Milwaukee Democratic Legislative Caucus

Announces Public Hearing on proposed medicaid cuts

                                             CONTACT:
                                             Rep. Sandy Pasch, (608) 266-7671
                                                                Sen. Lena C. Taylor, (608) 266-5810    
MADISON – State Representative Sandy Pasch (D–Whitefish Bay) and State Senator Lena C. Taylor (D-Milwaukee) announced that members of the Milwaukee Democratic Legislative Caucus will host a public hearing on the Walker administration’s Medicaid waiver that would result in nearly 65,000 Wisconsinites – including 29,000 children – losing or being denied state health care coverage on Thursday, December 1, 2011 at Washington Park Senior Center from 6:30 p.m.-9:00 p.m.

“Wisconsinites have experienced many attacks on our shared values since Scott Walker became governor, and among the most shocking is his administration’s plan to kick an estimated 65,000 individuals off their healthcare,” said Rep. Pasch, who serves as Chair for the Milwaukee Democratic Legislative Caucus.  “Decisions of this magnitude should be made with proper input and oversight, and it is clear that the public deserves a more accountable process to scrutinize their plan that is flush with unanswered questions and bad decisions that will impact countless Milwaukee families.”

This hearing is part of a series of events being hosted by Democrats statewide in response to the Department of Health Services’ plan to make $554 million in cuts to the state’s health care programs for eligible seniors, children, families and people with disabilities. This proposal will have a significant impact on the affordability of health care and medical services to thousands of Milwaukee-area residents.
“The fallout from the Governor’s proposal will be severe – approximately 64,000 people, at least 29,000 of whom are children, will lose their health insurance. The people must have an opportunity to voice their concerns, their doubts, and possibly their outrage,” said Sen. Taylor.
This event is free and open to the public, media, and all Milwaukee-area elected officials.

Milwaukee Democratic Legislative Caucus
Public Hearing on Proposed Medicaid Cuts
Thursday, December 1, 2011
6:30 p.m.-9:00 p.m.
Washington Park Senior Center
4420 W Vliet St, Milwaukee

GREAT NEWS!

I just heard from my doctors assistant and there is no new growth and the existing pockets have not grown since May! All of my organs are in excellent shape too! I am so psyched! This gives me time to work on some weight loss so I'll feel better mentally and physically. I thank God for his loving care and concern, by providing for me, giving me loving family and friends and the best medical team in the world!

Public Hearings

The following is an updated list of upcoming public hearings on the Medicaid cuts.  These events are open to the public and everyone is welcome to attend.  RSVPs are not required but appreciated.  Please help us spread the word.  Thank you. Sara

 

Milwaukee - Thursday, December 1st

6:30-9pm

Washington Park Senior Center

4420 W. Vliet Street, Milwaukee

RSVP

 

Rhinelander - Thursday, December 8th

4:30-6:30pm

Nicolet College, LRC Theater

5364 College Drive, Rhinelander

RSVP

Add your name to the petition urging HHS not to approve drastic cuts to Medicaid

Hello.  Please sign this petition to send the message that Wisconsinites will not allow the health of our state to be compromised.

The Wisconsin Department of Health Services has asked the federal government to allow them to make very harmful changes to BadgerCare and other Medicaid programs such as lowering eligibility level and increasing health care costs for working families

Don't let this happen!  Sign this petition to urge the federal government to reject these terrible changes. 

Sign the petition today at: http://www.change.org/petitions/save-badgercare

 

Thanks!

Recall In Danger!

http://caledonia.patch.com/articles/pro-recall-group-outs-facebook-page-that-boasts-about-destroying-signatures

Mentally Preparing For The Next CT Scan

The next CT scan is scheduled November 28th with a follow up doctors visit December 2nd. I tend to get very nervous and stressed as they approach which causes one tumor to burn. I know I am close to needing surgery again and have been mentally preparing for it. I have been dealing with shortness of breath and the weight gain has become cumbersome and hard to deal with.
I did some research on the website pmp pals and it appears to have new information, it's still confusing, so I have a list of questions to ask my doctor. I have the best surgeon for this situation, I don't doubt his ability, but there's always a chance that something could go wrong, the unexpected, the part you have no control over, is the scariest. 

I am being forced to deal with my own mortality and I'm not ready to. I am not ready to die yet, I actually refuse too, I still have to much to do! I have been spending as much time as possible with my family, which is always good for fabulous food, great conversation and belly laughs!Just in case something goes wrong, I want my family to have happy memories of me.

DHS should go back to the drawing board on Medicaid

State's plan for dealing with a $500 million budget hole would put too many of the poor at risk.

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Nov. 19, 2011 |(38) Comments

Related Coverage

• Editorial: DHS should go back to the drawing board on Medicaid
• Another View: Department's changes are fair, and it was time to make them

Dennis Smith bears a striking resemblance to a certain green fuzzy creature who steals a certain December holiday.
That's what his critics, including many Democrats, seem to think.
According to them, the secretary of Wisconsin's Department of Health Services is booting thousands of kids to the curb of the health care system on account of a radically conservative ideology.
We don't think Smith or his top deputy, Kitty Rhoades, are coldblooded. They are, in fact, levelheaded. Smith, in particular, has deep experience in the Medicaid system - he ran it under former President George W. Bush. But while we think Smith has come up with an interesting proposal for reining in escalating costs in the state's health care programs for the poor, we also think it is flawed.
There is no doubt his plan is innovative and an improvement over how some states have handled ballooning Medicaid costs. But his ideas risk hurting too many of Wisconsin's poor - especially kids - and we can't support his plan as written.
To enact his changes, DHS needs a waiver from the federal government's so-called "maintenance of effort," required under the federal health care reform law. We urge the federal Department of Health and Human Services to hold off on that waiver until the state does more to ensure that fewer of the poor are affected.
Smith and his counterparts across the country are staring at deep holes in their Medicaid budgets. The recession brought more people into the programs as people lost jobs, health benefits or both, and states, such as Wisconsin, expanded eligibility. Federal stimulus money backfilled the holes last year, but those funds have run dry and there will be no more federal bailouts.
In Wisconsin, the Medicaid rolls have increased at a rate nearly 10 times the rate of population growth. The state has an estimated $554 million deficit in state and federal money through June 2013 in Medicaid health programs, programs that now cover one in five Wisconsin residents.
But fewer people likely will be covered in the future, whether the state gets a federal waiver or not. According to the nonpartisan Legislative Fiscal Bureau, 65,000 people, nearly half of them kids, would either leave the programs or be turned out under the changes Smith is proposing. If Wisconsin doesn't get federal approval by Dec. 31 - and that looks like a tall order given the politics involved - the state would be free on its own under current rules to drop 53,000 adults by increasing elgibility requirements.
Smith's plan would take a number of steps to tighten standards, including sizable increases in premiums. In some cases, premiums would increase almost tenfold. The proposals also include moving 263,000 people in BadgerCare Plus into a lower cost plan with fewer benefits. Both adults and kids could be dropped from the program for one year if they failed to pay their monthly premium without a valid excuse.
The state also would disqualify from Badger Care Plus some who have access to employer-sponsored insurance plans. The department estimates that nearly 28,000 people no longer would be eligible for BadgerCare Plus after enactment of this particular rule change, including more than 11,000 kids.
The administration of Gov. Scott Walker argues that many of those families will find a way to cover their kids.
We think that's a fantasy. It's far more likely that families on the edge of poverty will forego insurance in order to pay the rent or put food on the table.
And that means that some of them will end up using emergency room care - some of the most expensive medical care in the business - when they or their kids get sick.
The Smith plan may save taxpayers money now, but it's built on an illusory foundation. Those same taxpayers will pay for the more expensive care of the poor through their health insurance premiums as providers shift the costs onto those who can pay.
We urge HHS secretary Kathleen Sebelius to deny the state's request for a waiver until the state amends its proposal so that fewer of the poor - especially kids - are affected. This is a special concern for Milwaukee's poor, a city with one of the worst rates of infant mortality in the country. Poor mothers need good prenatal care; fewer of them may get it under this proposal.
We give Smith points for creativity, but we think his plan is likely to be overly harsh on the poor. If we're wrong, he can come to Milwaukee anytime for a heaping helping of roast beast on us. We'll even carve it for him.

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BY THE NUMBERS

64,748: Number of people likely to drop from Medicaid rolls as a result of state's proposal.
29,120: Number of children among that number.
554,000,000: Depth (in dollars) of Medicaid budget hole.

Public Hearings on Proposed Cuts to Medicaid Monday, November 21 4pm-6pm Green Bay Thursday, December 1st 6:30pm-9pm Milwaukee Thursday, December 8th 4:30pm-6:30pm Rhinelander

www.savebadgercare.org

November 19, 2011

Another Chance to Be Heard! While the Department of Health Services only scheduled two town hall meetings in Madison and Milwaukee, Democratic legislators are scheduling additional opportunities for you to be heard.  Democratic legislators are hosting public hearings to discuss the Medicaid efficiencies and cost-savings initiatives recently released by the Department.   Public Hearings on Proposed Cuts to Medicaid Green Bay: Monday, November 21st 4pm-6pm Central Library Auditorium 515 Pine Street Green Bay, WI RSVP Milwaukee: Thursday, December 1st 6:30pm-9m Washington Park Senior Center 4420 W. Vilet Milwaukee, WI RSVP Rhinelander: Thursday, December 8th 4:30pm-6:30pm  Nicolet College LRC Theater 5364 College Drive Rhinelander, WI RSVP To understand what is at stake for our Medicaid and BadgerCare programs, refer to this fact sheet or Link here for a preliminary assessment of the likely consequences of the proposed changes relating to BadgerCare Plus, with regard to the "maintenance of effort" waiver portion of the DHS proposals and the benchmark plan. if you have any questions regarding this hearing please email or call Sara at: sara.finger@wiawh.org or (608) 251-0139 x1. Thank you!    Thank you for supporting BadgerCare and Medicaid.  Be sure to forward this email to others letting them know that MEDICAID MATTERS!  For more information and to join the Save BadgerCare Coalition, visit: www.savebadgercare.org. Looking for another way to stand up for BadgerCare? Participate in our Save BadgerCare Coalition Photo Petition Drive! Take a picture showing that you want to Save BadgerCare. You can print and use one of our signs (see attached), or you can get creative and make your own that explains why BadgerCare is important to you. Email your photo as an attachment to savebadgercare@gmail.com. Make sure you include your name, city and zip code. We'll post your photo on our site and use it to show our elected leaders that their constituents support and want to protect BadgerCare and Medicaid when policy decisions are made in the next month. Forward along to friends, family, colleagues and neighbors.  We're aiming to collect at least 500 images by the end of October!

Families can't afford Walker health cuts

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By Sandy Pasch and Jon Richards

Nov. 21, 2011 |(51) Comments

Wisconsinites have experienced many attacks on our shared values since Scott Walker became governor. Among the most shocking is his administration's plan to kick an estimated 65,000 individuals off their health care while choosing to give $2.3 billion in tax breaks to big corporations and special interests.
How did we get to this draconian situation? Walker's budget and budget adjustment bills granted his administration nearly carte blanche authority to rush through sweeping changes to our state's vital health programs with scant legislative oversight and little-to-no opportunity for thorough public review.
The ramifications of this power grab became apparent when the Walker administration unveiled its rushed plan to slash more than one-half billion dollars from our state's medical assistance programs. The non-partisan Legislative Fiscal Bureau estimates that Walker's plan could kick almost 65,000 individuals off our state's health programs. Among those who could lose health care are 29,120 children. This number would grow if parents simply miss a single premium payment.
If this plan is not approved by the federal government under a seemingly unattainable deadline imposed by the Walker administration itself, his administration would kick roughly 53,000 Wisconsin residents off their health coverage. It is clear that Walker has set up a clear lose-lose situation for thousands of our most vulnerable citizens.
The timing is terrible. Many Wisconsinites have lost their jobs, and many employers are eliminating health-insurance coverage for their employees - resulting in more individuals relying on BadgerCare programs for basic health needs. These programs actually prevent unnecessary and more costly emergency room use.
Unfortunately, under the Walker plan, uncompensated care could increase up to $60 million, which will be passed on to taxpayers through cost shifting and higher insurance premiums. Moreover, according to the Legislative Fiscal Bureau, Wisconsin has lost access to approximately $293 million in federal funds due to the Walker administration failing to invest $190 million in state funds within our medical assistance programs.
Shared sacrifice and tough decisions are necessary to address the difficult fiscal issues and health care crisis facing our state. Changes to make our state's health programs more cost-effective and efficient must be on the table. However, these changes should have been considered in an inclusive, accountable and evidence-based manner that allowed for ample public input and legislative oversight. And while there are some elements of the proposal that we support, the package as a whole deals a significant blow to the years of progress our state has made to ensure affordable access to quality health coverage.
To restore accountability and oversight to these life-altering decisions, we have authored legislation that would eliminate the far-reaching powers granted to DHS and bring back public input to changes being made to Wisconsin's health safety nets. This would ensure that the public will again have a voice in important decisions that impact the health of our state.
Unfortunately, instead of slowing down and allowing for more scrutiny of serious concerns and answers to questions surrounding their proposal, this administration chose to rush through its proposal that will end up punishing some of the neediest and youngest Wisconsinites through misguided, ideological decisions. Their continued willingness to place big corporations and special interests before the health of our communities exposes a pattern of decisions that Wisconsinites can no longer afford.
Rep. Sandy Pasch (D-Whitefish Bay) represents the 22nd Assembly District. Rep. Jon Richards (D-Milwaukee) represents the 19th Assembly District.

Cut Health Care For Congress First

Below is an email from Michael Morrill, a MoveOn member who created a petition at SignOn.org that is getting a lot of attention and may be of interest to you. If you have concerns or feedback about this petition, click here.

---

In April, the Republican-controlled House of Representatives voted to cut Medicare and Medicaid. And this month, even Democrats on the so-called Super Committee have offered deep cuts to these vital programs.

Essentially, Republicans in Congress are telling senior citizens and the poor that tax cuts for billionaires and millionaires are more important than providing a health care safety net for our most vulnerable.

But did you know that members of Congress get great taxpayer-funded health care? In fact, they have one of the best health care plans in the world.

It strikes us as the height of hypocrisy to be accepting government-provided, taxpayer-subsidized health insurance while denying seniors, the disabled, and the poor the basic coverage that Medicare and Medicaid provide.

That's why we're circulating this petition demanding that members of Congress who voted to cut Medicare and Medicaid stop accepting taxpayer-subsidized health insurance for themselves. If they believe our most vulnerable citizens should buy insurance on the corporate, for-profit market, shouldn't they do the same?

The petition is addressed to the U.S. Senate and House of Representatives and says:

If you voted to cut Medicare and Medicaid, you must stop accepting taxpayer-funded health care for yourself and your family.

Will you sign the petition? Click here to add your name, and then pass it along to your friends:

http://www.moveon.org/r?r=267956&id=33106-19217285-zVwCz6x&t=2

Thanks!

–Michael Morrill

The text above was written by Michael Morrill, not by MoveOn staff, and MoveOn is not responsible for the content.

Additional Hearings On Medicaid Cuts

Oshkosh - Friday, November 18th

4pm-6pm

UW Oshkosh Reeve Memorial Union, Room 202,

800 Algoma Blvd, Oshkosh

RSVP

 

Green Bay - Monday, November 21st

4pm-6pm

Central Library Auditorium

515 Pine Street , Green Bay

RSVP

 

Milwaukee - Thursday, December 1st

6:30-9pm

Washington Park Senior Center

4420 W. Vliet Street, Milwaukee

RSVP

 

Rhinelander - Thursday, December 8th

4:30-6:30pm

Nicolet College, LRC Theater

5364 College Drive, Rhinelander

RSVP

Special Report, Analysis & Commentary: The Future of BadgerCare & Medicaid

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Where the Rubber Stamp Hits the Paper

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The Joint Finance Committee Passive Review

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On Thursday, November 10, the Joint Finance Committee met to discuss and vote on the Wisconsin Department of Health Services proposal to drastically restructure and reduce enrollment in BadgerCare and Medicaid. On this day, 11 Republicans and 4 Democrats (Sen. Luther Olsen was absent) comprised the Joint Finance Committee. DHS Secretary Dennis Smith presented his proposal to the Committee. Recall that the Committee’s approval is all that is required to set the waiver request in motion to the federal government (CMS) for review. Act 32, the Wisconsin State Budget, delegated authority to Department of Health Services Secretary Smith to create changes in BadgerCare and Medicaid laws, needing only a "passive review" of the Joint Finance Committee, not a review by the full legislature. Therefore DHS will forward aspects of the plan that require federal approval to CMS. Calling a vote, the proposal of the Department of Health Services to approve all items included in the Maintenance of Effort waiver request, and all items related to Benchmark Plans was approved along party lines, 11-4. That same day, November 10, the waiver request was submitted to the Centers for Medicare and Medicaid Services (CMS).

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Federal Approval or Termination of Adults

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CMS typically has 90 days to review a waiver request, unless more information is needed from the state making the request. In this instance, however, the State has left CMS with fewer than 60 days to review the waiver request. Unfortunately over 53,000 childless adults in Wisconsin are, as Joint Finance Committee member Sen. Robert Jauch called them, "innocent hostages" caught in the middle of this DHS request and CMS review process and face BadgerCare program terminations if an approved waiver is not in place by Dec. 31, 2011. The state budget says that if the waiver isn’t approved by Dec. 31, 2011, those parents on BadgerCare Plus and adults on the Core Plan above 133% FPL will be dropped. Wisconsin Democratic legislators have asked Secretary Sebelius to help protect the 53,000 parents and adults on BadgerCare.

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How YOU Can Contact HHS to Comment on the Waiver

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Let Your Voice Be Heard!

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CMS does not have an "official" public comment process for the Wisconsin waiver request. Instead, you can contact the US Department of Health and Human Services (HHS) directly to comment on the Wisconsin DHS Waiver Request. Please send an email or call the Regional Director for our area, Kenneth Munson:

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Kenneth Munson

Regional Director

Region V of the Department of Health and Human Service

Call: 312-353-5160

Email: Kenneth.Munson@hhs.gov

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Mr. Munson will see that ALL comments on the waiver request (pro and con) are directed to appropriate CMS officials.

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Joint Finance Topics for Discussion

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HealthWatch Wisconsin observed the Joint Finance Committee debate and herein reports its observations, opinions and insight into the future of BadgerCare and Medicaid in Wisconsin.

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Joint Finance Hears Waiver Request

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In front of the Committee were elements of the Department of Health Services proposal that either change state law or are included in the “maintenance of effort waiver request.” This includes the "Alternative Benchmark Plan," where DHS is asking families above 100% FPL (equivalent to a family of 4 making approximately $22,000 a year) to participate in increased cost sharing with a reduced benefits package.

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Maintenance of Effort waiver elements include:

• Restricting BadgerCare Plus from anyone who has access to private insurance
• Re-calculating family incomes
• Eliminating express enrollment and backdating on applications
• Increasing premiums
• Cutting Transitional Medicaid
• Restricting 19-26 year olds from BadgerCare Plus
• Requiring Proof of Residency
• Instantly denying BadgerCare Plus if verifications are late
• and more

All other elements of the proposal were not in front of the Committee and will not go to the Legislature. The authority delegated to Secretary Smith allows him to make the other changes without any review. Recall, the state budget permits Secretary Smith to terminate BadgerCare eligible adults above 133% FPL if the waiver isn’t approved by federal authorities by Dec. 31, 2011.

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Joint Finance Convenes, Rep. Vos Makes Rules

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Rep. Robin Vos (Co-Chair of the Joint Finance Committee) instituted a “two question” rule to limit discussion. Rep. Grigsby and Sen. Taylor expressed concern as to the fairness of the rule given the complexity and enormity of the proposal in front of them, taking into account that the full legislature did not get an opportunity to weigh in on the matter. Rep. Vos replied, “I am the chair and I decide the rules...The nice part is that we get to have a hearing today.” Of course, Vos didn't mean a "public hearing." There was no chance for public comment in front of the legislature on this proposal, again, thanks to Act 32.

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Smith Summarizes the Cuts

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Department of Health Services Secretary Smith began his comments by saying that he had been across the state listening to the people of Wisconsin. He believed his proposal protected seniors and the disabled, and those below 100% FPL. He stated that people above 150% FPL were only on BadgerCare in the first place because it was the option of the state. Under his waiver, the only individuals who would lose coverage will be those who "make the choice not to pay their fair share."

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Smith said to give his proposal context he wanted to remind everyone that the last administration auto-enrolled people in the Core Plan in 2009, and the state was exceeding its funds. Wisconsin then chose to cap Core Plan enrollment. “The state could have chosen to enroll individuals but chose not to.” “That decision to cap the plan impacted more individuals than any part of the waiver.” Smith described the waiver as representing “a modest savings of 2% of state investment in the program.”

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To finish his remarks, Smith very briefly addressed the Alternative Benchmark Plan. Smith identified Benchmark Plan benefits as being “comprehensive benefits.” He quickly added that “children will continue to have benefits through the EPSDT program.”

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Smith, throughout the meeting, continually referenced the Core Plan enrollment "cap" and compared Wisconsin to other states. He said Wisconsin was struggling with ways to contain the cost of the growth of Medicaid, saying, “the overall cost of Medicaid will continue to grow.” He said it was his purpose to slow the rate of growth that looks “more in line with the economy.” Other states change co-pays, eliminate benefits across the board. Smith repeated that he wants to protect the rights of the disabled and seniors, and will therefore charge co-pays and eliminate benefits for other populations. Smith’s comments were short, summary statements, shy on detail or explanation. He opened the floor for questions.

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Questions and comments are summarized below. Fast-forward to the final minutes before the Committee voted. Sen. Jauch closed with a quote from Hubert Humphrey, “The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in shadows of life, the sick, the needy, and the handicapped.” He repeated, “History will record Republican behavior on this issue. It is callous.” Rep. Corey Mason, Rep. Tamara Grigsby, and Sen. Lena Taylor gave just as moving comments. .

HealthWatch Initial Analysis & Comment

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1. Not an Appropriate Waiver Request

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Above all else, Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to waive provisions of major health and welfare programs, including certain Medicaid requirements, and to allow a state to use federal Medicaid funds in ways that are not otherwise allowed under federal rules. The authority is provided at the Secretary’s discretion for demonstration projects that the Secretary determines promote Medicaid program objectives. What Secretary Dennis Smith put in front of the Joint Finance Committee was neither a demonstration project nor a plan to promote Medicaid program objectives. It wasn't even a test of the Affordable Care Act, another attempt by Secretary Smith to stretch the intent of the waiver. The Legislative Fiscal Bureau called attention to this fact in many instances throughout its review of the proposal. When evaluating the crowd-out provision (page 14), dependent coverage (page 16), or counting "household income" (page 21), the Fiscal Bureau identified Smith's proposal as "not an accurate test of the Affordable Care Act" for failure to implement similar provisions as the Act. Rep. Grigsby called what Smith proposed "a grand experiment...playing with people's lives," not a demonstration or test that promotes the objectives of Medicaid. Sen. Jauch suggested that we didn't even get to the threshold of what was appropriate for the federal government to evaluate; Smith wasn't even withholding the mission of the Department of Health Services: to protect and promote the health and safety of the people of Wisconsin.

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2. Using EPSDT (Early Periodic Screening Diagnosis and Treatment) as a Cover

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Smith presented the Alternative Benchmark Plan as not representing any benefits changes for children, since EPSDT would still be available.  Smith said that the changes under Alternative Benchmark were not on the benefits side, but instead were on the cost sharing side. He said that was more comparable to private insurance.

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We cannot agree with the premise of Smith's argument. Even though both Secretary Smith and Deputy Secretary Kitty Rhoades sang the praises of the Benchmark Plan as being "comprehensive coverage," it does in fact represent fewer benefits for increased cost to the families forced off the Standard Plan. While early periodic screening diagnosis and treatment (EPSDT, called "HealthCheck" in Wisconsin) provides for services and benefits, even those not included in the state plan, a family has to jump through hoops and hurdles to get to these benefits. Using HealthCheck means that many of the services children got on the Standard Plan will now have access restricted, with hurdles such as verifications, Prior Authorizations and clinical information. The Department, even under EPSDT retains discretion to approve referrals. But since the Walker administration has eliminated Consumer Assistance Grants and Civil Legal Services funding for low-income families, there are very limited opportunities to challenge these decisions.

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Smith never identified a process for DHS to evaluate requests, such as reviewing medical necessity, establishing criteria for provision of services, and determining the amount, duration and scope of services. Nor did Smith identify how the Department would assist families seeking services through EPSDT, the outreach and education that would be needed to facilitate the requests, and the relationship with the HMOs charged to provide these "other services."  

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3. Choice is Not Part of the Equation

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Secretary Smith noted that his proposed cuts were "not as bad" as the Core Plan cap. Smith reached this conclusion by first misrepresenting how the Core Plan was established and funded. His repeatedly characterized Core enrollees as having no choice--being auto-enrolled (which was only the method of enrollment for GAMP members when that Milwaukee program ended), while others were capped without choice of staying in the program by paying more.

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We don't accept the premise of his argument. Smith wanted us to accept that everyone has the ability to pay for health coverage and that some simply choose not to. He believed that the healthy people were selecting BadgerCare, creating "inequity" in the small group and individual market. Smith insinuated that BadgerCare stole the healthy from the private market. Secretary Smith said that health insurance is all about pools and Medicaid has taken healthy lives out of pools. This increases premiums for everyone else in private insurance. He said he wants BadgerCare to be more fair for the people of Wisconsin. Deputy Secretary Kitty Rhoades said that to pay for adult coverage, we “used the tobacco money, the title 21, then the hospital assessment money. All these adults were in programs with no way for us to pay for it.” HealthWatch maintains that Secretary Smith actually has two options. First, lift the cap on Core Plan enrollment, and quit complaining about the injustice of the cap. We agree! Second, add MORE people to the Core Plan and BadgerCare roster. Stop trying to save a failing small group and individual insurance market by ripping holes in the BadgerCare pool. And finally, stop mischaracterizing how the Core Plan was actually funded. Recall, it was the Walker administration that capped the Basic Plan and eliminated the Core Plan Waitlist Bypass for those with chronic health conditions.

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Pick Your Poison:

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How the Proposed Cuts Leave 64,748 Uninsured and an Unfulfilled Waiver Request Terminates 53,000 Adults

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Not a Matter of Semantics

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When Rep. Corey Mason was allowed to ask one of his two questions at the Thursday Joint Finance Committee meeting, he zeroed in on the people who would be cut from BadgerCare Plus because of the proposal Secretary Dennis Smith was offering. Mason called attention to the Legislative Fiscal Bureau Memo that identified almost 65,000 people who would not be eligible for BadgerCare Plus under the new proposal. Secretary Smith quibbled with the question. He said no one would be disenrolled. He said people would instead be impacted.  I guess he could have called it "collateral damage." Smith then relied on his earlier introductory remarks, and repeated that the impact on people of his proposal was not as bad as the impact the previous administration made on people when they capped enrollment in the Core Plan. He said that at least under his plan people will have a choice. They can choose to leave BadgerCare if they choose not to pay the premiums.

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The Legislative Fiscal Bureau staff explained that the enrollment impact could be described as “people who are technically eligible but will drop in response to the premium increase.” The Bureau representative continued, saying that premiums were different than residency requirement, where the table shows that there will be disenrollment for those that aren’t technically eligible. After this clarification, Smith said “we’re just simply carrying over federal policy.” Rep. Mason was not willing to let the point of his question go. He stated, “At the end of the day, 65,000 people won’t be in BadgerCare.” Smith quickly replied, “Some will have insurance.” Yes, and some will have a source of care, too...the emergency room.

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Rep. Tamara Grigsby said, “This doesn’t sound like a choice to me. We are leaving people without choices!” Grigsby continued, “This to me seems pretty harsh. A blatant and cold attempt to gut part of a well established safety net for our most vulnerable in Wisconsin, especially children. We are giving them a heck of a Christmas gift; a holiday surprise, taking away something as basic as health care. We used to be able to brag that we cover more people. Now, it’s embarrassing, the choices we have made. I’m embarrassed to be here with tit for tat...but it’s shameful to cut 65,000 people…but offer $2.3 billion in tax breaks is ok.” Turning her comment to Secretary Smith, Grigsby asked, “What is your answer for when these 65,000 actually become disenrolled, when they show up at the emergency room. What are people to do when they don’t have jobs, income or social support? And we’ve made it our business to rip away the safety net that is left. Will hospitals eat that cost? We know it will be the taxpayers and those paying…paying for worse life outcomes as we become the Mississippi of the north. Help me understand what happens when we send them the notice.”

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Smith replied, “We should note…this is why a demonstration is being submitted in the first place.” Smith repeated, “We are more fair and equitable because we give people a choice.”

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Sen. Lena Taylor asked Secretary Smith to be transparent, since he kept comparing the new proposal to the health reform law. Taylor insisted the Affordable Care Act calculates family income and dates of application differently than the new proposal. If Smith wanted a fair comparison, he’d compare apples to apples, not try to insist that his proposal is just a demonstration of what is to come under health reform. Smith’s response was to repeat, “We are protecting people with disabilities and the elderly.”

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People, Not Widgets

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Sen. Robert Jauch was more than disgusted with the proposal presented by Secretary Smith. In fact, he was disgusted with the presentation of the proposal. “It’s troubling for me to listen to the casual way you’re making a presentation that decreases health care for working families and unsuspecting children. It’s as if you’re talking about widgets instead of people. You use words like ‘fair,’ ‘equitable’ and ‘generous.’ I believe it to be inhumane and unjust. I am proud Wisconsin has the second lowest uninsurance rate, meaning healthier families and less uncompensated care in Wisconsin, where you’ve been a resident since January. Wisconsin has a Judeo-Christian tradition of taking care of thy neighbor. This cowardly legislature gave you [Smith] the authority to cut spending that impacts people’s lives. There have been cherished moments in Wisconsin history, when Thompson was governor and made a commitment to be a brother’s keeper….Now, there is a callous disregard and now we’re a brother’s keeper—unless you’re on BadgerCare.”

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Jauch continued, “Let’s knock off the notion of distinguishing whether people will be ‘dropped off’ or are ‘making choices and can’t afford’ BadgerCare. Sen. Jauch asked Smith to acknowledge that people will lose coverage. Smith declined to answer. He instead said he’d like to contrast his proposal with the cap the previous administration made to Core Plan enrollment. Sen. Jauch asked Smith why he was making excuses and justifications for the adverse impact his proposal would have on people’s lives.

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Conclusion

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The Joint Finance Committee rubber stamped a dangerous and foolish DHS proposal and failed in an essential responsibility to the people of Wisconsin. They failed to consider the greater good and the long term financial interests of the state. The Republican majority proved to be tone deaf to the concerns of families, children, and communities across the state served by the BadgerCare program. Sadly, the only groups that have the Republican majority's ear are a small band of ultra conservative insurance and other industry representative that put profit before human needs. They only think of "me" instead of "we." The actions of the committee will subject our economy to long term harm as we have fewer federal resources to cover medical care and larger uncompensated care costs (like certain emergency room services) that will drive up health care costs for everyone. But remember, damaging a program that affects 1.2 million people and many more family members and friends across Wisconsin is playing with fire. Before too long the smoldering will become a flame that could singe the short-sighted Republican majority.
We will certainly keep watch!

In This Issue

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Special Report, Analysis & Commentary: The Future of BadgerCare & Medicaid

How YOU Can Contact HHS to Comment on the Waiver

Joint Finance Topics for Discussion

HealthWatch Initial Analysis & Comment

Pick Your Poison:

Conclusion

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ABC for Health, in partnership with HealthWatch Wisconsin, a membership organization that focuses work on maximizing access to care and coverage for the people of Wisconsin, has developed “The HealthWatch Wisconsin Reporter.” 
This special edition newsletter tackles the big issues, providing in-depth analysis and insight into complex public health and health coverage questions.

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How the Medicaid Cuts Got to Committee

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In the late afternoon hours of Halloween, Wisconsin's Department of Health Services Secretary Dennis Smith delivered his compiled list of proposed cuts (part 2 and part 3) of Wisconsin's Medicaid and BadgerCare Programs to Wisconsin's Joint Finance Committee. Formally called a "passive review request," Joint Finance Committee members had 14 days to review the materials and inform Joint Finance Co-chairs Sen. Darling or Rep. Vos by November 17 if they had any "concerns" about the request, and if they thought a meeting might be necessary. By Tuesday morning, November 1, an objection to the proposal was raised, and thus a meeting of the Committee will need to convene. Read the objection letter here.

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DHS Complains about Health Reform in Letters to Sebelius, Touts Wisconsin's "Innovation" Over the Last Two Decades

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State officials jumped on an opportunity to comment on proposed rules on topics of health reform law implementation when issued by the US Department of Health and Human Services (HHS). In four separate letters, the "Office of Free Market Health Care" spoke of the "inequities and confusion" health reform would create. Smith touted Wisconsin's history of being at the "forefront" of health coverage and creative programs and expressed concern that health reform would cause Wisconsin's time tested programs to suffer.

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HealthWatch Wisconsin was struck by the irony of Smith's comments, submitted to HHS as he prepared for his testimony in front of the Joint Finance Committee, where his law-making and cuts to Wisconsin's nationally recognized BadgerCare Plus and Medicaid programs were set for passive review.

Read the Office of Free Market Health Care Comments on proposed Affordable Care Act Proposed Rules at the following links:

• Cover Letter
• CMS-2349
• CMS 9974
• REG-131491
• CMS-9989

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Reactions to the Joint Finance Committee decision:

• JFC passes Medicaid savings plans
• Save BadgerCare Coalition
• Wisconsin Alliance for Women's Health
• Wisconsin Council on Children & Families
• Citizen Action of Wisconsin
• One Wisconsin Now
• Rep. Mason
• Sen. Shilling  
• Rep. Grigsby
• Planned Parenthood Advocates of Wisconsin
• AARP
• Joint Finance Committee  
• Wisconsin State Journal
• Milwaukee Journal Sentinel
• Janesville Gazette
• Click Here to read a Press Release “Joint Finance Must Reject ‘BadgerCare Minus’ Proposal”
• Click Here to read a Press Release “DHS Medicaid Plans Panned as Redistribution of Medical Debt”

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JOIN US...

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...in uniting the Public Health Workforce through comprehensive education and advocacy

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Become a member or subscriber of HealthWatch Wisconsin! Team up with an impressive effort in Wisconsin that champions education and the accurate dissemination of health coverage information and the accessibility of health coverage for all people in Wisconsin. Let HealthWatch help you amplify your voice! The membership and subscription year begins July 1 of each year, but individuals or organizations may join at any time! Click here to complete an application. Thank you!

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Save the Date! HealthWatch 5th Annual Conference

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February 27 & 28, 2012!

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Madison will be the place to be this spring! As a Presidential primary approaches and "recall fever" is in the air, we'll gather elected officials, candidates, experts and more to discuss our featured topic "Waive Goodbye to Medicaid?" and get perspectives on the future of health coverage in Wisconsin! Mark your calendar for Monday and Tuesday, February 27 & 28 for the 5th Annual HealthWatch Wisconsin Conference!  Watch your inbox in the coming weeks as registration for the great event will open December 1st.
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Share your BadgerCare and Medicaid Story:

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In Wisconsin, about 1.2 million people rely on BadgerCare and Medicaid programs to provide essential, affordable, and effective health care services. And the impact of these programs reaches thousands more--our friends, neighbors, grandparents, colleagues, and health care providers large and small in every county of Wisconsin. Tell your BadgerCare or Medicaid Story! Why is BadgerCare or Medicaid important to you and your family? What would happen if BadgerCare or Medicaid ended? CLICK HERE to complete a story form!

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

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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. Please CLICK HERE to view these HealthWatch Wisconsin public hearings.

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Do You Know the Advocate of the Year?? Help with the HealthWatch Annual Awards!

HealthWatch Wisconsin is currently accepting nominations for the Third Annual HealthWatch Awards to be presented at the HealthWatch Wisconsin annual conference. The Health Watch Wisconsin council seeks to recognize outstanding work in healthcare advocacy and service in four categories. Click on the category you wish to nominate someone for to download a nomination form!

• Advocate of the Year
• Elected Official of the Year
• Outstanding Outreach Effort Award
• Outstanding Media Coverage Award

Return your form to HealthWatch Wisconsin by email, FAX: 608-261-6938 or US Mail: 32 N. Bassett St., Madison, WI 53703. To view last year’s winners, Click Here.

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Read the Reporter Online

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Visit our HealthWatch "Update" Library

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Watch Archived Videos of the HealthWatch WatchDog

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Read the BadgerCare+ Bulletin

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Read our Latest Press Releases

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See Available Publications

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HealthWatch Wisconsin Update Staff .

Bobby Peterson

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Brynne McBride

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Adam VanSpankeren

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ABC for Health, Inc. is a Wisconsin-based, nonprofit public interest law firm dedicated to linking children and families, particularly those with special health care needs, to health care benefits and services. ABC for Health’s mission is to provide information, advocacy tools, legal services, and expert support needed to obtain, maintain, and finance health care coverage and services.

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