Clearly, the events unfolding in Wisconsin as Governor Scott Walker pursues his 2011 budget repair bill - a bill that is necessary to correct an annual shortfall he created last month by immediately passing tax cuts for business and the wealthy – will have big consequences. To date, most of the attention has been focused on Mr. Walker's disintegration of collective bargaining rights for public employees. That is a big issue in Wisconsin and the response has been predictably heated.
But underneath the mass protests is a cornucopia of hard core conservative ideology tucked away in this bill (and his upcoming biennium budget) that, if passed, will not only drastically reshape the lives of every citizen of the Badger state, it will signal to other states that consolidating power is again in vogue. Who will that hurt the most? Long answer is everyone, but the short answer is (and has always been) the poor, the unemployed, the elderly, and persons with disabilities.
The radical ideology of the Walker administration is now surfacing in tangible proposals and legislation. And, just as George W. Bush sought consolidate as much power at the executive level to ensure expedient approval of conservative orthodoxy, so too has Gov. Walker taken controversial steps to expedite his proposals. Stripping the collective bargaining rights of public employees is one step in that direction.
Just as damaging however is an overlooked proposal in the repair bill to give Wisconsin's Secretary of Health and Human Services sole authority to rewrite Medicaid eligibility and benefit rules without the Legislature's approval.
The proposal would allow Walker's Department of Health Services to write rules to change state laws dealing with medical care for children, parents and childless adults; prescription drug plans for seniors; nursing home care for the elderly; and long-term care for the elderly and disabled outside of nursing homes. The programs that could see changes under the proposal would include the BadgerCare Plus and BadgerCare Core plans, FamilyCare and SeniorCare.
Through this change, Governor Walker is giving HHS carte blanche to redesign, if it so chooses, the states largest entitlement program without having the full Legislature debate and vote on the changes.
Under the bill, the administration's rewrite of the Medicaid program would be reviewed only by the Legislature's budget committee, which has a broader margin of control for majority Republican lawmakers than any other legislative committee.
Wow. After all the breathless attacks on the manner in which health care reform was passed, we now have a proposal to strip actual health care policy and governing from Wisconsin's state legislators. And if that isn’t scary enough, the recently appoted Sec. of Health and Human Services for Wisconsin is none other than Dennis Smith, former head of the Centers for Medicaid and Medicare Services under George W. Bush, and most recently a fellow at the Heritage Foundation who spent the last two years advising States how to dismantle their Medicaid programs all together.
Dennis Smith, December 2009
By piling billions of dollars in new costs onto states and imposing greater federal control over the states, Congress is recklessly increasing the likelihood that states will exert their own authority as sovereign units of government and end their participation in Medicaid entirely.
The savings to state budgets are so enormous that failure to leave Medicaid might be viewed as irresponsible on the part of elected state officials.
So let’s recap:
A Republican comes into office with budget surplus for the current year; immediately cuts taxes on business and the wealthy to create a deficit; and then uses that deficit to create a “fiscal emergency” that can extract benefit concessions and strip bargaining rights from public employees and dismantle care for poor children and families, elderly, and persons with disabilities to pay for it. Sounds familiar...
And all of this is happening at warp speed. Gov. Walker has been in office less than 50 days, the budget repair bill was proposed a week ago, has been passed out of committee, and is only being prevented from assured passage by the couragous actions taken by Senate Democrats.
But this is only the tip of the iceberg in Wisconsin. If/when this bill passes, the upcoming biennium budget will not only include dramatic changes in Medicaid; as a result of teachers losing any remaining advocacy leverage with the State, upcoming funding for public education is projected to decrease by as much as $900 million, essentially blowing up the states largest and most impoverished school district, Milwaukee Public Schools. And with that, Governor Walker will have moved Wisconsin closer to his ultimate goal - privatized, market-driven health care and education.
If successful, it will also drastically change the shape of our democracy in states around the country.