What Medicaid Changes in Wisconsin Mean for the Disability Community

The following guest blog comes from Lisa Pugh, public policy coordinator at Disability Rights Wisconsin in Madison, Wis. We’d love to hear what’s happening in state governments across the U.S. Please leave us a comment below.

If you have been watching the national news you know that all is not right in Wisconsin. While the focus has been mainly on the issue of collective bargaining and benefits and wages for public employees, there are five pages tucked within Governor Walker’s 144 page budget repair bill that will have significant consequences for persons with disabilities. As it becomes increasingly clear that Wisconsin is a likely testing ground for ideas on state deficit reduction and Medicaid reform, disability advocates nationally should pay attention.

Many know that former CMS director Dennis Smith is now the head of Wisconsin’s Department of Health Services. And although while he served recently as a senior fellow at the conservative Heritage Foundation in Washington, D.C., Smith advocated for states to pull out of Medicaid, he has not proposed such a drastic move for Wisconsin. However, in Walker’s bill, the Governor gives Smith and his Department broad authority to change rules regarding Medicaid. Specifically, the proposed legislation would give the Department of Health Services the ability to rewrite Medicaid policy related to benefits, reimbursement, eligibility, cost-sharing and a wide range of other conditions without public hearing. The Department could enact these changes within approximately two weeks of the bill’s passage as emergency rules with indefinite expiration.

Advocates describe the bill as an “unprecedented seizure of legislative authority that would put critical decisions affecting the lives of 1.1 million Wisconsinites in the hands of unelected bureaucrats, with minimal public and legislative involvement.” Wisconsin has long been a leader in progressive preventative care and long term care programs including BadgerCare Plus, Core and Basic as well as Family Care, SeniorCare and Children’s Waivers which have received broad bipartisan support in the state for decades. An attorney who drafted the Medicaid portions of the bill also noted in her description to legislators that the legislation “would allow DHS to change any Medical Assistance law, for any reason, at any time and potentially without notice or public hearing.” The governor has described these changes as necessary in order to provide the flexibility in Medicaid which will reduce the need for painful cuts. Advocates are concerned that the bill puts critical decisions about vital aspects of people’s lives behind closed doors.

Medicaid is a vital safety net for more than 1.1 million Wisconsinites, including working families, older adults, and adults and children with disabilities including mental illness, developmental disabilities, and physical disabilities.