I've been blogging about the stealth attack on Wisconsin Medicaid for just about a week now. Deep in Gov. Scott Walker's so-called "budget repair bill" lies an immense policy change on Medicaid (aka Medical Assistance.)
The bill gives the Wisconsin Department of Health Services (DHS) broad power to create "emergency rules" on Medicaid. In the ordinary way of things, emergency administrative rules must be voted on by the Joint Finance Committee, after public hearings. Then there must be a second vote, also with public hearings, to turn the emergency rules into final rules. However, this bill maintains that Wisconsin's budget emergency is so dire that we must give the DHS power to create emergency rules that could be approved by the Joint Finance Committee by "passive review." This means that they don't hold hearings, don't vote, and the rule just automatically takes effect in 14 days. And it's supposedly such an emergency that these emergency rules need not go through the process to become final rules. So, no public hearings. No public input. An appalling short-circuiting of the democratic process.
Here is the summary of the bill prepared by the non-partisan Legislative Fiscal Bureau. The Medical Assistance provisions are outlined on pages 8 & 9.
More disturbing still: the new Secretary of the Department of Health Services, one Dennis Smith, appointed by Scott Walker, is a former fellow of the Heritage Foundation. During his tenure there, he authored a position paper advocating that the states drop Medicaid entirely. This is the man who would be heading up the changes and cuts to Wisconsin's Medicaid program, without legislative oversight or public input.
Over a million Wisconsin residents rely on some form of Medicaid programs, including my six-year-old daughter who has significant developmental disabilities. A factsheet released by a new Medicaid Matters Alliance here in Wisconsin outlines how many people rely on which programs, and what a devastating effect any major cuts could have.
So I was at the Capitol here in Madison last night, on the edges of the chanting crowd in the Rotunda, carrying a sign encouraging people to ask me more about the Medicaid issue, and passing out copies of the factsheet.
I thought that the endgame of the Medicaid-slashing had to do with shaking loose the dollars for tax breaks for the "haves," a process that has already begun to be rammed through in Wisconsin with $140 million in corporate tax breaks signed into law last month alone.
But then I had a conversation with a fellow from northern Wisconsin, who works for an organization that helps people with disabilities to live independently. And what he said connected a whole new set of dots for me.
Are you aware, he asked me, that many provisions of the federal health care reform are dependent on the Medicaid structures in the states? That health reform needs the Medicaid structures in place in order to be carried out?
Oh, my goodness gracious.
Over this past week, I've suddenly become powerfully aware that Walker's budget-repair bill, particularly the union-busting, represents a national strategy prepared within conservative think-tanks and being implemented in states where funding from the Koch brothers and their ilk managed to co-opt elections in 2010 and win new large Republican majorities. (By the way, the Koch brothers have just opened a lobbying office here in Madison...)
Does the stealth attack on Medicaid in Wisconsin have bigger fish to fry than budget-savings and tax-cuts for corporations? Is it really about dismantling federal health care reform, and the even bigger longer-term threats to big-money interests contained in the Affordable Care Act? Is THIS why my daughter and thousands of the most vulnerable people in Wisconsin are about to get thrown under the bus?
I haven't seen anyone writing on this yet. But I have an awful, sinking feeling that the guy in the Rotunda was right. This is really what the attack on Medicaid is all about.
The floor is yours.