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The following program is a
PBS Wisconsin original

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production.
>> After a whopping victory,

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an investiture. Judge Susan
Crawford sworn in as justice

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on the Wisconsin Supreme
Court. And a final audit of

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the just passed state budget
shows a billion and a half

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dollars in tax cuts, along
with spending hikes.

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[MUSIC]
I'm Frederica Freyberg.

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Tonight on "Here& Now" a
veterans housing and

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recovery program at risk.
Our political panelists give

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their take on a toss up
governor's election. And we

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continue our series Rx
Uncovered looking at a

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prescription coupon that
leaves some paying more.

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It's "Here& Now" for August
1st.

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>> Funding for here and Now
is provided by the Focus

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Fund for Journalism and
Friends of PBS Wisconsin.

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>> First tonight, more than
350 military veterans are

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homeless in Wisconsin.
According to the latest

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estimates, some are getting
a fresh start through the

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Veterans Housing and
Recovery Program, which

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offers job training and
support for addiction. But

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the program is now at risk
after falling short of the

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funding it needed in the new
state budget. That's a

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concern for the veterans who
rely on these services

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today, and for those who
will need them in the

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future. But as "Here& Now",
reporter Steven Potter tells

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us, there are hopes new
bipartisan legislation could

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restore funding and keep the
program running.

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>> It's like I developed all
these bad habits with my

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anger and drinking, and I
ended up in a shelter again.

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>> Michael Cable is a
veteran of the United States

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Navy. He's also been
homeless many times first as

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a child, then as a young
adult. And then he became

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homeless again after leaving
the Navy in 2010.

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>> Came back. I was a full
blown alcoholic and anger.

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Just couldn't deal with my
emotions at all.

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>> Struggling to deal with
life after the military.

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>> You come back and it's
like your life's gone.

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Everything's changed.
>> He knew something drastic

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needed to happen. And it
did.

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>> Once I got sober, I felt
so much different about

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everything. I used to dream
about everything all the

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time. And now I was actually
doing things, working

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towards those dreams.
>> What changed is that

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Michael was accepted into
the state's veterans Housing

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and Recovery Program at the
Chippewa Falls location,

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known as Klein Hall.
Graduating from that program

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in May, he got hired at a
local plastics factory. And

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then all of his hard work
paid off. As this formerly

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homeless veteran became a
homeowner.

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>> I literally bought the
first house I seen. I gave

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him a full price offer and
moved in, and I. Every day

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I'm just standing there
like, I can't believe it.

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It's amazing.
>> Since opening in 2007,

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Klein Hall has helped
roughly 1000 of Wisconsin's

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homeless and at risk
military veterans find their

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footing and eventually
secure permanent housing.

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And while Michael is one of
the success stories, he

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could also be one of the
last veterans to use the

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Transitional housing and
Recovery program due to a

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lack of funding in the new
state budget. Klein Hall in

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Chippewa Falls and another
similar location in green

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Bay are slated to close
their doors at the end of

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September.
>> We were really saddened

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and disappointed with the
budgetary decisions. It's a

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horrible situation.
>> The Veterans Housing and

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Recovery Program is run by
the Wisconsin Department of

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Veterans Affairs. Out of
three locations. Assistant

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Deputy Director Joey Hoey
says they now only have

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enough money to keep one
site open.

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>> So we made some very
difficult and agonizing

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decisions. We've decided
that we're going to focus

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our efforts on one of the
three sites. It's in Union

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Grove down by Milwaukee.
>> Politically, Democratic

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Governor Tony Evers has
blasted Republicans in

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control of the state budget
writing committee. In a

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statement, Evers said,
quote, there will now be

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fewer options for homeless
veterans as a result of the

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legislature's irresponsible
decision to reject the

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investments that I proposed.
Joint Finance Committee

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Chairman Senator Howard
Marklein and Representative

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Mark Born responded by
saying the governor failed

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to make this program a
funding priority during

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budget negotiations. And
they added that the governor

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was, quote, looking for a
scapegoat to blame for his

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administration's failure to
adequately manage the

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changes to the program
volume and demands.

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>> Who cares? Who cares
whose fault it is? That

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doesn't help the problem.
>> For veterans like Derek

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Aune, who first heard about
it in prison. This program

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is not only transitional,
but it can also be

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transformative.
>> I'm learning all the time

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about this mental health
stuff is I do not do regular

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life well, but I know that
if I want to stay out of

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prison, then I have to be
willing to do stuff like

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this because it's the best
way for me to keep myself

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like in the right frame of
mind.

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>> Discharged from the
Marines 20 years ago.

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Derrick has been homeless
several times over the years

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at Klein Hall. He says he's
found stability and he's

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been allowed to keep his
emotional support animal, a

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friendly, attentive, husky
mix named Phoenix, with him.

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He appreciates that the
program here is built

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specifically and only for
veterans.

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>> That makes a big
difference. And you'll hear

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that from almost every
veteran across the board.

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With any situation, whether
it's treatment or groups or

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whatever. There it is a
different feeling when

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you're amongst other
veterans.

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>> Randy Withrow is the
Klein Hall site director for

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Lutheran Social Services,
which contracts with

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government veterans affairs
agencies to manage the

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program.
>> Nobody's homeless because

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they don't have shelter. It
is a myriad of things that

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occur in their lives,
whether it be legal, mental

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health, substance abuse,
financial that leads them to

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homelessness. And part of
our job is to make sure that

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we shore up those areas so
that then when they become

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either renters or owners,
that they have the skills

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and the ability to handle
that day to day living that

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you and I may take for
granted.

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>> Veterans stay in the
program for a maximum of two

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years and participate in
employment and education

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training. They receive meals
and transportation

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assistance and are also
required to maintain

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absolute sobriety. Program
staff members are working to

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place veterans currently in
the program in other housing

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initiatives, or to move them
to the Union Grove location

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that's staying open. But
there is concern that if too

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much changes, some veterans
will end up back on the

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streets.
>> Change is not something

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that they necessarily
experience well, and now

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they've got to go and meet a
new group and interact and

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integrate into something
that's different.

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>> Veterans affairs
officials say there is still

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hope that the two housing
program locations, scheduled

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to close in September, could
be saved if new funding is

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secured soon and there is
legislation being circulated

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at the state Capitol to do
just that.

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>> If we were to get
funding, we could quickly

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restart the program.
>> With two of the three

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locations closing. The
overall program will shrink

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considerably from more than
100 beds total to just 40

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beds at the Union Grove
location, veterans say

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keeping the program running
is a necessity.

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>> These kind of things are
pivotal. If you don't want

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to have people rolling back
through the system over and

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over and over again.
>> Just having a place where

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you can catch your breath
and really get back your

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sanity doesn't take much.
Just a place to stay. Some

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food and a counselor.
Someone cares. Someone you

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talk to, life changing.
These guys are grateful for

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every bit of it.
>> Reporting from Chippewa

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Falls. I'm Steven Potter for
"Here& Now".

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>> With Democratic Governor
Tony Evers announcement that

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he will not run for a third
term, the November 2026

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election for governor is
wide open, and already

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candidates are lining up on
the Republican side.

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Whitefish Bay businessman
Bill Berrian and Washington

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County Executive Josh
Shewman have entered the

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race. Democratic Lieutenant
Governor Sarah Rodriguez is

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also formally declared. Now,
there are a whole lot more

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names potentially throwing
their hat in the ring. For

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more on this, we turn to our
political panelists,

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Republican Bill McCoshen and
Democrat Scot Ross. Nice to

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see you both again.
>> Great to be with you. So

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good to be here.
>> Bill, what kind of

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opportunity is this for
Republicans?

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the second time in my 60
years on this earth where

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we've had an open
gubernatorial seat. 2010 was

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the last time Scott Walker
beat Milwaukee Mayor Tom

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Barrett. So the fact that
it's an open seat is an

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opportunity for Republicans
to actually win here, both

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of the national
prognosticators, whether

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it's the Cook Political
Report or Larry Sabato's

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Crystal ball, moved this
race from lean Democrat as

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soon as Tony Evers made his
announcement to toss up. So

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it's an opportunity for the
Republicans to potentially

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take back the governorship
in 2026 here in the state of

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Wisconsin.
toss up kind of status, how

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would policymaking change
if, in fact, a Republican

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were to win?
>> Well, I mean, obviously,

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if the Republican Party,
which is wholly controlled

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by Donald Trump, were to win
the gubernatorial election

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and Democrats not pick up
either of the chambers, it

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would be the most radical,
extreme. Partisan handout to

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special interests and
corporate and the wealthy

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that we've ever seen in the
history of Wisconsin. But I

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think that you have to look
beyond, you know, the sort

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of toss up numbers when it
comes to the Cooke. Yeah. On

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on you know, if you look at
it on face Wisconsin, you

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know, goes back and forth.
But if you look at the real

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numbers and where the
Republican Party is right

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now, you know, if you're not
Donald Trump, the party has

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Wisconsin voters have
elections. Election after

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election after election. And
we I think we've only had

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two of any consequence that
have gone Republican in the

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last like 15 years. Ron
Johnson, of course, who got

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in there because, you know,
the D triple DS abandoned

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Mandela Barnes and he was
racist third party ads. And,

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and, and the Supreme Court
race where they just, you

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know, they were Democrats
quite didn't quite, hadn't

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quite figured out how to
lock up those races yet. Now

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it's a completely different
universe. And the Republican

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Party, with Donald Trump in
full control of the

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government, isn't getting
more open for isn't getting

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more accommodating for swing
voters?

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>> Bill, as to the
Washington influence,

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seventh Congressional
District Republican Tom

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Tiffany has been talking
about running for a long

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time. What's he waiting for?
>> He says he's going to

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make a decision sometime
around Labor Day. I hope he

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does it sooner than that.
There are several

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congresspeople in in the
House now that are running

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for governor and different
states. Byron Donalds being

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at the top of the list in
Florida. I think the

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president's a little
concerned about that,

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House, the GOP majority in
the House, is so slim to

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begin with. So I don't know
if Tom Tiffany is going to

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get in if he's got a lot of
strong suits, for sure, but

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is fundraising. He's got
$125,000 cash on hand, which

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today and Scott would agree.
That's a good assembly race.

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That's not a gubernatorial
race. So fundraising is his

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biggest shortcoming. We'll
see if he gets in. At the

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end of the day, where Scott
and I actually do agree,

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Donald Trump's going to pick
the winner of this primary,

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whoever he endorses in this
primary will win the race

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for sure. On our side.
>> Who else are Republicans

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looking at, Bill? I mean,
there's there is a long list

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of people out there.
>> Well, other names that

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are being bandied about are
State Senator Mary

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Felzkowski, who comes from
roughly the same geography

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as Tom Tiffany. She
represents the 12th Senate

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district up north. If she
won't get in, if Tiffany

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00:12:27,714 --> 00:12:30,250
does get in. But if Tiffany
doesn't get in, I would

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00:12:30,317 --> 00:12:33,086
expect to see her join the
race. You might remember she

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00:12:33,153 --> 00:12:35,189
voted against the state
budget. She's the first

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00:12:35,255 --> 00:12:38,625
Senate president to ever
vote against a state budget.

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00:12:38,692 --> 00:12:41,094
Eric Hovde name still gets
talked about, and I think

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00:12:41,161 --> 00:12:43,163
there's a player to be named
later again, because it's an

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00:12:43,230 --> 00:12:46,433
open seat. It's a real
opportunity. So I think

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00:12:46,500 --> 00:12:48,368
there's probably somebody on
our side that people aren't

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00:12:48,435 --> 00:12:51,071
talking about yet who could
get in this race. Remember,

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00:12:51,138 --> 00:12:54,975
we got 375 days between now
and the August 11th, 2026

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00:12:55,042 --> 00:12:57,911
primary.
>> I'm sorry. I just want to

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00:12:57,978 --> 00:13:00,948
say, like, I think the
reason, you know, part of

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00:13:01,014 --> 00:13:03,750
the part of the challenge is
the Republicans have, in

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00:13:03,817 --> 00:13:05,118
contrast to the Democrats,
is that they're two

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00:13:05,185 --> 00:13:07,187
Republicans have no
experience. I mean, you

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00:13:07,254 --> 00:13:09,857
know, you know, God bless
Washington County, but it's

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00:13:09,923 --> 00:13:11,725
not even one of the top ten
largest counties in

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00:13:11,792 --> 00:13:15,262
Wisconsin. Whereas on the
very long list of people

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00:13:15,329 --> 00:13:18,899
with credentials who have
delivered for the people of

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00:13:18,966 --> 00:13:22,803
Wisconsin, starting with the
gotten $750 million back

254
00:13:22,870 --> 00:13:25,239
from opioid settlements,
something that the previous

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00:13:25,305 --> 00:13:27,808
Republican administration
and previous Republican

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00:13:27,875 --> 00:13:30,310
attorney general refused to
allow us to get. You've got

257
00:13:30,377 --> 00:13:32,412
the county executive in the
state's largest county.

258
00:13:32,479 --> 00:13:35,449
David Crowley, you've got
state Senator Kelda Roys,

259
00:13:35,516 --> 00:13:37,985
who's, you know, who's on
the Joint Finance Committee

260
00:13:38,051 --> 00:13:40,454
and who's run a couple times
before. You know, there's a

261
00:13:40,521 --> 00:13:43,090
long list of people with
real credentials about doing

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00:13:43,156 --> 00:13:46,693
the things that
mention was Ben Wikler,

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00:13:46,760 --> 00:13:50,531
former party chairman.
than Ben Wikler. He is the

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00:13:50,597 --> 00:13:54,568
best fundraiser on their
side or our side. So if he

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00:13:54,635 --> 00:13:58,305
decides to get in, he'll be
formidable.

266
00:13:58,805 --> 00:14:00,507
Scott?
>> Oh, absolutely. Yes. I

267
00:14:00,574 --> 00:14:03,210
mean, Ben's a great guy
who's traveled around the

268
00:14:03,277 --> 00:14:05,579
state doing the rubber
chicken circuit, you know,

269
00:14:05,646 --> 00:14:08,415
for years. I mean, it's a
reason why a lot of us

270
00:14:08,482 --> 00:14:09,950
thought in 2022 that Rebecca
Kleefisch was going to be

271
00:14:10,017 --> 00:14:13,086
the nominee for the
Republicans, but the

272
00:14:13,153 --> 00:14:16,490
they don't want to have a
woman at the top of the

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00:14:16,557 --> 00:14:18,959
ticket. So they went with an
out of state businessman who

274
00:14:19,026 --> 00:14:21,929
lost.
status of the governor's

275
00:14:22,296 --> 00:14:24,298
race. How much confidence,
though, does the most recent

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00:14:24,364 --> 00:14:25,666
ten point victory of
Justice, Susan Crawford,

277
00:14:25,732 --> 00:14:28,402
give Dems?
>> Well, there are two

278
00:14:28,468 --> 00:14:31,371
different races, but it also
shows that Democrats are

279
00:14:31,438 --> 00:14:34,808
able to have been able to
mobilize their voters in a

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00:14:34,875 --> 00:14:38,245
way that Republicans simply
have not been able to do for

281
00:14:38,312 --> 00:14:40,147
a very, very long time.
Again, they've lost. They've

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00:14:40,214 --> 00:14:42,015
won a couple statewide
elections. But the margins,

283
00:14:42,082 --> 00:14:44,518
percentage wise and number
wise, are so much more

284
00:14:44,585 --> 00:14:46,420
narrow than the blowouts
that the Democrats have been

285
00:14:46,486 --> 00:14:50,724
able to do, because, again,
they're talking about the

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00:14:50,791 --> 00:14:52,759
They want to make sure that
people are protected. They

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00:14:52,826 --> 00:14:56,330
want to make sure that
abortion rights are

288
00:14:56,396 --> 00:14:58,265
some cases, you know, they
want to make sure that when

289
00:14:58,332 --> 00:15:02,102
you go into court that you
have your day in court and

290
00:15:02,169 --> 00:15:05,105
it's not balanced towards
different to what the agenda

291
00:15:05,172 --> 00:15:07,140
of the of the Republicans
are most embodied by the

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00:15:07,207 --> 00:15:09,943
fact that, you know, we've
got this big bad bill which

293
00:15:10,010 --> 00:15:13,046
is now going to bankrupt,
you know, the country, you

294
00:15:13,113 --> 00:15:16,250
know, kicked 270,000
Wisconsinites off of their

295
00:15:16,316 --> 00:15:18,519
health care, you know,
snatch snap benefits, you

296
00:15:18,585 --> 00:15:21,822
know, literally take the,
the, the food out of out of

297
00:15:21,889 --> 00:15:24,892
babies and children. That's
the agenda of the

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00:15:24,958 --> 00:15:28,028
Republicans. And Democrats
and contrast with what we're

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00:15:28,095 --> 00:15:31,231
trying to do.
>> I wanted to just jump to

300
00:15:31,298 --> 00:15:32,799
the next Supreme Court
election. And have you

301
00:15:32,866 --> 00:15:34,868
described the stakes of
that?

302
00:15:34,935 --> 00:15:38,005
>> Well, we have Rebecca
Bradley, who hasn't decided

303
00:15:38,071 --> 00:15:41,675
whether she's going to seek
reelection or not on her

304
00:15:41,742 --> 00:15:45,179
most recent finance report.
She hadn't raised any money.

305
00:15:45,245 --> 00:15:48,348
My advice to her is, if
you're not going to run, get

306
00:15:48,415 --> 00:15:51,418
out and give people time to
raise money. I think one of

307
00:15:51,485 --> 00:15:53,287
the dynamics that there's a
relationship between the two

308
00:15:53,353 --> 00:15:56,323
races, I don't think the
Supreme Court race is going

309
00:15:56,390 --> 00:15:58,492
to be as hotly contested as
the last two were. I don't

310
00:15:58,559 --> 00:16:02,429
think it will be a $100
million race because it

311
00:16:02,496 --> 00:16:04,998
isn't for the majority. I
race, now that it's an open

312
00:16:05,065 --> 00:16:07,501
seat, will be the political
Super. Bowl in Wisconsin in

313
00:16:07,568 --> 00:16:10,804
2026.
appeals court Judge Chris

314
00:16:10,871 --> 00:16:13,273
Taylor is running for
Supreme Court. How

315
00:16:13,340 --> 00:16:16,910
formidable is she?
>> I think she's an

316
00:16:16,977 --> 00:16:18,445
incredibly formidable
candidate and has built her

317
00:16:18,512 --> 00:16:20,848
career on protecting the
rights of people in

318
00:16:20,914 --> 00:16:22,983
Wisconsin. You know, whether
it is for living with

319
00:16:23,050 --> 00:16:26,119
dignity or abortion rights
or whatever, you know, just

320
00:16:26,186 --> 00:16:29,590
that's the that's the that
is the profile profile that

321
00:16:29,656 --> 00:16:32,359
she has, the record that she
has. And especially as a

322
00:16:32,426 --> 00:16:34,228
judge. And you know, that
contrast, again, with

323
00:16:34,294 --> 00:16:37,231
Rebecca Bradley, who was one
of the most divisive, one of

324
00:16:37,297 --> 00:16:39,666
the most noxious elected
officials that we've had in

325
00:16:39,733 --> 00:16:42,135
the history of the state of
Wisconsin. And I think, you

326
00:16:42,202 --> 00:16:44,938
know, for her, what's you
know, the problem is, if

327
00:16:45,005 --> 00:16:48,509
she's waiting for a federal
incentive to taking out the

328
00:16:48,575 --> 00:16:52,513
incumbent from a judicial
race when, by and large,

329
00:16:52,579 --> 00:16:54,615
over decades? And Bill agree
with this, the incumbent

330
00:16:54,681 --> 00:16:57,784
wins almost used to be
unheard of, that almost 100%

331
00:16:57,851 --> 00:16:59,152
judicial candidate wouldn't
win. Yeah.

332
00:16:59,219 --> 00:17:02,389
>> All right. We need to
leave it there. But really

333
00:17:02,456 --> 00:17:04,992
nice to see you both again.
We'll have you on more now

334
00:17:05,058 --> 00:17:06,793
that we're heating up into
this next election cycle.

335
00:17:06,860 --> 00:17:08,595
Thank you.
>> Thanks.

336
00:17:08,662 --> 00:17:13,267
>> Great to be with you.
>> Leftover money from the

337
00:17:13,333 --> 00:17:17,070
RNC in Milwaukee brings
welcome news for nonprofits

338
00:17:17,137 --> 00:17:20,741
in the city. The Milwaukee
2024 Host Committee

339
00:17:20,807 --> 00:17:24,444
announced this week a $5
million donation to multiple

340
00:17:24,511 --> 00:17:27,581
local charities. That money
comes from the remaining

341
00:17:27,648 --> 00:17:30,484
funds that were raised to
support last summer's

342
00:17:30,551 --> 00:17:33,353
Republican National
Convention in Milwaukee. The

343
00:17:33,420 --> 00:17:36,356
donations will go to
organizations that focus on

344
00:17:36,423 --> 00:17:40,327
youth, veterans and shelters
like Sober living and

345
00:17:40,394 --> 00:17:44,164
halfway houses. Turning to
health care, we continue our

346
00:17:44,231 --> 00:17:47,768
coverage of prescription
drugs as drug prices for

347
00:17:47,835 --> 00:17:50,871
patients go up, health
insurance coverage of them

348
00:17:50,938 --> 00:17:54,508
goes down. In our series Rx
Uncovered Here and Now,

349
00:17:54,575 --> 00:17:58,278
producer Marissa Wojcik
unpacks why this is

350
00:17:58,345 --> 00:18:01,515
happening and the impact
it's having on patients. In

351
00:18:01,582 --> 00:18:05,385
tonight's story, we look at
how health plans use

352
00:18:05,452 --> 00:18:08,589
accumulators to divert
financial aid away from

353
00:18:08,655 --> 00:18:12,693
patients in need.
>> I couldn't believe what I

354
00:18:12,759 --> 00:18:14,428
found out when this
happened. I couldn't believe

355
00:18:14,494 --> 00:18:18,065
it was legal.
>> Tamra Varebrook lives

356
00:18:18,966 --> 00:18:23,103
conditions. She can still
live her life as long as she

357
00:18:23,170 --> 00:18:27,007
has her medication.
>> I changed jobs and

358
00:18:27,074 --> 00:18:30,477
started over with a new
copay and new deductible.

359
00:18:30,544 --> 00:18:34,014
That's when this hit me, I
wasn't getting my

360
00:18:34,081 --> 00:18:36,350
medications. And you know, I
thought, what? Why aren't

361
00:18:36,416 --> 00:18:38,619
you sending them? They're
like, well, you have a

362
00:18:38,685 --> 00:18:42,356
$6,000 balance. I had my
first experience with copay

363
00:18:42,422 --> 00:18:44,725
accumulators. I had never
even heard of him.

364
00:18:44,791 --> 00:18:47,594
>> A copay accumulator
sounds like an obscure

365
00:18:47,661 --> 00:18:51,532
insurance term, and it is.
>> And I know people don't

366
00:18:51,598 --> 00:18:53,433
understand this. If this
doesn't directly affect

367
00:18:53,500 --> 00:18:55,836
them.
>> It's also a growing trend

368
00:18:55,903 --> 00:18:59,740
among health plans for
Tamara's conditions. Her

369
00:18:59,806 --> 00:19:02,509
medication costs her the
equivalent of buying a car

370
00:19:02,576 --> 00:19:05,812
every year.
>> Right now, I take the

371
00:19:07,414 --> 00:19:12,252
entire prior year to save
up, to try to have enough to

372
00:19:12,319 --> 00:19:16,123
buy my drug in January. It's
ridiculously expensive, but

373
00:19:16,190 --> 00:19:19,359
it's the thing that makes me
be able to walk in my arms,

374
00:19:19,426 --> 00:19:22,596
bend and, you know, keep,
you know, my joints moving

375
00:19:22,663 --> 00:19:25,399
so I don't end up in a
wheelchair.

376
00:19:25,465 --> 00:19:28,602
>> To afford her drugs, her
doctors told her about

377
00:19:28,669 --> 00:19:32,539
patient assistance programs.
It's often the drug

378
00:19:32,606 --> 00:19:35,075
manufacturer helping the
patient to afford their own

379
00:19:35,142 --> 00:19:38,946
high priced medication. This
kind of financial assistance

380
00:19:39,012 --> 00:19:42,749
is referred to as a copay,
coupon or copay card.

381
00:19:42,816 --> 00:19:45,485
>> That were meant to help
the patients get their drugs

382
00:19:45,552 --> 00:19:49,556
and pay down their
deductibles, pay down their,

383
00:19:49,623 --> 00:19:52,726
you know, on their
out-of-pocket maximums.

384
00:19:52,793 --> 00:19:56,163
>> Here's how they work a
patient is prescribed an

385
00:19:56,230 --> 00:20:00,300
expensive name brand drug
that doesn't have a generic.

386
00:20:00,367 --> 00:20:03,871
Their health plan has a high
deductible and out-of-pocket

387
00:20:03,937 --> 00:20:07,207
maximum, which they must
meet before the plan will

388
00:20:07,274 --> 00:20:11,345
cover the drug. The copay
card provides the financial

389
00:20:11,411 --> 00:20:13,981
assistance to cover the
patient's deductible and

390
00:20:14,047 --> 00:20:17,084
out-of-pocket max. When
those are met, the health

391
00:20:17,150 --> 00:20:20,521
plan kicks in and covers all
or part of the cost that

392
00:20:20,587 --> 00:20:23,624
remains of the drug,
potentially saving the

393
00:20:23,690 --> 00:20:26,360
patient thousands of
dollars.

394
00:20:26,426 --> 00:20:29,763
>> It was a life changer. I
was, you know, pretty low

395
00:20:29,830 --> 00:20:34,234
income at the time when a
lot of my medical issues

396
00:20:34,301 --> 00:20:37,204
started and I would never
have been able to afford

397
00:20:37,271 --> 00:20:40,274
these medications.
>> One day, she realized she

398
00:20:40,340 --> 00:20:43,911
wasn't receiving the life
changing assistance or her

399
00:20:43,977 --> 00:20:46,813
medication. Tamara was
blindsided.

400
00:20:46,880 --> 00:20:49,883
>> They weren't shipping it.
And so I kept calling and

401
00:20:49,950 --> 00:20:52,753
saying, well, why isn't this
shipping there? Like, you

402
00:20:52,819 --> 00:20:55,889
owe $6,000. And I'm like,
what do you mean I owe

403
00:20:55,956 --> 00:20:58,258
$6,000?
>> The drug company had

404
00:20:58,325 --> 00:21:01,128
provided the copay card.
>> I've already gotten this.

405
00:21:01,195 --> 00:21:05,766
And you know, it should be
my deductible. At least

406
00:21:06,633 --> 00:21:09,069
should be covered.
>> The problem was the

407
00:21:09,136 --> 00:21:13,273
financial assistance no
longer covered her. The

408
00:21:13,340 --> 00:21:16,310
pharmacy told her.
>> If you don't pay for it

409
00:21:16,376 --> 00:21:18,345
in full, you are not getting
your medication. And I went

410
00:21:18,412 --> 00:21:20,981
months without.
>> Tamara had recently

411
00:21:21,048 --> 00:21:24,151
started a new job where her
health plan contained a

412
00:21:24,218 --> 00:21:28,856
copay, accumulator.
>> I spent countless hours

413
00:21:28,922 --> 00:21:32,426
on phone calls. I can't even
tell you how upsetting it

414
00:21:32,492 --> 00:21:35,062
was.
>> The accumulator is a

415
00:21:35,429 --> 00:21:38,232
relatively new tool used by
health plans and pharmacy

416
00:21:38,298 --> 00:21:42,236
benefit managers. A copay
accumulator takes the

417
00:21:42,302 --> 00:21:46,340
financial assistance, the
copay card, and only applies

418
00:21:46,406 --> 00:21:50,410
it to the total cost of the
drug. It does not count

419
00:21:50,477 --> 00:21:53,680
towards the patient's
deductible or out of pocket

420
00:21:53,747 --> 00:21:57,718
maximum. In other words, the
patient no longer saves

421
00:21:57,784 --> 00:22:01,622
money. The health plan saves
money by taking the full

422
00:22:01,688 --> 00:22:04,858
amount of the copay card and
still collecting the

423
00:22:04,925 --> 00:22:09,162
deductible and out-of-pocket
maximum paid by the patient.

424
00:22:09,229 --> 00:22:11,932
>> This is a very scary
moment for me, just knowing

425
00:22:11,999 --> 00:22:14,201
a lot of other people with
Mis.

426
00:22:14,268 --> 00:22:18,205
>> Jim Turk has multiple
sclerosis or Ms, a disease

427
00:22:18,272 --> 00:22:21,208
that attacks the body's
nerves. There's no cure,

428
00:22:21,275 --> 00:22:24,511
only treatment.
>> If you're on drugs, I

429
00:22:24,578 --> 00:22:26,713
mean, that's your lifeline.
That's something that's

430
00:22:26,780 --> 00:22:28,882
preventing that, or at least
slowing that down

431
00:22:28,949 --> 00:22:30,551
significantly from
happening. So they don't

432
00:22:30,617 --> 00:22:33,153
have as much stress in their
life either. And the stress

433
00:22:33,220 --> 00:22:36,089
in their life can also
exacerbate the symptoms. So

434
00:22:36,156 --> 00:22:39,026
it's just this vicious
circle.

435
00:22:39,092 --> 00:22:42,563
>> He's an advocate for
people with Ms. Knowing the

436
00:22:42,629 --> 00:22:45,232
struggles firsthand.
>> I look at a list to see

437
00:22:45,299 --> 00:22:49,036
what all the drugs cost.
Ocrevus the one that I was

438
00:22:49,102 --> 00:22:51,638
on last, which was actually
the newer drug, was one of

439
00:22:51,705 --> 00:22:55,242
the cheaper drugs. And that
was, I think, 70 or $80,000

440
00:22:55,309 --> 00:22:59,646
a year, which I can't
afford. I'm on disability.

441
00:22:59,713 --> 00:23:02,983
>> Having been the recipient
of copay cards. He stresses

442
00:23:03,050 --> 00:23:05,786
their importance for
patients to survive.

443
00:23:05,853 --> 00:23:08,689
>> You have to make the
choice between paying for

444
00:23:08,755 --> 00:23:12,793
your drugs. That might be a
lifesaver or paying for

445
00:23:12,860 --> 00:23:16,129
groceries. And obviously,
there's no choice there. Or

446
00:23:16,196 --> 00:23:18,031
paying for rent. And that's
really what it comes down

447
00:23:18,098 --> 00:23:21,168
to.
>> And a copay accumulator.

448
00:23:21,235 --> 00:23:23,770
>> They're essentially
designed to be confusing.

449
00:23:23,837 --> 00:23:26,273
>> Makes that choice even
harder.

450
00:23:26,340 --> 00:23:30,944
>> I thought, Holy cow.
Well, in 21 states it is now

451
00:23:31,011 --> 00:23:33,714
illegal, but not Wisconsin.
>> Other states have

452
00:23:33,780 --> 00:23:37,017
outlawed accumulators, and a
bill currently in

453
00:23:37,084 --> 00:23:40,587
Wisconsin's legislature
would as well. At a hearing,

454
00:23:40,654 --> 00:23:44,024
health plans and pharmacy
benefit managers spoke in

455
00:23:44,091 --> 00:23:46,593
opposition.
control the soaring prices

456
00:23:46,660 --> 00:23:50,397
of prescription drugs set by
pharmaceutical

457
00:23:50,464 --> 00:23:52,599
manufacturers, but instead
rewards drug makers for

458
00:23:52,666 --> 00:23:54,801
steering patients towards
more expensive brand name

459
00:23:54,868 --> 00:23:57,871
drugs.
a ploy by pharmaceutical

460
00:23:59,106 --> 00:24:02,242
companies to get patients to
take expensive name brand

461
00:24:02,309 --> 00:24:04,278
drugs.
>> Rather than benefiting

462
00:24:04,344 --> 00:24:07,581
those in financial need. A
lot of these coupons from

463
00:24:07,648 --> 00:24:10,250
manufacturers act as an
inducement to move to higher

464
00:24:10,317 --> 00:24:13,320
cost products.
>> Supporters of

465
00:24:13,954 --> 00:24:17,224
accumulators say they lower
costs by saving health plans

466
00:24:17,291 --> 00:24:21,828
money, not just one patient,
but others refuted these

467
00:24:21,895 --> 00:24:25,232
claims.
assistance programs from

468
00:24:25,299 --> 00:24:28,402
manufacturers are for drugs
with no generic

469
00:24:28,468 --> 00:24:31,271
alternatives. The copay
assistance increases

470
00:24:31,338 --> 00:24:33,774
medication adherence.
Studies have found that

471
00:24:33,841 --> 00:24:37,211
morbidity and mortality
associated with poor

472
00:24:37,277 --> 00:24:42,349
medication adherence cost
the US healthcare system

473
00:24:42,416 --> 00:24:45,986
$528 billion annual
Nonadherence can lead to

474
00:24:46,053 --> 00:24:49,089
treatment failure, resulting
in poor outcomes such as

475
00:24:49,156 --> 00:24:51,592
worsening of condition,
admission to the emergency

476
00:24:51,658 --> 00:24:54,828
room and hospitalization,
and requiring new

477
00:24:54,895 --> 00:24:57,598
prescriptions to treat
subsequent comorbidities,

478
00:24:57,664 --> 00:25:00,801
which results in higher cost
to the entire health care

479
00:25:00,868 --> 00:25:03,170
system. That is what will
increase premiums.

480
00:25:03,237 --> 00:25:05,672
>> This rings true for
Tamra.

481
00:25:05,739 --> 00:25:09,576
>> The specific drug is not
the only cost of chronic

482
00:25:09,643 --> 00:25:14,648
disease. Chronic disease
causes people to miss work,

483
00:25:15,582 --> 00:25:19,586
end up in emergency rooms,
hospital bills.

484
00:25:20,420 --> 00:25:23,957
>> Drug manufacturers do not
like accumulators because

485
00:25:24,024 --> 00:25:27,995
the assistance doesn't go to
help the patient. She fears

486
00:25:28,061 --> 00:25:30,831
they may end up not
providing the assistance at

487
00:25:30,898 --> 00:25:33,367
all.
>> I'm afraid that the

488
00:25:33,767 --> 00:25:36,603
pharmaceutical companies
stop the programs because

489
00:25:36,670 --> 00:25:39,473
they're not helping the
patients, and that would be

490
00:25:39,540 --> 00:25:42,242
a real nightmare because
then everybody would suffer.

491
00:25:42,309 --> 00:25:45,546
This is where we're at in
Wisconsin now, and I feel

492
00:25:45,612 --> 00:25:49,049
bad for everybody who has a
child or, you know, any

493
00:25:49,116 --> 00:25:54,121
adult that runs into these
issues because most people

494
00:25:55,055 --> 00:25:58,525
are not prepared with that
kind of money, and you

495
00:25:58,592 --> 00:26:00,060
aren't going to get your
medication.

496
00:26:00,127 --> 00:26:03,363
>> Reporting from Germantown
I'm Marisa Wojcik for "Here&

497
00:26:03,430 --> 00:26:05,999
Now".
>> For more on this and

498
00:26:06,667 --> 00:26:09,536
other issues facing
Wisconsin, visit our website

499
00:26:09,603 --> 00:26:13,473
at PBS Wisconsin. Org and
then click on the news tab.

500
00:26:13,540 --> 00:26:16,710
That's our program for
tonight. I'm Frederica

501
00:26:16,777 --> 00:26:19,746
Freyberg. Before we go, I'd
like to acknowledge and say

502
00:26:19,813 --> 00:26:22,816
goodbye to one of our
reporters. Aditi Debnath

503
00:26:22,883 --> 00:26:26,653
joined us in 2023. She's
been a great asset. Now

504
00:26:26,720 --> 00:26:30,791
she's on the move. Today is
her last day at PBS

505
00:26:30,858 --> 00:26:33,660
Wisconsin. We wish her all
the best. Have a good

506
00:26:33,727 --> 00:26:35,395
weekend.
[MUSIC]

507
00:26:45,105 --> 00:26:48,475
>> Funding for here and Now
is provided by the Focus

508
00:26:48,542 --> 00:26:53,213
Fund for Journalism and
Friends of PBS Wisconsin.