of Health Services (DHS) has been given an unprecedented delegation of legislative authority to write the rules of the Wisconsin Medicaid Program. The budget gives legislative authority to unelected leaders of DHS to make changes to BadgerCare and Medicaid programs with very limited oversight and no public input. The budget simply eliminates the requirement that the department hold any meetings, and there is no requirement for publication of whatever changes DHS makes to the programs, including any of the "unspecified changes" DHS can make in benefits and eligibility. Read more inside today's Update.

LogistiCare Takes Over Non-Emergency Medical Transportation Services in Wisconsin

July 1 is the implementation date of the new contract between the Wisconsin Department of Health Services (DHS) and LogistiCare, the private company now charged with providing non-emergency medical transportation for the entire state of Wisconsin. In a press release dated June 30, the Deputy Secretary of DHS is quoted as saying, "Whether you are in a rural or urban area, you will be able to count on the same level of service...we are now able to offer Medicaid enrollees better ride coordination and service quality." LogistiCare said it currently employs 87 people in its Wisconsin call center, including Spanish and Hmong speakers. HealthWatch Wisconsin has been following this transition from county managed to privatized services. To read how things are going on the first day of the contract, see our Grapevine Issue below.

Rate Review in Wisconsin: Public Meeting Held

The Affordable Care Act, (health reform) requires states and the federal government to review private health insurance premium increases that appear excessive. In a final regulation, the U.S. Department of Health and Human Services (HHS) has determined that an insurance plan rate increase of 10% or more is considered "unreasonable."
HealthWatch Wisconsin provided extensive background information on the concept and progress of rate review in Wisconsin in its popular investigative newsletter, the HealthWatch Reporter.
On June 29, Wisconsin’s OCI held its first public meeting to give an update on the rate review grant progress in Wisconsin. Unfortunately, the meeting was mercifully short and included many insurance industry representatives (e.g., Anthem BlueCross/BlueShield, Medica, Network Health Plan, United HealthCare, Security Health Plan, Humana, and Trilogy), but few consumer advocates. OCI staff read the first three pages of the meeting’s handout before Guenther Ruch, the OCI staff person heading the meeting, opened it up for open questioning. Some of the initial points made by OCI were:
  • OCI hired an actuarial consultant.
  • Wisconsin regulatory authority rests with a competitive market.
  • ACA grant money is being used to enhance and preserve our competitive marketplace.
  • OCI wants to be “proactively reactive to what is going on.”
  • Current rate filings vary widely and are inconsistent.
  • Website information is not consumer friendly.
To efficiently review requests for rate increases, OCI said it will contract with a variety of outside actuarial entities to determine the reasonableness of requests that fall into a certain “review path.” Review paths range from “a review for completeness of required items and consistency with previous filings to a referral to an actuarial consultant for review of trend assumptions, assessment of impact and appropriateness of rate increase, validation of calculations and formulas, etc.”
HealthWatch Wisconsin will continue to follow this topic and the other key benchmarks required to maintain the federal money for rate review in Wisconsin.

Health Reform Implementation: July 1, 2011

July 1, 2011 is another trigger date for parts of the Affordable Care Act (health reform) to go into effect. States can anticipate very few changes, the most noticeable being that federal Medicaid will not reimburse hospitals or health care facilities for "health care-acquired conditions" such as hospital-acquired infections. The rule also authorizes states to identify other provider-preventable conditions for which Medicaid payment will be prohibited.

New Regulations on Internal Claims & Appeals and External Review

The Affordable Care Act incorporates new language to require insurance issuers to incorporate the internal claims and appeal processes rules promulgated by the Department of Labor. Similarly, with respect to internal claims and appeals processes for individual health insurance coverage, issuers must initially incorporate the internal claims and appeals processes set forth in applicable state law and update such processes in accordance with standards established by the Secretary of the US Department of Health and Human Services (HHS).
These rules are currently being circulated for public comment. The intent is to help plans and issuers in coming into full compliance with the law through an orderly and expeditious implementation process. Comments are due on or before July 25, 2011 to the address listed in the rule.
What to Watch: A bill is being drafted and circulated to give Wisconsin's Commissioner of Insurance (OCI) rule-making authority (equivalent to the unusual delegation of legislative authority the state budget granted DHS Secretary Dennis Smith). In the current draft of this legislation, OCI is able to roll back the improvements made to Wisconsin's internal claims and appeals processes and external review. HealthWatch Wisconsin will be following this issue and featuring any developments in a future edition of the Update

Enrollment Services Center Applications

A tip for applications you submit to the Enrollment Services Center:
Childless Adults may be familiar with the Enrollment Services Center (ESC), the application site for Medicaid, BadgerCare Plus Core Plan, BadgerCare Plus Basic Plan, and FoodShare. While the Core Plan and Basic Plan programs aren’t accepting new applicants (the Core Plan is taking applications for the Waiting List only) individuals may still apply for Medicaid and FoodShare through the ESC. If a childless adult already has coverage through Core Plan or the Basic Plan, or already has FoodShare benefits, she is not prohibited from applying for Medicaid (perhaps through Elderly, Blind and Disabled Medicaid—EBD) if she is interested in a disability benefit program. This individual or her advocate will need to pay careful attention to this new application, as the applicant already has an open benefits case at the ESC. To prevent mix-ups, lost applications, or delays, consider calling the ESC prior to the submission of a new benefits application to request the “case number” from the applications open FoodShare or Core Plan case. Include this case number on the new benefits application so the cases link together at the ESC.
For example, Susan applied for Core Plan coverage back in September 2009. Since obtaining coverage, Susan has been in and out of the hospital several times and her medical conditions have worsened dramatically. She is now hospitalized and will require a nursing home. Susan’s advocate helps her complete the applications for Elderly, Blind and Disabled Medicaid to help her obtain Medicaid coverage. Before sending in her application forms to the ESC, either Susan or her advocate should call the ESC at 1-800-291-2002 to request the case number assigned to Susan on her Core Plan case file. They will write this number on her Elderly, Blind and Disabled Medicaid application. The advocate should then follow up with the ESC to make sure the case worker has all the appropriate application and verification information.

LogistiCare Off to a Shaky Start in Madison?

LogistiCare’s contracts for non-emergency medical transportation for Wisconsin began today, and already HealthWatch has been hearing some interesting things. In Madison, some people have arrived at their appointments late, including urgent care appointments, and others have been concerned that the vehicles of the private drivers that LogistiCare works with are not marked in any way.
More and more, we’re hearing that people don’t know who they talked to and aren’t sure who to call. Remember, to schedule transportation to a non-emergency medical appointment, you should call LogistiCare at 866-907-1493. If you have any problems, try to get the name of the person you talked to and keep a written record of the exchange. HealthWatch will continue to track this issue in future editions of the Update. Stay tuned for more information!
Have trouble with LogistiCare or hear anything about this?  Contact HealthWatch Wisconsin and let us know! Together we can get more attention on this issue!

HealthWatch Public Hearings: The Human Impact of Medicaid/ BadgerCare Cuts in Wisconsin

HealthWatch Wisconsin has posted the complete video footage of public testimony on the impact of proposed BadgerCare+ and Medicaid cuts that will affect 1.2 million Wisconsinites covered by these programs. In March, HealthWatch Wisconsin sponsored two days of public hearings during the HealthWatch Wisconsin Annual Conference, drawing hundreds of people to listen, learn, and for some, to share their stories and the stories of loved ones. HealthWatch Wisconsin staff was on hand to record participants' testimony.
View the public testimony footage online.
Member Profile
Sara Finger, Executive Director of the Wisconsin Alliance for Women's Health
By Katie Foran-McHale

A long-time advocate for women’s health issues, Sara Finger spearheaded an effort in 2004 to create an organization that would unite and amplify the voices of women’s health advocates in Wisconsin, ultimately resulting in the creation of the Wisconsin Alliance for Women’s Health.
At WAWH, Sara scans the news for issues that have an effect on women’s health, monitoring policies that affect women on both the state and national level. After identifying issues, she and her team work to create messages around those policies, leading to fact sheets, calls to action, press releases, impact statements and more.
“We work to inform, engage, empower and mobilize our supporter base,” she said.
Sara and the WAWH work to create a supporter base built up of a wide diversity of organizations, including non-traditional partners like health care professionals, women of color, and the business, rural and faith communities. “It’s not a one size fits all message, it’s not a one size fits all movement,” she said.
With issues that can pertain to these partners, Sara and the WAWH provide individual focuses that examines the impact of women’s health issues from specific angles. For the business community, they examine women’s health issues and their economic impact. For women of color, they examine issues from a cultural competency standpoint, ensuring that women are provided with adequate choices. With the faith community, they approach issues from a social justice standpoint. With the rural community and health care professionals, they focus on access to care.
Sara develops relationships with these partners, working together to help shape policy that supports women’s health. Recently, the WAWH worked with members of the Catholic community to support compassionate care for rape victims, with the Catholic community citing that providing emergency contraception is the compassionate thing to do.  
Sara and the WAWH work with at least 50 organizations on women’s health issues, one of them being HealthWatch Wisconsin. Sara has been a member since 2005 (and is a brand-new Council member), involved with the Save BadgerCare Coalition and projects related to health care reform, consumer assistance and various Medicaid programs.
She said the resources HealthWatch Wisconsin provides are invaluable to her and her organization, providing health care advocacy, legal advocacy and navigation that fit well with the WAWH’s mission. Sara is a member of the HealthWatch Wisconsin leadership team, the HealthWatch Council.
Currently, Sara is concerned with the way she feels women’s health issues are being marginalized in Wisconsin’s and the nation’s current political climate.
“We find people shying away from women’s health below the waist, and more than ever, we need to look at the full health, well being and economic security of women if we’re truly going to raise the status of Wisconsin women’s health,” she said.
However, she said this need for advocacy provides inspiration. “The hijacking of certain women’s health issues has really motivated us to set the record straight, and develop messages and messengers that can help us reclaim and reframe the debate.”
For more information about the Wisconsin Alliance for Women’s Health, visit

CKSN Corner
Covering Kids with Special Needs

The National Youth Leadership Network announces their new curriculum: Reap What You Sow: Harvesting Support Systems Curriculum Training Packages. Reap What You Sow brings youth and adults together to build support systems. For more information, click here.
July 25-27. Leadership, Legacy, and Community: A Retreat to Advance Maternal and Child Health (MCH) Scholarship and Practice. Hyatt McDonald's Lodge, Oak Brook, IL. Learn more information here, or register here.
September 21. Making Connections: Care in the Community Conference. Radisson Hotel, Wauwatosa, WI. Topics will include advocacy, mental health, transition and a health benefits update. For more information, visit
September 22. Did you know? Now you know! Aging and Disability Resource Center of Manitowoc County, Manitowoc, WI. 5:30-8:30 p.m. Topic: Parents and partners on a journey; public support systems available to assist you and your child; private insurance and your provider. To register, call 877-568-5205 or email
October 1. Did you know? Now you know! Aging and Disability Resource Center of Manitowoc County, Manitowoc, WI. 9 a.m.-noon. Topic: More about Medicaid; advocating for systems change. To register, call 877-568-5205 or email

State & National News
Analysis and Comment

Day 1 Under the New Budget

The unspecified cuts to Medicaid and BadgerCare programs can be anything from reducing income eligibility, increasing premiums or co-pays, increasing the number of verifications or reviews, changing covered services, eliminating dual eligibility (for private insurance and BadgerCare), offering different benefits for different people, and more. We will not know for sure what the cuts will actually look like--but can take a nod from sections of the budget and Act 10. What we do know is that DHS can change rules with relatively no oversight and without any requirements to tell anyone what they are doing. HealthWatch is following additional items in the budget that impact the care and coverage of our residents. Below are a few more (in addition to those discussed in our last several newsletters):
1. Income Maintenance: The Enrollment Center "Compromise." The original plan to have a central enrollment center akin to the enrollment services center used for the BadgerCare Plus Core Plan was nixed in the final version of the budget. Instead, a re-organization and grouping of county income maintenance workers will be created. The budget calls for the creation of 10 multi-county consortia, outside Milwaukee County, and directs the state to replace Milwaukee County IM workers with state positions.
2. Give DHS Your Overmatch! Buried in the budget, actually included in the requirement that county consortia be formed for income maintenance functions, is the requirement that counties (except Milwaukee) contribute the cost of their current income maintenance overmatch to support the cost of DHS contracts with the income maintenance consortia! HealthWatch Wisconsin will definitely follow this topic and bring you in-depth reporting on this in the near future.
3. Family Planning Only Services Say Goodbye to Men. The budget ended the relatively recent addition of men to the BadgerCare Plus Family Planning Only Services program. A federal waiver allowed the state to provide these services to men in the first place. The budget states that family planning services can be offered to women between the ages of 15 and 44 as long as the family income is below 200% FPL. The budget directs DHS to request federal approval to require parental notification for family planning services to women under 18.
4. Contraceptive Equity. This provision, designed to eliminate the state mandate that health insurance policies provide coverage for contraceptives prescribed by a health care provider and outpatient medical services related to contraceptives, was REMOVED from the state budget as being non-fiscal. It is anticipated that this is not the end for this issue--watch for a standalone bill on this subject.
5. Goodbye Legal Services Money. Discussed in the Update in past months, the anticipated cuts to civil legal services are official. Governor Walker's budget eliminates all indigent civil legal service funding. (In comparison, indigent civil legal services were in the 2009-2011 biennial budget at a $1,958,600 appropriation in FY 10 and a base-year appropriation of $2,546,100 in FY 11.)  ABC for Health is one of the non-profit public interest law firms that will feel the impact of this cut. ABC’s attorneys and health benefits counselors help individuals and families determine the best health coverage choices; apply for health coverage programs; negotiate with insurance companies; and challenge insurance claim denials. Many of our clients are overwhelmed with the changes ahead in Medicaid and private insurance. Consumers are confused by the political conversation about which programs are actually in effect, how to enroll or challenge denials, and what appeals and other legal rights are available. Cutting civil legal services, in addition to blocking health reform’s implementation and reducing enrollment and expenditures in BadgerCare and Medicaid programs, will harm thousands of Wisconsin families.


Urge feds to consider health grant applications without Gov. Walker's support
Representative Jon Richards, Representative Sandy Pasch, 1 July

"Please consider Community Transformation Grant applications originating from Wisconsin without support from Governor Walker, whose opposition to these grants appears to be driven more by ideology than facts."
State blocks plans to apply for federal health grants
Guy Boulton, Milwaukee Journal Sentinel, 29 June

"The state is blocking plans by the Milwaukee Health Department and University Health Services in Madison to apply for federal grants that would provide about $27.5 million for health programs designed to promote healthier lifestyles and reduce chronic diseases such as diabetes."
Former HHS Secretary Leavitt says most states aren't on track to meet exchange deadline
Christopher Weaver and Bara Vaida, Kaiser Health News, 27 June
"Many Republican officials have been conflicted about whether to ignore the requirements or to go ahead with planning exchanges to fend off the federal government."

Wisconsin slips in health care quality ranking
Guy Boulton, Milwaukee Journal Sentinel, 19 June

"But it performs below average in 27 measures, such as adequate dialysis and certain infections stemming from medical care. Wisconsin also does a dismal job in providing care to African-Americans that is similar to the care given to whites."

Click here for more health care news!