March 23, 2016

Modest Progress this Session on a Few Health Care Issues

One of the positive developments in the Wisconsin legislature over the last several years has been the bipartisan work in a few areas of health care policy, such as behavioral health and dementia. Yet despite broad support for a number of bills in those two areas, the 2015-16 session ended with considerably less progress on those issues than we had anticipated – thanks in part to concerns about the state’s precarious budget situation.

A new WCCF synopsis of the action on health care legislation during the 2015-16 session summarizes some of the significant bills debated by legislators since enactment of the budget bill. It contrasts the bipartisan agreement on a number of behavioral health bills and also on a package of legislation related to dementia with the sharply divided debate about funding for family planning.

Our summary also touches briefly on another area of strong disagreement between Republicans and Democrats – the question of whether the state should expand Medicaid eligibility to all adults up to 138% of the federal poverty level (which for a single parent with one child is equivalent to earning $10.63 per hour).  Because that expansion, which would cover about 83,000 adults in BadgerCare, would qualify Wisconsin for almost full federal reimbursement of our coverage of childless adults, it would save the state roughly $200 million per year. However, the Governor and many Republican legislators still oppose that idea, and a bill to expand Medicaid did not get a public hearing.

Our overview of the major health care issues summarizes four bills relating to behavioral health – two that were approved by both houses and two others that were passed easily by the Assembly but died in the Senate.

The pattern was similar for a package of bills related to improving services for people with dementia. Three of those bills were ultimately approved in both houses of the legislature, but several others died in the Senate – either because of concerns about the budget implications or because the legislature ended the session ahead of the usual schedule.

The three bills in the dementia package that ultimately passed in both houses will: provide grants to counties for training mobile crisis teams, direct DHS to prepare a report describing where individuals who have dementia are currently placed in crisis situations, and provide $1 million for respite care under the state’s Alzheimer’s Family and Caregiver Support Program. The bills that were not approved would have increased funding to DHS for additional dementia care specialists, provided training for those specialists, and created a dementia specialist certification program.

Wisconsin’s budget challenges are likely to be similar in the next biennium. If that’s the case, and if the Affordable Care Act is not repealed by Congress and the next president, state lawmakers should reconsider their rejection of the federal Medicaid expansion funding.  If they don’t reverse that decision and continue to make tax cuts a top priority, the state’s very tight budget is likely to continue to block important legislation next session, even in areas where legislators in both parties agree that additional spending is needed.

Jon Peacock