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Policy changes coming under new budget

By Matt Pommer

The new budget gives Gov. Scott Walker’s administration the power to make sweeping changes in Medicaid and BadgerCare policies with minimal public or legislative input.

Up to $500 million in Medicaid spending would be reduced, but how the reductions would occur is left with Walker’s Department of Health Services. That provision was part of the “emergency” budget bill enacted earlier, but the new budget law makes significant changes in oversight of any changes.

Review of new policies by the Legislature’s health committees is eliminated. Also gone are the “emergency” law provisions keeping the regular rule-review process.

Why did the Legislature grant such huge power to the executive branch? Legislators don’t like public hearings about reductions, especially when many of those who would appear might be disabled. They would prefer their own austerity talk not be dimmed by public hearings on the impact of cutbacks in spending.

The Council on Children and Families notes that the new biennial budget eliminated provisions for public hearings when policy changes conflict with state law.

“The biennial budget bill substantially reduces the ability of the public to provide meaningful input into these policy decisions,” the council said in a study examining the differences between the “emergency” legislation of last winter and the new state budget law.

Meanwhile, two groups have issued a reminder that slashing Medicaid spending — including the Wisconsin budget law and the budget plan enacted by the U.S. House of Representatives — will impact employment in Wisconsin.

Cutting nearly a half-billion dollars in Medicaid spending would cost an estimated 9,500 jobs in Wisconsin, according to the Jobs at Risk report prepared by Families USA. The federal Medicaid changes, developed by U.S. Rep. Paul Ryan of Janesville, would reduce state Medicaid programs by 5 percent in 2013, 15 percent in the following year and up to 33 percent in 2021.

Nino Amato, executive director of the Coalition of Wisconsin Aging Groups, noted that Medicaid affects 1.2 million seniors and people with disabilities in Wisconsin. About 70 percent of Wisconsin’s Medicaid spending provides help for the disabled and seniors.

Ron Pollack, executive director of Families USA, noted the economic impact of reduced Medicaid spending. The federal government provides about 58 percent of Medicaid spending in the state.

“Every federal Medicaid dollar that flows into the state stimulates state business activities and generates jobs,” said Pollack. Cutting Medicaid spending means fewer jobs and stunts the economic recovery, he added.

Wisconsin is among states that are asking the Obama administration to grant a wavier to provide flexibility in how it administers Medicaid money. Getting that waiver is not guaranteed. Unless the waiver is obtained, the state budget law directs across-the-board cutbacks in Medicaid eligibility.

Matt Pommer worked as reporter in Madison for 35 years. He comments on state political and policy issues.

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