This led the Wisconsin Legislature and Governor Evers to play "beat the clock" with the state budget, with Evers signing it in the early morning hours of July 3, barely beating Trump/GOP's Big Bill of Bollocks into becoming law, as the Big Bill of Bollocks cut off any of these sort of enhanced Federal match rates for hospitals to limit the cost of the bill (while adding tens of billions a year to ICE at the same time). Well, it turns out that the presidential Administration that Small-D VO stands with may screw over the state in the strategy that Van Orden told the state to take. And Western Wisconsin Democrats recently sent a letter to Van Orden asking him to try to get the Trump Administration from taking away hundreds of millions of dollars from the state.You have got to be kidding me. Republican Rep. Derrick Van Orden of Wisconsin wrote a letter urging his state’s Democratic governor to take steps to protect rural hospitals from the fallout of Republicans’ widely reviled budget bill — which Van Orden voted for. www.msnbc.com/top-stories/...
— Dizzygirl (@dizzygirl.bsky.social) July 4, 2025 at 11:59 AM
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On July 2nd, 2025 you sent a letter to Governor Evers regarding the state’s biennial budget stating: “As you are aware, timely enactment is especially critical this year due to the proposed increase in the state provider tax, which must be effectuated before the anticipated signing of the One, Big, Beautiful Bill on or around July 4, 2025.” You further stated “Wisconsin will immediately receive a $500,000,000 plus up for rural healthcare infrastructure, and an additional billion dollars annually for healthcare in our great state.” As you know, the Wisconsin state budget was passed by the State Senate and State Assembly on July 2nd, 2025, and was signed into law on July 3rd, 2025, before the signing of the One, Big, Beautiful Bill which was signed on July 4th, 2025. Unfortunately, the Trump administration is currently moving forward with an unprecedented action to deny Wisconsin’s ability to draw down the additional promised hospital assessment dollars, which will cost our state nearly $800 million every biennium. Our hospitals, and especially our rural hospitals were counting on that funding to keep their doors open. This increased funding is needed to help hospitals sustain and expand access to care for patients across Wisconsin when one-third of the state’s hospitals are operating at a deficit, driven by $1.6 billion in losses from Medicaid reimbursement. At a time when our medical institutions are facing unprecedented financial challenges, we must do everything we can to ensure their ability to continue to operate. Our state budget was counting on it, and our constituents’ lives literally depend on it. We implore you to do everything in your power to reverse these catastrophic decisions.If the Trump Administration were to reverse themselves and disallow the added hospital assessment, it would not only likely lead to more hospitals in the state to close, but it would add expenses to a Wisconsin Medicaid budget that was already running at a deficit. Because at the start of this month, the state's Department of Health Services said that state tax dollars going into these medical care programs was on track to go over what was budgeted.
Since our previous quarterly report, the Department has another quarter of enrollment and cost experience data and has completed Calendar Year 2026 capitation rate setting for Medicaid acute and long-term managed care programs. Based on this additional information, the Department projects expenditures will exceed available budget by $213.2 million GPR by the end of the biennium, which is 2.2% above budgeted levels under 2025 Act 15, the 2025-27 biennial budget. Several factors are contributing to the projected deficit. The Act 15 Medicaid budget adopted lower Family Care and Family Care Partnership enrollment growth trends than the Department recommended during budget development. The actual enrollment trend so far this biennium suggests program enrollment will be even higher than the Department anticipated prior to passage of Act 15. This quarterly projection assumes that by FY 27, MCO enrollment will be 3.4% higher than Act 15 provided. At the same time, the Department has now finalized Family Care managed care organization (MCO) capitation rates for CY 26, which overall are more favorable than budget, and which partially offset the higher enrollment costs. The net biennial impact is an expected $45 million GPR deficit for these services. In addition, fee for service nursing home expenditures and Children’s Long Term Supports (CLTS) program costs are significantly higher than budget due to higher-than-projected utilization, adding $59 million GPR and $38 million GPR to the deficit, respectively.The report goes on to note that despite lower-than-expected enrollment in BadgerCare Plus and SSI managed care services in Wisconsin, costs for items like prescription drugs and substance abuse/mental health services are also running higher, so the state will likely have to tap into its $2.5 billion surplus to take care of the Medicaid deficit before the budget cycle ends on June 30, 2027. So if the Trump Administration decides to





















