Insurance salesperson is probably not the job title most Democratic politicians envisioned when they ran for office, but right now it’s what they are doing.
They are pressing hard to sell the public on an expansion to Medicaid, so around 90,000 more Wisconsin residents will have access to good, affordable insurance. And Republicans are hell bent on making sure they don’t get it, as they’ve done throughout the 10 years since the Affordable Care Act passed, labeling it an “expansion of welfare.”
It’s unclear to a lot of people why it is such a tough sell — especially this year when the federal government has added a $1 billion “sweetener” to the mix for Wisconsin as one of just 12 holdout states. That money could be used for any project or program as a one-time bonus. It is on top of the $630 million the state would get in additional resources for Medicaid costs in the 2021-23 biennial budget. (The Medicaid program is called BadgerCare in Wisconsin.)
But Democrats and advocates are focused on selling it to the public to up the pressure, because Republicans already stripped it from Gov. Tony Evers’ budget, tossing the $1.6 billion payout to Wisconsin in the dust bin earlier this month. And they have indicated they plan to just gavel in and gavel out of the special session Evers called to take up the matter on Tuesday.
Lt. Gov. Mandela Barnes is part of a broad political effort by advocates and elected officials to make sure that Wisconsinites know what expanding BadgerCare would mean to the state. He says it’s not only for people who can’t afford insurance, but also for people who would like to see the extra $1 billion go for the projects Evers said he would spend the money on, including economic redevelopment, broadband, infrastructure, mental health services, environmental remediation and rural hospitals. It could also be used, as Democrats have pointed out to GOP colleagues, simply to lower state taxes.
At a press conference on Monday, the day before the vote, Barnes stood up with Liliana’s owner and chef Dave Heide who talked about the restaurant industry and the detrimental impact that the high cost of private health insurance has on small businesses, startups and health care providers — particularly coming out of a pandemic.
“It is important to make sure that tomorrow’s special session does not go ignored,” Barnes told reporters. “It’s important that the speaker [Robin Vos] doesn’t choose to gavel in and gavel out as he’s done so many times in the past. People in the state are counting on the Legislature to do the right thing. If we aren’t providing health care for folks, what are we doing?”
There’s not much suspense around Tuesday’s special session, and all the political chatter is focused on what will happen after Republicans ignore the governor’s call to discuss and vote on expanding BadgerCare.
On Monday, Barnes was touring Heide’s vacant space that will become Little John’s if local social entrepreneurs can raise $6 million to turn it into a massive-scale restaurant using food from grocers that would otherwise go unused to make healthy meals for people, regardless of their ability to pay.
A reporter asked Barnes what it means if Republicans refuse to take action.
“That is a signal that they don’t support the people of the state,” he replied. “There are folks in districts all across Wisconsin, blue districts, red districts that when it comes to health insurance, health care, health access — it’s not a partisan issue. The health and safety of people in this state is most important. I just wish that the majority party in the Legislature would realize that as well.”
A standoff between the governor and the Legislature, after the lawmakers send him a budget, may be the only chance of getting the Medicaid expansion. And that would require Evers to veto the budget and do some hard negotiating with Republican leadership.
It would be a bold move, leading to a showdown between the two branches of government, but he would bring $1.6 billion to the table. Evers, as usual, has been cagey about any potential veto. Asked about what happens after the session and whether a budget veto is on the table, Barnes demurred.
“He hasn’t been explicit about what our course of action is going to be,” said Barnes, adding with a chuckle, “Whenever I speak on behalf of the governor I get in trouble. So, I don’t want to take that road and say what is or is not gonna happen. I haven’t heard anything definite.”
Republicans at JFC, however, remained steadfast in their rejection of BadgerCare expansion. After Democrats proposed a motion to simply keep the topic on the table for future discussion rather than tossing it out with other issues Republicans were discarding, such as cannabis legalization, JFC co-chair Rep. Mark Born (R-Beaver Dam) got a bit testy. He didn’t like that Democrats said it shouldn’t be labeled with a “shaming” term like “welfare.” Born called that “ridiculousness” and “crap” giving a lengthy speech on how he is a straight shooter and would call it welfare because that’s what it is.
“They’re supposed to be a helping hand to get back on your feet, not a continuous handout,” said Born, lumping all safety net programs together. “But this is a health insurance welfare program.”
Born said the problem isn’t access to health insurance, because he said those without insurance could buy private insurance under the Affordable Care Act. He did not address the problem that many can’t afford insurance, particularly insurance that covers high quality care.
“The problem is that we won’t put people in a government welfare program to do it,” Born said. “We created a plan in Wisconsin … to help bring down the rates for folks on private health insurance on the exchange that we know helps our hospitals and doctors get better reimbursement rates, and provides access for folks on those health insurance plans to go to those clinics that are associated with those health insurance plans so they end up in emergency rooms, like so many of our Medicaid welfare insurance patients do.”
The Democrats on JFC put forward their best pitches for expansion. Speeches they continue to give across the state.
“It’s a once in a generation opportunity for Wisconsin to leverage federal funds, save state taxpayer dollars, add more coverage or eligibility to individuals, close the uninsured gap and reinvest those savings in our health care system and elsewhere,” said Rep. Evan Goyke (D-Milwaukee).
He addressed Wisconsinites who may not care about Medicaid expansion, saying if you care about the UW System or public schools or roads or aid to local governments, “this vote matters” because the state will have to spend more on health care to insure fewer people and have less for those causes. “And why? Because a hole is punched in the budget today by rejecting Medicaid.”
Goyke also pointed out that Oklahoma, where Donald Trump won 65% of the vote and carried every county, also voted in a referendum earlier in 2020 to expand Medicaid despite elected Republicans, including the governor, campaigning against it.
Rep. Greta Neubauer (D-Racine) spoke to the human cost of forgoing the expansion. “I have found that the longer we talk in terms of numbers, the more impact of expanding BadgerCare is lost on us. Expanding BadgerCare will change people’s lives, it will save lives.”
Sen. Jon Erpenbach (D-West Point) pointed out that expanding BadgerCare would mean that people who make slightly more than Wisconsin’s minimum wage of $7.25 an hour — up to just under $12 an hour — will be left out of Medicaid.
“If you want to give low-income people a chance, give them access to good quality health care so it’s there when they need it, and it won’t bankrupt them in the future,” he pleaded, “if you want to give people a chance to economically better themselves, don’t make them lose sleep over something.”
He also called out what he saw as the hypocrisy of Republicans turning down the expansion, while taxpayers pay for legislators’ insurance. “What’s most ironic about this, Mr. Co-chair, is this decision is coming from 14 people [Republicans on JFC] who have health care, subsidized by the taxpayers of Wisconsin. Taxpayers are paying for your health care. They pay for my health care. Who the hell are we to say to somebody making $10 an hour, you can’t be on BadgerCare because you make too much money? That’s what this vote is.”
Poor people aren’t lazy
A Milwaukee woman without health insurance owned a daycare that was open 24 hours a day, seven days a week, providing child care for low-income working families. She was making $13,000 a year and her house was in foreclosure. When she saw a doctor it was at a “free” clinic where a patient paid $20 for an office visit.
She was “lucky.” She got a job with good health insurance that started shortly before doctors found a five-pound tumor that had to be removed. The clinic did not have an ultrasound machine, which would have led to the tumor being discovered sooner.
Sen. LaTonya Johnson (D-Milwaukee) told this story to her colleagues on JFC shortly before they took the vote to dump BadgerCare expansion from Evers’ budget.
Johnson knows the story well. She was that woman.
“People who are poor are some of the hardest working individuals in this state,” said Johnson. And the job providing health insurance that allowed her to have the major surgery was her election to the Wisconsin Assembly.
“The one thing that turned my situation around was a family sustaining, paying job with benefits,” said Johnson. “That’s what this job provided. And for those of you who feel like you’re doing the Lord’s work by just sitting here, pick up the Bible and read it. Because the Lord’s work consists of you looking after your neighbor, treating your neighbor the way you would yourself.”
Fallout from the tumor still causes her health complications, and she waited to have it removed until after the legislative session ended. But then-Gov. Scott Walker called for a special session on health care and while in recovery, she had to return and sit in the chamber at the Capitol as Republicans voted to kick 90,000 people off of BadgerCare. She knew exactly what it would mean for people she knew and whose children she cared for in her daycare.
“When I got my diagnosis instead of me just being traumatized because of what that meant, I was just so happy that it didn’t happen six months prior because neither me nor my daughter had health insurance,” Johnson told JFC at its first budget meeting. “Then I came in to take this vote to kick 90,000 people off of their Medicaid and I myself had just undergone a major surgery.”
She pointed out that every single member of the committee had access to government-funded health care through the state. “And stop taking the stance, or implying, even if you’re not saying with words, that poor people are lazy. And start trying to think of ways that you can improve the quality of life for everybody.”