Coming soon will be discussions on important inclusions for Women & Girls in Wisconsin.
Our Budget Team is busy working their way through Governor Evers' 592 page budget.
Coming soon will be discussions on important inclusions for Women & Girls in Wisconsin.
Walker Administration Files Suit Against Federal Government to Allow for Suspicionless Drug Testing of FoodShare Recipients
Just a quick update to yesterday's post, where we mentioned that one of Governor Walker's budget vetoes would provide the state even more latitude to require drug testing of FoodShare Employment and Training participants who are able-bodied adults without dependent children and are subject to FoodShare work requirements. The veto would allow the state to require all program applicants and recipients be tested for drug use, regardless if the state has a reasonable suspicion of the person using illegal drugs. The Governor's veto is constitutionally problematic because federal courts have been skeptical of drug testing regimes for public benefit recipients without a reasonable suspicion that the recipient is using illegal drugs. It is also problematic because federal law does not allow states to create additional eligibility criteria for the program, and federal law does not list passing a drug test as on of the eligibility criterion for the program.
Because federal officials warned the Walker administration that the federal government was unlikely to approve the drug testing requirement, the Walker administration has filed a federal lawsuit requesting that a federal judge allow the state to implement the drug testing program and prevent the federal government from blocking it. Wisconsin Attorney General Brad Schimel filed the lawsuit on behalf of the Walker administration.
Please check back for more updates once we have more news regarding the status of the lawsuit.
Governor Walker signed the 2015-2017 state budget into law on Sunday. The Governor also vetoed several provisions that impact issues we have followed closely on this site. Most of the Governor's vetoes will have a negative effect on the issues we have covered.
We will continue to update the various issue pages on this site until they reflect the final budget project signed into law by Governor Walker. Please like us on Facebook or follow us on Twitter to be alerted about any updates to this site. Once all of the content on this site is updated, we will format the information into a final report on the Wisconsin State Budget Impact on Wisconsin Women and Girls, just as we did for the 2011-2013 and 2013-2015 state budgets.
In the meantime, please read below for important updates regarding the Governor’s vetoes on long-term care, drug testing FoodShare recipients, and BadgerCare.
The Governor’s proposed budget contained many drastic changes to Wisconsin’s successful long-term care programs for people with disabilities and the elderly. The Governor’s budget proposed to transition from the current regionalized model that is run by not-for-profit managed care organizations to a statewide model that could be potentially run by for-profit insurance companies that could possibly result in individuals having to change their doctors, caretakers, and even the group homes where they reside.
The Joint Committee on Finance (JFC) altered the Governor’s proposal by requiring the Department of Health Services (DHS) to maintain at least five managed care regions, which at least partially addressed some of the concerns raised by advocates.
The Governor vetoed this requirement to maintain a minimum of five managed care regions, which raised immediate concerns from advocates with people with disabilities that Wisconsin’s long-term care programs would be transitioned to a statewide model run by for-profit insurance companies, thus undermining the existing model that has worked very well for Wisconsinites with long-term care needs.
For more detailed information regarding future of Wisconsin’s long-term care programs under the new model passed in the state budget, please see this Frequently Asked Question resource from the Survival Coalition of Wisconsin Disability Organizations.
Drug Testing of FoodShare Recipients
One of the more troubling aspects of Governor Walker’s budget were his many proposals to require that applicants for and recipients of many different public benefits programs be subjected to drug screening, and if indicated by the drug screening, drug testing in order to be eligible for benefits. In addition to being constitutionally dubious, there is little evidence that these proposals would do much to help people with substance abuse disorders.
The Governor’s veto eliminated the requirement that drug testing of FoodShare Employment and Training participants who are able-bodied adults without dependent children and are subject to FoodShare work requirements be done only if there is a "reasonable suspicion" the recipient was using drugs. This is troubling because in order for such drug testing requirements of public benefits recipients to pass constitutional muster, there must be a reasonable suspicion that the person is using illegal drugs. As a result, this suspicionless testing of all applicants and participants of this program is likely to face an uphill legal battle if it is challenged in court.
In addition, the Governor also vetoed the Legislature’s requirement that the state pay for any drug treatment for those applicants or enrollees who test positive for drugs. The Governor’s veto would mandate that state-funded treatment would only be available if the individual did not have health insurance coverage that would pay for the treatment.
The Governor’s proposed budget required DHS to request approval from the federal government to make significant changes to Wisconsin’s state Medicaid program that provides health insurance to low-income individuals and families, known as BadgerCare. Under the proposed budget, DHS would ask the federal government for permission to implement the following changes in regard to childless adults on the program:
· Require childless adults to pay monthly premiums
· Require childless adults who engage in risky health behavior, as determined by a health risk assessment, even higher premiums
· Limit lifetime program eligibility for childless adults to 48 months, regardless of their health care condition or their ability to afford other health insurance coverage
The changes would be unprecedented and likely devastating to those childless adults who rely on the program, who make $11,770 or less a year in order to be eligible.
The JFC placed minimal reporting requirements on DHS to provide some information to the JFC regarding DHS’ federal waiver request. Under the JFC’s proposal, DHS would provide a summary of the provisions of their federal waiver request and estimate the fiscal impact of these provisions if implemented to the JFC before submitting the request to the federal government. If the federal government approved any provisions of DHS’ waiver request, DHS would provide the JFC with a report summarizing any provision approved by the federal government and an estimate the fiscal impact of those approved provisions.
Citing concerns that these requirements were “administratively burdensome,” the Governor vetoed these reporting requirements.
The state Assembly passed the state budget in an identical form as passed by the state Senate. 11 Republicans voted with all of the chamber's Democrats to oppose the bill, which passed on a vote of 52-46.
The bill now heads to Governor Walker, where he has the option of vetoing out specific lines and appropriations in the bill before signing it. We will provide detailed analysis of any gubernatorial vetoes that affect policies that we have covered on this site. Please stay tuned for updates.
The state Senate passed their version of the budget last night. The senate version of the budget largely mirrors the version passed by the Join Finance Committee (JFC) last week. However, the Senate version does contain some important changes for the JFC version, including:
A provision that would largely repeal Wisconsin's prevailing wage law, which provides for a minimum wage rate for workers on public construction projects. The provision would exempt local government, school district, and technical college projects from the prevailing wage requirements. Such projects represent about 90 percent of projects currently subject to the prevailing wage. The provision would also apply the federal prevailing wage to state projects.
The Senate voted unanimously to delete a provision inserted into the budget by the JFC that would have essentially eliminated Wisconsin's open records laws, which allow the public and media to scrutinize the actions of public officials.
In addition to the changes mentioned above, the Senate rejected several amendments that would have provided much-needed funding for many of the programs that are essential to the well-being of women and girls that we have covered on this site:
The Senate rejected a motion to accept federal money to expand BadgerCare to childless adults earing up to 138% of the Federal Poverty Line. In addition to providing over 80,000 more Wisconsinites with health insurance, this proposal would save the state $360 million in the form of increased federal funding. For more information on this issue, see our previous post on Medicaid expansion and this Wisconsin Budget Project Blog post on updated projections from the Legislative Fiscal Bureau.
The Senate rejected a motion to restore the $250 million in funding that the JFC cut from the University of Wisconsin System.
The Senate rejected a motion that would have held private voucher schools to the same performance and accountability standards at public K-12 schools.
Finally, the Senate rejected an amendment to increase state funding for public K-12 education by $270 million.
The Assembly is currently debating the budget as passed by the Senate. We will provide an update as soon as the Assembly finishes its work on the budget.
Last Thursday, the Join Committee on Finance finished its work on the proposed 2015-2017 state budget. The JFC's final day of action included votes on substantial tax proposals and the transportation budget. The committee also passed what is commonly referred to as "Motion 999," which is the final omnibus motion passed by the JFC that often contains non-fiscal policy items and changes to previous JFC actions. This year's 999 motion would have essentially eliminated the vast majority of Wisconsin's open records laws that allow the public to scrutinize the actions of public officials. However, because of almost unanimous opposition to these proposed changes to the open records laws from voices across the political spectrum, the Governor and legislative leaders quickly announced that these changes will be removed from the budget.
As for issues we have covered more closely on this site, the final omnibus motion did include some relevant changes. First, the motion mainly left intact the changes to Wisconsin's long-term care programs, Family Care and IRIS, that the JFC made back in may. However, the motion does call for increased opportunities for public input into the Department of Health Services' (DHS) waiver application process to the federal government by requiring DHS to hold two public hearings before submitting the waiver. In addition, DHS will have to provide quarterly reports to the JFC detailing the Department's progress on the waiver request and the Department's discussions with various stakeholders. Despite these new requirements, advocates for older adults and people with disabilities remain very concerned about the future of these long-term care programs under the new model approved by the JFC in May.
The omnibus motion made other relatively minor changes to issues covered on this site, including public K-12 education and voucher schools. The motion also contained what appears to be sweeping changes to regulations of payday lenders by greatly expanding the types of permissible business practices in which payday lenders can engage. Under the proposal, payday lenders would be allowed to sell insurance, provide financial advice, and even operate a currency exchange. Advocates for consumers and low-income people expressed significant concerns that these changes will be detrimental to low-income consumers, who often have limited financial literacy.
The tax motion passed by the committee included an important provision that would allow people with disabilities, or their families, to set up Achieving a Better Life Experience (ABLE) accounts, which are tax-deferred savings accounts for people with disabilities to pay for qualified expenses associated with a disability. According to the Survival Coalition of Wisconsin Disability Organizations, ABLE accounts "allow people with disabilities and their families to contribute their own money to tax-deferred accounts, which can then be withdrawn tax-free to pay for qualified expenses such as educational opportunities, transportation, employment supports, housing and health care. ABLE accounts will foster financial independence for people with disabilities and empower them to privately pay for qualified services without the fear of losing access to needed programs." Advocates for people with disabilities believe current income and asset limitations for public programs that people with disabilities rely on for the services and care they need, such as Medicaid, create a disincentive for people with disabilities to work and earn income. Current law only allows people with disabilities to accumulate $2,000 in assets before losing access to long-term care programs.
The budget was approved by the Senate late last night with a few modifications. The Assembly is debating and voting on the budget today. We will post about the Senate actions shortly and provide updates about the Assembly action once the Assembly finishes its work on the budget. Once the budget is passed in identical forms by both chambers, it will go to the Governor for his signature, at which time he can decide whether to exercise his powerful veto pen to remove individual budget provisions.
Advocates Push Back Against Attempt to Insert Partial Repeal of Wisconsin Family Medical Leave Act Into State Budget
Some industry and local government advocacy organizations are urging legislators to include a partial repeal of the Wisconsin Family Medical Leave Act (FMLA) in the state budget. Their proposal would exempt public and private employers from the Wisconsin law if they are already governed by the federal FMLA. The proposal would leave in place the state FMLA's requirement that family leave be provided to care for one’s domestic partner or parent in-law with a serious health condition. Such relationships are not covered under the federal FMLA.
Advocates for working parents and families expressed significant concern regarding the proposal, as Wisconsin's FMLA is more generous than federal law. Wisconsin law requires employees to work fewer hours in order to be eligible and doesn't allow employers to require employees to substitute accrued paid or unpaid leave for their family medical leave. For a full rundown on the differences between the Wisconsin and federal FMLA's, see this helpful chart from the U.S. Department of Labor.
While it is currently unclear whether the partial repeal of Wisconsin's FMLA will become part of the state budget, the proposal appears to face an uphill battle at the moment. Both Assembly Speaker Robin Vos and Joint Committee of Finance Co-Chair John Nygren have expressed their personal support for the measure, but have indicated that they do not think there is currently enough political support in the Legislature to include it in the budget.
We will continue to keep an eye on this issue as the budget continues to be debated in the Legislature. In the meantime, for those interested public polices that would make our workplaces more family friendly, take a look at the National Women's Law Center report that outlines a roadmap of policies that states can adopt to promote economic justice, which includes a section on requiring employers to provide their employees with the opportunity to earn paid sick days.
Joint Finance Committee Makes Significant Changes to Governor's Long-Term Care Proposals, but Many Advocates Remain Concerned Program's Future
We have closely followed the Governor's proposed changes to Wisconsin's long-term care programs for people with disabilities and older adults. Many advocates for people with disabilities and older adults expressed significant concerns regarding these changes because they were concerned that the Governor's proposal would undermine several existing programs that have successfully empowered people to access long-term care in their homes so that they could remain active members of their communities and avoid receiving long-term care in nursing homes.
Last week, the Joint Finance Committee (JFC) passed a sweeping omnibus motion along party lines that made significant changes to the Governor's proposal. Many of these changes were in direct response to concerns raised by advocates. However, many advocates remain concerned that, if enacted, the changes approved by the JFC will undermine many of the successful aspects of Wisconsin's long-term care system. Below is a summary of some of the most important aspects of the JFC omnibus motion.
The JFC approved the Governor's proposal to expand the Family Care program statewide, which means that the eight counties that currently do not participate in the Family Care program will do so by start of 2017. The JFC motion would preserve the regional model of the program, but opens the program up to be administered by private, for-profit insurance companies. Currently the program is administered by nonprofit Managed Care Organizations (MCO's). The JFC motion gives the Department of Health Services (DHS) the authority to request a waiver from the federal government in order to get permission to implement any changes to the program. Before crafting the proposed waiver, DHS must consult with "stakeholders," but the JFC motion does not specify which stakeholders and in what manner they would be consulted.
The Governor's proposal would have eliminated the Include, Respect, I Self-Direct (IRIS) program, which is a self-directed, community-based program for adults with disabilities and elderly adults who have long-term care needs. Participants are able to choose and direct the services that they need to participate in their communities, instead of being forced to look to nursing homes and other institutions for long-term care solutions. While the JFC motion does still provide a self-directed care option, it does so by folding the existing IRIS program into a managed care model, thus eliminating IRIS as a separate program. Advocates remain very concerned that self-directed care under a managed care model will be a very different reality for program participants than self-directed care under the current IRIS model. For an example of such concerns, here is a rundown of how self-directed care would be different under the IRIS program versus the Family Care program.
Aging and Disability Resource Centers
The Governor's Proposal would have dramatically changed the governance structure of Aging and Disability Resource Centers (ADRC's), which help people with disabilities and older adults navigate different benefit systems. The Governor's plan would have allowed the privatization of ADRC functions by providing DHS with the authority to eliminate county-run ADRCs and contracting out many of their functions to private, for-profit entities. Advocates were concerned that a privatized ADRC system would be less accessible and be potentially riddled with financial conflicts of interest.
The JFC motion deleted the Governor’s recommendations, but will require DHS to conduct a number of studies regarding the services provided by ADRC's and their governance structures.
Because many of the changes to Wisconsin's long-term care system will require a waiver from the federal government, it is difficult to fully assess the JFC's actions. While many in the advocacy community continue to have significant concerns regarding these changes, much will depend on the DHS's engagement with stakeholders as the Department crafts the waiver request. The final details of the waiver request will likely hinge on which stakeholders are consulted and how much, if any, of their feedback is included in the final product. We will continue to provide updates on any potential changes to the JFC's long-term care provisions once the budget heads to the full Assembly and Senate for further debate.
Joint Committee on Finance Approves Governor’s Recommended Changes to BadgerCare for Childless Adults, Rejects Federal Medicaid Expansion Money, and Rejects Governor’s Proposed Changes to SeniorCare
The Joint Committee on Finance (JFC) approved a motion yesterday that will have significant ramifications for health care accessibility and affordability in Wisconsin. Many of these decisions were on issues that have been covered at length by this site, including proposed changes to BadgerCare for Childless Adults, full Medicaid expansion under the Affordable Care Act, and proposed changes to the SeniorCare prescription drug program. For a more complete rundown on the committee’s actions, see below.
Changes to BadgerCare for Childless Adults
The committee largely approved the Governor’s proposed changes to BadgerCare for childless adults along a party-line vote. The Governor’s proposal would allow the Wisconsin Department of Health Services (DHS) to request approval from the federal government to make the following changes for any childless adult on the program:
Rejection of Federal Medicaid Expansion
The committee also voted along party lines to reject a motion by the committee’s Democrats to accept federal funding to expand BadgerCare eligibility to childless adults earning between 100-138% of the federal poverty line (FPL). Updated projections from the Legislative Fiscal Bureau estimated that the amount of money the state could save if Wisconsin implemented full Medicaid expansion increased from previous estimates. The LFB previously estimated that accepting full Medicaid expansion would save the state $345 million. The new estimates increased the projected savings to $365 million. As a result of the committee’s decision, tens of thousands of Wisconsinites will still find themselves in a health care coverage gap and the state will have to make hundreds of millions of dollars of budget cuts to other vital public institutions, such as the cuts proposed by the Governor to the University of Wisconsin System.
Reject the Governor’s Proposed Changes to the SeniorCare Prescription Drug Program
The JFC did fully reject the Governor’s proposed changes to the SeniorCare prescription drug program, which would have required eligible seniors to first sign up for the more expensive Medicare Part D prescription drug program. The LFB estimated that many low-income seniors who fall into a relatively likely scenario would pay about $188 a year more for their prescription drugs if the Governor’s proposed changes were approved.
The committee’s unanimous rejection of the Governor’s SeniorCare proposals is likely good news for the thousands of women who rely on the program. For more information about how the Governor’s proposal would have affected women in Wisconsin, please see our SeniorCare issue page and our blog post on the topic.
Other Budget Health Care Updates
The JFC made many other important decisions regarding health care policy. We will provide more information regarding these changes in subsequent posts.
The Joint Committee on Finance (JFC) voted 12-4 on partisan lines yesterday to approve a motion that will allow the Wisconsin Department of Health Services (DHS) to apply for a waiver with the federal government that would allow Wisconsin to screen childless adults on BadgerCare for substance abuse as a condition of BadgerCare eligibility.
In addition to approving the Governor's recommendation to seek a waiver from the federal government to allow DHS to drug screen childless adults on BaderCare, the JFC also required the Department to (1) provide the committee with a summary of the provisions of the proposed waiver and estimates of the fiscal effect of that proposed waiver, and (2) if the federal government approves the waiver to permit drug testing, and prior to implementing that policy, to submit a report to the JFC that summarizes the provisions and estimates the fiscal effect of the approved waiver.
We have covered the issue of drug testing participants in public benefit programs at length on our budget site. Many advocates express skepticism that this approach will actually provide people with substance abuse disorders with the help that they need to treat their addictions. Rather, advocates fear that this approach will unnecessarily stigmatize lower-income people who need BadgerCare in order to access vital health care services. For instance, advocates for people with disabilities have expressed significant concerns about the affect this proposal could have on childless adults who rely on BadgerCare and have simultaneous mental illness and substance abuse disorder diagnoses. Federal courts have also ruled that similar proposals to drug test public benefit recipients in other states are unconstitutional.
The full Department of Health Services budget is up for debate and executive action in the JFC tomorrow, including votes about the Governor's other proposed changes to BadgerCare coverage for childless adults, so we will have many more updates soon to follow.
Cecely Castillo is the Policy Director at the Wisconsin Alliance for Women's Health and is overseeing our state budget impact on women and girls.