Monday, April 22, 2013

Rejecting Medicaid expansion too risky (with video)

Health care providers are urging Gov. Scott Walker and lawmakers to reverse course and expand Medicaid in Wisconsin. / AP Photo/Scott Bauer
There are many unknowns as the health care industry and other private businesses prepare for the implementation of the health care reform law known as Obamacare. The U.S. health care system is one of “Byzantine complexity,” as Dr. Larry Hegland, chief medical officer at Ministry Saint Clare’s Hospital, told the Daily Herald Media Editorial Board in an interview last week. Obamacare didn’t create that problem, and it doesn’t cure it.
One of the key and very positive provisions in the law is the expansion of Medicaid, the insurance program for low-income families and individuals, known in Wisconsin as BadgerCare. The expansion, which would make the program available to people with incomes up to 138 percent of the federal poverty level, was rejected by Gov. Scott Walker, who instead unveiled a system that would push people who fall between 100 percent and 138 percent of poverty into a new, private market for health insurance known as a health exchange.
Here’s the problem, according to a broad coalition of hospitals, doctors and other providers we interviewed: The exchanges might not work. They might be too complex for this population to navigate without help. They might be overloaded at first, and there might not be enough customer help to get people what they need.
We don’t know because the health insurance exchanges are not up and running yet. That in itself is a reason not to build a plan, as Walker has, that relies on Obamacare exchanges running smoothly when the reality seems likely to be anything but.
Health care leaders are right. It’s risky. And the fact that essentially the entire health care field is speaking with one voice on this issue — along with Hegland, we met with representatives of Aspirus Wausau Hospital, the Wisconsin Hospital Association and the Wisconsin Medical Society — ought to cause lawmakers to give this issue a second look as they write the budget for the coming biennium. There’s a strong argument for delaying the time when the state begins to push people onto the exchanges.

Wednesday, April 17, 2013

Coalition to Strengthen BadgerCare Continues to Grow
44 health care and business groups urge state lawmakers to take good deal that insures more people and saves taxpayers money
Madison—A group of over 40 Wisconsin health care providers and business groups are urging the state legislature to amend Gov. Walker’s budget proposal by taking federal health care financing to strengthen the BadgerCare program.

The coalition made the request in a letter delivered this week to all state lawmakers.  Rep. Jon Richards (D-Milwaukee), member of the Joint Finance Committee, released the following statement in response to the letter (attached). 

“Our coalition continues to grow.  Health care providers from around the state, including traditional Republican business groups like MMAC, are urging the legislature to accept this good deal because it will provide a huge benefit to our health care system and to the people they care for—all while saving state taxpayers money.  

“By accepting these federal funds, Wisconsin can insure more people and save taxpayers $100 million in the next two years, compared to what Gov. Walker proposed in his budget. 

“It’s not too late to take this good deal.  I call on my Republican colleagues to listen to the health care providers in their districts and to say yes to BadgerCare.”

Wednesday, April 3, 2013


   April 3, 2013     

Action Alert: Greendale Public Hearing

Public Hearings on the Budget: Let Your Voice Be Heard!

Wisconsin's Joint Finance Committee (JFC) has announced it will hold four "public hearings" on the proposed executive budget. Beginning TOMORROW, April 4 in Greendale, WI, these hearings are an excellent opportunity to speak out and let your elected officials know how you feel about proposed changes to BadgerCare Plus and Medicaid programs in the budget. The hearings are scheduled as follows:
Greendale - April 4, 2013
Greendale High School Auditorium
6801 Southway
Greendale, WI 53129     Green Bay - April 8, 2013
Lambeau Field Legends Club Room, 4th Level
1265 Lombardi Ave
Green Bay, WI 54304
WI Dells - April 10, 2013
Kalahari Resort Suite 2 & 7 Main Level
1305 Kalahari Drive
Wisconsin Dells, WI 53965     Baldwin - April 18, 2013
Baldwin-Woodville High School Auditorium
1000 13th Avenue
Baldwin, WI 54002

You can also submit written testimony by email or submit written testimony via U.S. mail to: Joe Malkasian, Room 305 East, State Capitol, Madison, WI 53702.

This is the first in a series of ACTION ALERTS from HealthWatch Wisconsin to remind people of the upcoming hearings. Remember, there are rules that accompany these hearings. Your comments will be restricted in time, so be sure to address the Joint Finance Committee briefly and efficiently.

About the Budget Bill:

As things stand now, Wisconsin rejected the chance to expand Medicaid and take advantage of the Federal Government paying 100% of the cost of certain new Medicaid enrollees through 2016. Instead, Wisconsin plans to dramatically change our Medicaid and BadgerCare Plus programs. The proposed executive budget bill AB 40 caps BadgerCare Plus for all non-disabled adults at 100% FPL.

Read HealthWatch Wisconsin's new "Top Ten" list for April on the value in expanding Medicaid in Wisconsin, instead of cutting it, as proposed in the budget.

For a summary of the proposed budget changes and commentary, view one of our recent WatchDog episodes:

    Wisconsin's Budget Proposal-Part I: "Medicaid Expansion?"
    Wisconsin's Budget Proposal-Part II: "The Faulty Justifications for WalkerCare"
    Wisconsin's Budget Proposal-Part III: "Medicaid Common $en$e"

In a press release issued by HealthWatch Wisconsin, ABC for Health's Bobby Peterson says, "Governor Walker put politics above the needs of people in Wisconsin," commenting on the Medicaid provisions of the proposed state budget. Peterson continued, "The Administration justified its new plan for health care in Wisconsin as 'a path from dependence to independence' for the 87,000 parents that could face termination from BadgerCare Plus in 2014. In reality, the WalkerCare proposal is a shell game strewn with red tape that pushes people from BadgerCare (subsidized health care in contracted private health plans) through to Exchanges (subsidized health care through private health plans in the new federal marketplace)."

Peterson continues, "To make matters worse, the Governor's plan costs more money, separates children from parents' coverage, and leaves billions of our federal tax payments in Washington for other states to spend for their health care needs. Meanwhile back home, counties spend hundreds of millions of local tax levy dollars on mental health services that federal resources could partially cover." Peterson relies on fiscal estimates provided from Legislative Fiscal Bureau Reports to support his conclusion that the Walker administration operates from a "very different reality" driven by political ambition.

Peterson concludes, "The Walker administration had a huge opportunity to strengthen BadgerCare, help local property tax payors, and save the state money. Let's hope that better public policy emerges from the Joint Finance Committee and the Legislature."
Your Voice is Needed and Appreciated!

If you can't attend a public hearing in person, consider submitting written testimony or contacting your elected officials NOW to let them know your thoughts on the dire need for BadgerCare Plus and Medicaid programs in Wisconsin!
Call the Legislative Hotline: 1-800-362-9472
Call or Email Your Elected Official Directly
Join HealthWatch Wisconsin to Help Us Promote Access to Health Care & Coverage in Wisconsin

To see a listing of current Joint Finance Committee members, please click here.

On behalf of the staff and students at ABC for Health, thank you for being a subscriber to the HealthWatch Wisconsin Update, Reporter, Action Alerts & WatchDog. ACTION ALERTS are funded by HealthWatch Wisconsin member dues. Please join and support HealthWatch Wisconsin or make a tax-deductible donation to ABC for Health, to keep projects like HealthWatch Wisconsin sustainable!

Senator Leibham Capitol Connection E-Update ~ April 3, 2013

~ Budget Initiatives Focusing on Health Services and Children and Families ~

This week, I will continue my efforts to outline some of the major provisions in Governor Scott Walker’s recently proposed biennial state budget for 2013-15. Two weeks ago, I highlighted some of the major K-12 education priorities in the budget, and this week I will examine those portions of the budget that relate to health services and programs for children and families. Again, please remember that Governor Walker’s budget is simply a proposal at this time. The legislature now has an opportunity to make its own changes to the budget before it becomes law.

There are two primary state agencies that administer programs related to health services and children and families. The Department of Children and Families (DCF) has a proposed annual budget of $1.1 billion, and the Department of Health Services (DHS) has an annual budget of around $10 billion. This substantial annual commitment of resources funds both state programs as well as federal programs (like Medicaid) that are administered by the state. While Governor Walker’s budget proposal contains numerous provisions related to health services and children and families, I have included descriptions of some of the most significant ones below:

Rising Medicaid Costs- The budget proposal starts with the fact that administering the various Medicaid programs currently in existence costs Wisconsin more each year. In fact, it would cost the state $1.1 billion in new money to simply fund Medicaid programs as required by current state and federal law over the next two years. There are several factors driving these increased costs. First, over the next few years, more individuals are expected to enroll in Medicaid programs as a result of many factors, including continuing tough economic conditions and the implementation of the federal Affordable Care Act (ACA). Second, federal matching funds for Medicaid in Wisconsin are expected to decline. The budget provides $170 million in new taxpayer money (general purpose revenue) to replace this federal funding that has disappeared. Finally, costs to administer Wisconsin’s Medicaid program are increasing due to increasing enrollment and costs associated with implementation of the ACA. The budget provides an additional $76 million in new state funds over the biennium simply to fund increased administrative needs that will accompany the implementation of the ACA and other federal requirements in Wisconsin.

Changes to BadgerCare Plus Eligibility- The budget would create several changes to eligibility levels for BadgerCare effective on January 1, 2014, once the ACA has been implemented. Under the proposal, all adults living in poverty would be covered. Currently, certain nonelderly, nondisabled adults with incomes at or below 200% of the Federal Poverty Level (FPL) are eligible for BadgerCare Plus. The proposal would reduce this eligibility level to individuals at 100% of the FPL or below for all such adults. Individuals who would no longer be able to obtain BadgerCare coverage could receive health care coverage through the federal health care exchange created by the ACA. For nonelderly, nondisabled childless adults, this change would ensure that all such individuals with incomes below 100% FPL are eligible for BadgerCare, through the Core Plan. Currently, childless adults with incomes up to 200% FPL are eligible, but there has been a freeze on new enrollment since late 2009 which has prevented any new individuals from enrolling. The proposed budget would remove the freeze and allow all childless adults under 100% FPL to enroll.

Medicaid Residency Verification- The budget would streamline and improve the process of determining eligibility for Medicaid in Wisconsin by implementing an electronic residency verification system. This system would quickly and easily check the residency status on individuals applying for public assistance in Wisconsin to ensure that they are actually Wisconsin residents. The budget estimates that the implementation of this program would save $20.5 million over the biennium.

Carbone Cancer Center- The budget would provide $3.75 million over the biennium of new support for the University of Wisconsin Carbone Cancer Center to allow the development of new research and imaging projects and to support the Wisconsin Oncology Network. The proposal would require the Cancer Center to raise an equal amount of new funds from other sources.

Mental Health Treatment Expansion- The proposal would provide almost $30 million over the biennium to fund expanded mental health services across the state through a variety of initiatives. $16.7 of this money would go to an expansion of the Comprehensive Community Services program which is designed to provide individualized, community-based mental health services to children and adults. These services include psychiatric medication, mental health counseling, and other services. Additionally, the bill would create an Office of Children’s Mental Health to ensure that children’s mental health needs are being given direct attention. Finally, the bill would provide $1.3 million for expanded coverage of in-home counseling services and an additional $1.3 million for peer-run respite centers. Peer-run respite centers allow individuals experiencing a crisis situation to seek help from other individuals who have had the same kinds of experiences in the past.

Child Care Fraud Detection- The budget proposal would provide $1.4 million over the biennium to continue fraud prevention initiatives currently underway in the Wisconsin Shares child care program. Additionally, it would convert current temporary staff positions into 13 permanent positions to track, investigate, and stop occurrences of fraud in the Wisconsin Shares program. This funding will ensure that no backlog develops in fraud prevention activities.

Child Care Electronic Benefit Card- The proposal would further seek to reduce fraud in the Wisconsin Shares program for allowing for the creation of an electronic benefit transfer method of payment. Currently, DCF reimburses child care providers directly for costs association with the Wisconsin Shares program. Under the new proposal, DCF would directly give parents an electronic benefit card to use in making child care payments to providers. The goal of this provision is to reduce instances of providers defrauding the state by seeking reimbursement for services that were not provided. Since parents have a better understanding than the state of when their children are actually in child care, there is less of a chance that parents would pay for hours in which there was no care given.

These are a few of the major initiatives in Governor Walker’s budget related to health services and children and families. Again, the budget proposal contains many other related provisions. However, I have highlighted only a few that I think might be most interesting or relevant. To review all of the budget recommendations on these and other issues, I would encourage you to review a detailed memo on this issue by the legislature’s non-partisan Legislative Fiscal Bureau (LFB) at:

Over the next few months, I will be reviewing these provisions, along with the rest of the budget, as I continue to consider the Governor’s proposal. I continue to welcome your input on these and other important issues.

As always, it has been a pleasure communicating with you. Please remember to communicate with me and share your input by calling 888-295-8750, writing to me at P.O. Box 7882, Madison, WI 53707-7882, or by e-mailing me at . You can also log on to the 9th Senate District on-line office at

It is an honor representing the residents of the 9th District in the State Senate!

~ Senator Joe Leibham Announces State Budget Public Hearings and
9th Senate District Budget Input Sessions ~

Over the past several weeks, I have been sharing information on specific parts of Governor Scott Walker’s 2013-15 state budget proposal. I have received many thoughtful responses and much constructive input on each of these segments and I will continue to provide more information on the budget in the weeks to come.

As the budget process continues to move forward, I am pleased to announce that I will be hosting a set of State Budget Constituent Input Sessions for residents of the 9th Senate District in Plymouth, Chilton, Sheboygan, Kiel, Oostburg and Manitowoc. In an effort to reach as many people as possible, I have worked to offer sessions at varying times of the day, on weekdays and weekends. If you are interested in the state budget, I encourage you to attend.

The purpose of the Budget Input Sessions is to receive citizen input on the 2013-2015 state budget plan proposed by Governor Scott Walker and currently under consideration by the State Legislature. As I begin to review and deliberate the state budget plan, it is important that I hear from my constituents.

2013 – 2015 9th Senate District State Budget Input Sessions

Thursday, April 4, 2013
7:00 a.m. - 8:30 a.m.         Roadside Restaurant – 5575 N. State Road 57, Plymouth (back room)

Saturday, April 6, 2013
10 a.m. – Noon                 Chilton Public Library – 221 Park Street, Chilton

1:30-3:30 p.m.                  Sheboygan Municipal Courtroom (inside the Sheboygan Police Department) }
                                       1315 N. 23rd Street, Sheboygan

Saturday, April 13, 2013
8:00 – 9:30 a.m.               Kiel City Hall (Council Chambers) – 621 Sixth Street, Kiel

11 a.m. – Noon                Oostburg Public Library – 213 N. 8th Street, Oostburg

Monday, April 15, 2013
5:00 -7:00 p.m.                University of Wisconsin Manitowoc (County Board Room) - 705 Viebahn Street, Manitowoc

Participants will be recognized to speak on a first come first speak basis and individuals attending are asked to keep their initial comments to 3 minutes – additional time will be offered if time allows. I look forward to a respectful and constructive discussion on the state budget that will guide the operation of our state for the next two years.

The Joint Finance Committee (JFC), of which I am a member, has also planned a series of Public Hearings on the budget around the state to allow the members of the committee to get statewide input from Wisconsin residents.

2013-2015 Public Hearings of the Joint Finance Committee

Thursday, April 4, 2013
10 a.m. – 6 p.m.             Greendale High School Auditorium - 5801 Southway, Greendale

Monday, April 8, 2013 
10 a.m. – 5 p.m.             Lambeau Field – Legends Club Room - - 4th Level - 1265 Lombardi Avenue, Green Bay

Wednesday, April 10, 2013
10 a.m. – 5 p.m.             Kalahari Resort – Suites 2 and 7 (Main Level) - 1305 Kalahari Drive, Wisconsin Dells

Thursday, April 18, 2013
10 a.m. – 5 p.m.            Baldwin-Woodville High School Auditorium - 1000 13th Avenue, Baldwin

If you are unable to attend any of my Input Sessions or the JFC hearings, I encourage you to send your input to me at the contact information below.

For more information on the 2013-15 state budget, citizens may want to check out the following web sites:

State of Wisconsin Department of Administration - Governor’s Budget Page:

Non-Partisan Legislative Fiscal Bureau’s Recent Publications Page:

The Wisconsin Legislature’s electronic bill notification service also allows you to track the progress of the budget bill - Assembly Bill (AB) 40 - in the Legislature. This free service provides individuals with immediate electronic updates on specific legislative proposals. You can access this service and track the progress of a bill by clicking on the following link:

As always, it has been a pleasure communicating with you. Please remember to communicate with me and share your input by calling 888-295-8750, writing to me at P.O. Box 7882, Madison, WI 53707-7882, or by e-mailing me at  You can also log on to the 9th Senate District on-line office at

It is an honor to work for and represent the residents of the 9th District in the State Senate.


~ Issue Corner ~

Each week, I highlight a hot topic that is being discussed by the legislature. I intend this section to be a window into the informal conversations happening at the state capitol, but will not indicate an endorsement or position on the issue. In addition, I will review and consider all input I receive about the issue, but due to the volume of emails I already receive, you may not receive a direct reply every time you share input.

Senate Bill (SB) 99

** Note – Senator Leibham has not yet taken a position on this bill – the information is provided to inform and seek input.

SB 99 makes a simple change to our current state tax code by adopting a tax benefit for educators. Specifically, this bill provides an income tax deduction for elementary and secondary teachers who use their own funds to purchase classroom supplies. The amount of the deduction is up to $250. Eligible requirements apply to an educator who is a teacher, instructor, counselor, principal, or aide in a public, private, tribal, or charter school for at least 900 hours in the taxable year that the deduction is being claimed. This specific deduction is also available on a federal tax return, with very similar eligibility requirements.

You can view an electronic copy of SB 99 here:

Also, I encourage you to sign up for the legislative notification service so that you can track this proposal as it makes its way through the legislature: 

Tuesday, April 2, 2013

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Send a Message to Your Legislators Today - Strengthen BadgerCare in the Budget!

April 2, 2013


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Joint Finance Committee Budget Hearings

April 4 - Greendale
April 8 - Green Bay
April 10 - Wisconsin Dells
April 18 - Baldwin

Now is the time to make your voice heard and tell our leaders to improve on the Governor's BadgerCare proposal!

Lawmakers in Wisconsin are considering the Governor's proposed 2013-15 budget, with Joint Finance Committee hearings throughout the state over the next few weeks. Take a moment today to send a message to Strengthen BadgerCare in the Budget!

Check out our talking points on the Save BadgerCare coalition's asks for the 2013-15 budget regarding BadgerCare - feel free to borrow liberally to craft your email to legislators.

Call or email your legislator NOW and urge them to Strengthen BadgerCare and save state taxpayer dollars in this budget. 

To send a message to all members of the Joint Finance Committee & Your Representatives:
  1. Link here
  2. Select "Joint Finance Committee" under the "choose your legislator" list.
     In addition, select your own State Representative and State Senator to include them in your message.  Don't know who represents you - link here:
  3. Select "Strengthen BadgerCare in the Budget"
    as your "subject".
  4. Add your message and let them know why BadgerCare is important to you! Remember - use our talking points about budget improvements that need to be made.
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:

FANTASTIC: Powerful posters against gun violence

Rebuild the Dream

Just recently, news broke that Senate leaders were considering dropping some of the most meaningful provisions from gun violence legislation.

Even super-majorities of gun owners overwhelmingly support common-sense measures like a ban on high-capacity magazines and universal background checks. We are little more than three months after the massacre at Newtown. But most U.S. senators seem more worried about NRA attack ads in 2014 than the gun violence that is taking innocent lives today.

The answer to gun violence is not simple. In many communities, nothing stops a bullet like a job. Plus, we need more community-based violence prevention programs. But we also need strong common-sense gun laws. To win that fight, we need to reach out to spark new energy.

To engage our friends and neighbors, we are teaming up with the Creative Action Network. Dozens of artists have submitted astonishing, moving posters that remind us why we fight and inspire us to dream differently. They could not come at a better time.
Check out these powerful posters at now -- and then share them with your friends, family and community.
The most-shared posters will be given a place of honor at a gallery show in San Francisco on April 18th, helping the artist sell prints.

Click share today and you will be supporting talented individuals at the creative edge of 21st century advocacy.

Not only that: You will help change the minds of friends, relatives and neighbors, and inspire them to join the fight.

In the weeks to come, Rebuilders will do more than share moving designs online. We will also bring this art out onto the sidewalks and streets of our communities -- and bring culture and creativity into a perilous political moment.
Visit today.

The gun crisis, along with the struggle for fair immigration laws, is a key fight of the moment. Congress's limited courage is already failing. We need to step up.

Thank you,

Van and the rest of the Rebuild the Dream team

Rebuild the Dream is a platform for bottom-up, people-powered innovations to help fix the U.S. economy. You can follow us on Twitter, and like us on Facebook.

Monday, April 1, 2013


Moving Forward On Medicaid: More Important Than Ever, Richmond Times-Dispatch, April 1, 2013
As a community physician for more than eight years, I've seen how medical care helps keep families strong and secure. When parents and their kids can access health care — and have a way to pay for it — they are much less likely to face unpaid bills or have to put off doctor visits. Instead of worrying about how their family is going to survive, they can focus on how their family is going to thrive.
Why Uninsured Might Not Flock To Health Law's Marketplaces, Kaiser Health News, March 31, 2013
But persuading millions of people to buy insurance, even those eligible for subsidies, is still expected to be a very tough sell. The Obama administration, which will run the marketplaces in at least 33 states has yet to release any details of its marketing campaign designed to let people know about new insurance options and how to enroll. 
Using Medicaid Dollars For Private Insurance, New York Times, March 31, 2013
The Obama administration and Republican officials in several states are exploring ways to redirect federal money intended to expand Medicaid, the main public insurance program for the poor, and use it instead to buy private health insurance for Medicaid recipients. The approach could have important benefits for beneficiaries and for the future of health care reform. But the idea also carries big risks. Federal officials will need to enforce strict conditions before agreeing to any redirection of Medicaid dollars that were originally intended to enlarge the Medicaid rolls
Mental health "parity" is officially a done deal. Congress passed a law back in 2008 requiring health insurers to treat mental health on a par with physical health, covering care for mental illness and addiction no less than they cover physical care. Many states have also passed their own mental health parity laws. So why has former Congressman Patrick Kennedy of Rhode Island -- lead sponsor of the 2008 bill together with his late father, Sen. Ted Kennedy -- spent much of the last couple of years criss-crossing the country to advocate for mental health parity? 
States that want to privatize the healthcare law's Medicaid expansion will need a waiver from the federal government, the Health and Human Services Department said Friday. The option of a private expansion has gained traction since Arkansas Gov. Mike Beebe (D) first proposed it last month.
The Secret Republican Plan to Repeal Obamacare, The Atlantic, March 28, 2013
Republicans are doing their best to highlight and stoke the kind of constituent anger that would force Democrats to tweak the law. In fact, if Democrats come under enough pressure, Republicans believe they might be able to inject Obamacare into the broader entitlement-reform discussion they are planning to tie to the debt-limit debate this summer.