On Medicaid -it's a start, but GOPs making it much tougher than it needs to

I wanted to give a slight review on a portion of the moves made in Wisconsin's Joint Finance Committee this week on health care issues. And some of it might be a bit surprising to you, and some of it might be even more infuriating than you know.

I’ll leave out the savings that Medicaid expansion would have given to Wisconsin taxpayers for now (although I’ll get back to it), and look at the 50-part (!) budget motion that WisGOP pushed through this week on Medicaid and other DHS services.

I want to list some items where GOPs actually gave more money to a provision Evers had, and items where GOPs either shot down an Evers idea entirely or added something that wasn’t in the budget. This list will be far from the only ones, but you’ll get the idea. Most of these will be given in all monies (state and federal combined).

GOPs give more money than Evers.
1. Disporportionate Share Hospital Payments - Evers wanted to add $71.4 million more a year, JFC GOPs are giving another $73.9 million a year. This is for hospitals and the “disproportionate share” is the amount of low-income people that facility may serve. This is intended to reward/encourage hospitals to serve people on Medicaid, and help them make ends meet.
2. A supplement for hospitals in rural areas that serve Medicaid recipients. Evers wanted $615,800 a year, GOPs gave $4.04 million. Who says Republicans don’t mind giving out tax dollars (if it goes to their rural communities)? Just don’t have it Medicaid “welfare”.
3. Family Care direct care funding . Evers wanted $29.5 million over the 2-year budget, GOPs gave $66.5 million (!). This goes to managed care organizations to help them pay higher wages and benefits to home care workers, where major work shortages have emerged.
4. Nursing home reimbursement. Evers wanted $26.4 milion for 2019-21, GOPs gave $74.0 million. Numerous nursing homes have been closing recently, as they can’t make ends meet, so the higher reimbursements might encourage these facilities to stay open.
5. Personal care reimbursement. Evers wanted $16.75 million for 19-21, GOPs gave $91.0 million (!). Same reason as 3 and 4.it’s a 1.5% increase on January 1, 2020 and again 6 months later.
6. Continue FoodShare “reforms” started under Walker. Evers didn’t have any money set aside for these race-baiting provisions. GOPs set aside $46.6 million to continue the program, its hoops that applicants have to jump through, and its drug testing. Although once you include the reduced enrollment in FoosdShare, the total extra cost is slightly less than $20 million! It’s almost like preventing people from getting benefits was an intended result!

A couple of things to note here. First is that you can tell GOPs are definitely scared voters will blame them for the nursing homes closing and the labor shortage for caregivers of our most vulnerable, so they threw a lot more money into these items. This Walker-like series of tweets from Joint Finance Co-Chair John Nygren are a great illustration of how GOPs are trying to use this extra funding to attempt a “See, we care too!” message.

I am happy to report that the message was received and Republicans voted to support these priorities at historic levels, well above @govevers budget. No amount of rhetoric or spin can argue the fact that many of our investments in healthcare exceeded @GovEvers proposal.

— John Nygren (@rep89) June 6, 2019

We voted to increase funding for Personal Care workers by $37 million GPR over the biennium. This is a 9% increase. @GovEvers budget only increased rates by $7 million over the biennium.

— John Nygren (@rep89) June 6, 2019

But it's worth mentioning that most of these incentives go to hospitals, HMOs, and other health care businesses over having it go to give choices to individuals. Also, if GOPs has chosen to expand Medicaid, they could have done many of these exact same things, with one notable difference. The Feds would have picked up another 31% of these costs. Republicans are trying to divert from their losing position, but it just underscores their pig-headed idiocy regarding expanded Medicaid.

Now look at what the GOPs turned down that Evers wanted in the budget.

1. $200 million in increased payments to ALL hospitals – The Medicaid expansion was supposed to take care of this, but when that went away, so did this.

2. $20 million supplement to hospitals that have a lot of pediatric care - $45 million for a new benefit to work on “nonmedical services that contribute to the determinants of health.”

3. $38.8 million for enhanced reimbursements for dental providers who see a certain amount of Medicaid patients.

4. $22.8 million to allow Medicaid benefits to continue for women up to 1 year after they give birth, instead of 2 months. The “pro-life, family values” GOP turned this down, and they also didn’t approve of $618,700 that would have allowed doula services to be paid by Medicaid.

5. $9.15 million to increase eligibility for the “Birth to 3” program for children with developmental delays/disabilities.

6. $4 million for incentives to have behavioral health providers adopt electronic health records and exchange other types of patient information.

7. $6.6 million to increase state-funded activities and programs that try to prevent tobacco usage.

8. $500,000 to give out grants that encourage healthy aging.

Priorities, I guess. And telling ones.

I'll admit that if the Health Services budget goes through as it stands, and gets reluctantly signed by Governor Evers, there will be improvements on where we are today in terms of providing services to our most vulnerable and adequate reimbursements to those who take on those often-thankless jobs. But it doesn't come close to giving what Wisconsinites the health care funding and services it voted for in November, and what they overwhelmingly want today.

So like a lot of other things in this state, the 2018 election was merely a beginning to working ourself out of the hole we were put in during the Age of Fitzwalkerstan, and there is much more left to be done.