The Budget Repair Bill being discussed in the Legislature has focused on employee benefits, but includes a sweeping shift of authority for setting Medicaid policy. If passed, this unprecedented seizure of legislative authority would put critical decisions affecting the lives of 1.1 million Wisconsinites in the hands of unelected bureaucrats, with minimal public and legislative involvement. This bill would give the Department of Health Services the ability to rewrite Medicaid policy related to benefits, reimbursement, eligibility, and a wide range of other important aspects. It could impact BadgerCare Plus, Core and Basic as well as Family Care, SeniorCare and Children’s Waivers, among other programs vital to families’ lives.
On February 14th The Legislative Fiscal Bureau released the following in a memo titled Non-Fiscal Policy Items Contained Within the Budget Adjustment Bill (SS SB 11): (http://www.thewheelerreport.com/releases/February11/0214/0214lfbnonfiscal.pdf)
“There is one item included on the non-fiscal list that should be noted. That item is entitled, “Medical Assistance — Study and Implementation of Program Changes.” The provision could potentially give broad authority to the Department of Health Services, with approval of the Joint Committee on Finance, to significantly modify the medical assistance program and supersede most statutory provisions regarding the program. While the provision may result in significant savings in the future, it has been included on the list because it would remove the entire Legislature from determining substantial elements of the medical assistance program.”
This proposal would affect:
- 775,000 children and adults have basic medical coverage in BadgerCare
- 90,000 Wisconsin children and adults with severe mental illness use Medicaid services
- 9,800 children and young adults (0-21) with severe disabilities utilize Medicaid community based supports and medical coverage
- 20,509 people with developmental and physical disabilities stay independent at home and in their communities with Medicaid funded supports
- 18,000 seniors stay independent at home and in their communities with help from Medicaid
- 90,000 Wisconsin seniors rely on SeniorCare for affordable prescription drugs
- This proposal would open the door to far-reaching changes in Medicaid under the guise of a ‘budget repair bill”.
- This proposal would yield NO savings to the state budget in this biennium.
- Major Medicaid decisions that affect families’ lives should not be made behind closed doors.
- The proposal would give the Administration the authority to implement emergency rules making critical changes that supersede current statutes.
- The Administration would be able to extend the emergency rules for as long as four years, with no obligation to define the emergency.
- This proposal severely limits the debate on this very important issue, silences the voices of families and individuals and weakens the legislative branch of government.
- A system that supports 20% of Wisconsin’s population deserves to have open public hearings when rules are changed.
This is an argument that I have heard very little about from the media. I believe that this is a discussion that Governor Walker is happy that he has not had to defend. When did it become OK to allow unelected officials to set policy with minimal legislative input? But more importantly, when did we elect officials who do not get input from the people?