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>> The following program is
a PBS Wisconsin original

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production.
>> Wisconsin is reporting

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that our first cases of
measles in 2025 were

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confirmed over the weekend.
>> State health officials

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encourage vaccinations as
measles hit Wisconsin and in

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Rx Uncovered. Health benefit
advocates help patients get

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the medicine they need. I'm
Frederica Freyberg. Tonight

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on "Here& Now" the latest
economic outlook forest

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land, wildfires, the rise of
measles and part five of our

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series Rx Uncovered. It's
"Here& Now" for August 8th.

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[MUSIC]
>> Funding for "Here& Now"

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is provided by the Focus
Fund for Journalism and

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friends of PBS Wisconsin.
>> A whole new spate of

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tariffs went into effect
this week. Job numbers were

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weaker than expected this
summer, and business

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analysts say consumers are
tightening their belts. How

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do economic trends
nationally translate to how

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Wisconsin is faring now and
going forward? We asked

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Steven Deller, UW-Madison
professor of agricultural

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and applied economics, and
thanks for being here.

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>> Thank you.
>> So when you look at the

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broad economic landscape,
what are you seeing.

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>> From a Wisconsin
perspective? And I think

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this is kind of generally
true across the country is a

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lot of businesses have gone
into a wait and see mode.

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That's why the job numbers
are weak. We're not seeing

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an increase in unemployment
rates. We're seeing a

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decline in the number of
hires, primarily because

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businesses are unsure what's
happening. And when we're

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unsure, we kind of go into a
lockdown mode. We go into a

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holding pattern, if you
will. So I think that's why

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the job numbers are as weak
as they are, and it's going

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to take a while for this to
kind of play out.

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>> And so this is this
mostly around tariffs or

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interest rates or inflation
or all of it.

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>> I think it's all of it. I
think the major concern is

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that we're not sure exactly
what the policies are going

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to be. The tariffs are on.
The tariffs are off. They're

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back on again. They're off
again. And it's that

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uncertainty businesses I
mean there's kind of we know

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what we know. We know what
we don't know. We can make

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educated guesses. And then
what's going on. That's

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uncertainty. And when we're
in a situation like that,

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that's when people just
hunker down. They go into

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wait and see mode. And, you
know, in terms of like

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consumers, it is kind of
anticipatory shopping. It is

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kind of like, okay, now
let's go into a wait and see

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mode. And it's just we don't
know what's happening.

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>> So you said that the
trends kind of are the same

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nationally and in Wisconsin.
But is there anything

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specific to Wisconsin that
we should be watching. For?

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>> Wisconsin? Our highs, our
growth periods are not as

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strong as the national
averages. Our lows are not

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as weak as the national
averages. So Wisconsin is

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kind of steady, if you will.
You have to go back to the

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farm crisis of the early
1980s, before Wisconsin kind

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of broke that trend. So I
think Wisconsin's going to

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be kind of in a stable mode
for a little while.

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>> And yet are the things
that make Wisconsin more or

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less vulnerable to a
downturn?

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>> Not necessarily. One of
the reasons is because our

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economy is pretty
diversified. We don't we're

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not heavily dependent upon
one particular industry. I

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mean, you can point to some
of the big ones, like

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agriculture, food
recreation. So there's some

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industries that maybe might
be susceptible. But in

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general, Wisconsin's a
pretty diversified economy.

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>> So all of this said, are
you seeing indications of a

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slowdown nationally and in
Wisconsin?

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>> Yes. And I think that's
what the job numbers are

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saying. And in talking with
businesses around the state,

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and again, I tend to talk to
the smaller businesses,

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which tends to dominate most
of Wisconsin. They're just

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in a again, a wait and see
mode. They're they're

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delaying expansion plans.
They're not going into

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shutdown mode. And one of
the reasons they're not

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going into shutdown mode is
because they have such a

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difficult time hiring labor.
Wisconsin has been facing a

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structural labor shortage
for years, long before

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Covid, and particularly
coming out of Covid and

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businesses. Remember that
difficulty of hiring people,

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so they're really hesitant
to lay people off because

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they don't want to go
through that again. So

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again, they're in that wait
and see mode.

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>> And so you're looking at
kind of a business activity

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as a bellwether. Are there
others?

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>> Yes. One is consumer
expenditures. One of the

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things is we saw an increase
in consumer expenditure

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after the announcement of
the tariffs. And the reason

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for that is people were
thinking, oh, I'll buy it

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now. I'll buy it before the
tariffs hit. So there was

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kind of a spike in spending
from consumers. Well that

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kind of spike has you know
those purchases have played

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out now. And now they're
going into a wait and see

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mode. So I think if we start
to see consumer expenditures

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slow down much more than
they already have, then

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that's a warning sign. The
other thing is we're seeing

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the housing market start to
slow down, and there's other

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factors going on there. But
again, I think it's that

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reflection of just I'm going
to delay making any major

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purchases because I'm not
sure what's going to happen.

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>> All right. We leave it
there. Steven Deller thanks

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very much.
>> Thank you.

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wildfires is a regular
feature these days in

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Wisconsin. According to
current maps, there are 700

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active wildfires in Canada,
most of them categorized as

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out of control. What's the
risk of wildfires or forest

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fires in Wisconsin? And
could cuts in federal

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funding of the U.S. Forest
Service? If forest

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management in Wisconsin,
we're joined now by James

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Barnier forest fire
protection section chief for

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the Division of Forestry.
And thanks very much for

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being here.
>> Thank you.

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>> So I know that the
Wisconsin DNR also has these

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fire management dashboards
online. How has this year

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compared historically for
wildfires in Wisconsin?

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>> This year is fairly
unique. It was one of our

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more uncommon types of
events. We've had. As you

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might remember, a drier than
normal winter. We saw a

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significant number of fires
in January and February,

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which we traditionally don't
see. So those fires cause a

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lot of great a lot of work
on our staff to be prepared,

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be ready. Typically, when
we're trying to get ready

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for our typical spring
season, which is March,

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April and May. And so that
really took a toll on our

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staff overall from that
working those two months

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earlier. Traditionally, we
see snowfall during that

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time frame.
>> Right.

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>> So what are conditions
like right now for fires in

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Wisconsin?
>> Well, to be honest, we're

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just starting to get back
into some drought

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conditions. We're starting
to staff up again and just

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prepare for fires for the
summer months.

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>> When a fire breaks out.
What kind of fuels it

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spread?
>> Well, most of our fires

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are caused by people, and
typically in the state of

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Wisconsin, most of our fires
are wind driven, usually

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with low RH and higher
temperatures, but mostly

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with wind. And low RH is
what we see drives most of

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our fires. And that usually
that light fuels that grass

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type fuels that would spread
really fast. And then once

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that gets ignited, the fire
gets a lot bigger. There's

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called ladder fuels. Those
ladder fuels get you know,

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get into the tops of the
trees. And then when you see

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those really significant
type of crown fires.

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>> So you have told us that
it is not likely that

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Wisconsin would ever see
fires like those in in

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Canada. Why not?
>> Why wouldn't say we

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wouldn't see types of fires
of that magnitude of 250,000

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acres. We probably wouldn't
see that size of fires. But

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we do see a lot of
significant what I would

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say, catastrophic for the
state of Wisconsin. Anything

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between, you know, 3000 to,
you know, 15,000 acres,

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those types of fires in the
are common. You know, every

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so often in the state of
Wisconsin and have

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significant impacts across
the state.

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>> A number of DNR
firefighters have been in

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Canada. Tell me about that.
>> So we've sent up 20

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people to both Ontario, and
Manitoba. And during that

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time frame in, they're
actually fighting fires and

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working within that
organization on their IMT

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incident management teams to
help facilitate that. So

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doing so, it is a
significant event.

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>> How much forest land does
Wisconsin have and who's

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responsible for its
management, fire prevention

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and firefighting.
>> Just in general, there's

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about 57% of the forested
lands is privately owned and

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about another 10% industry
owned. And the rest is

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government entities. And so
we provide Wisconsin DNR,

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provide support with those
landowners through, you

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know, sound forest
management practices to

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provide some management
plans for them or through,

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you know, industry working
through industry foresters

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and ensuring that we have a
good, solid forest, healthy

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forest to help limit those
large scale fires.

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>> So we know that state
officials have concern about

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federal cuts to states from
the U.S. Forest Service.

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What role do the feds play
in wildfire management?

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>> They provide us a lot of
funding sources. So, yes,

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roughly a little over $2
million to support

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perspectives associated with
wildfire preparedness. And

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that where would that money
go? Well, we work heavily

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with our partners, local
fire departments. Our one of

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our key components within
the state of Wisconsin. And

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we provide grants to those
to help facilitate responses

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to those fires. Also for our
needs, for our training

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responsibilities, our tools,
our resources, and even some

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of our funding of our
positions.

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>> James Barnier, thanks
very much for joining us.

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>> Thank you.
>> Measles was declared

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eliminated in the U.S. 25
years ago, but this year

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marks the most cases since
then, with spread of the

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disease to 40 states and
more than 1300 cases.

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Earlier this month,
Wisconsin reported nine

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cases in Oconto County. But
health officials say they

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believe any spread there is
contained. Still, Wisconsin

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kindergartners have one of
the nation's lowest

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vaccination rates against
measles, with less than 85%

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of them up to date on the
measles vaccine. Last year.

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That's compared to about
92.5% of kindergartners

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nationwide, according to the
CDC. We turn to Doctor James

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Conway, pediatric infectious
disease specialist at the UW

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School of Medicine and
Public Health. And thanks

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for being here.
>> Happy to be back.

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>> So with Wisconsin
vaccination rates, how at

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risk are we for measles
outbreaks?

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a sitting duck. You know, as
we see people traveling and

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introducing the disease into
various areas, all it takes

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is one person who's
incubating the disease to

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show up in an area with
under-immunized populations.

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In a way, it goes. That's
really how these things get

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started.
>> Are you surprised that we

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haven't seen that kind of
outbreak?

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surprising given our low
rates and how much travel

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people have been doing as
we've come out of Covid and

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gotten back to more normal
activity. You know, we know

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that disease gets introduced
fairly regularly. You know,

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while many of them are
related to the Texas

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outbreak, we still see cases
countries. And so all it

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takes is one person showing
up in the right place at the

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right time.
>> Now, I understand that

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Wisconsin is one of only 13
states that has a personal

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conviction waiver for
parents to opt out of the

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vaccine. Is that opt out on
the rise?

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>> Yeah, it's been debated.
You know, there are medical

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waivers in every state, and
some states also have

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religious waivers. But this
personal exemption waiver is

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something that's a little
unusual. And it really

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allows people that just have
a deep held personal

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conviction to opt out of it.
Some states are discussing

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actually allowing more of
that while other states are

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shutting it down and
actually trying to contain

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that activity.
>> So what's it like for a

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00:12:38,926 --> 00:12:41,862
doctor like yourself to see
a preventable disease like

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this spreading?
>> Yeah. It's heartbreaking.

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I mean, I saw plenty of
measles earlier in my

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career, both in my training
here in the United States

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and in my work globally.
And, you know, as we worked

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so hard to eradicate polio
when I was younger, measles

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was really the next one on
the chopping block. And in

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the 90s, we were very
optimistic. We were getting

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closer. You know, I've seen
so many children suffer with

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this disease. Adults don't
do well with it either. And

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00:13:06,320 --> 00:13:08,822
then having to see people
unfortunately subjected to

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this again, you know, it's
really both preventable. And

246
00:13:11,158 --> 00:13:13,827
just so unfortunate.
>> How transmissible are

247
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measles?
>> Measles is probably one

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of the most transmissible
things on the planet. You

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know, we talk about the fact
that you probably need about

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00:13:20,968 --> 00:13:23,537
95% of people to be
vaccinated in any community

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to keep an outbreak from
spreading. And so when we're

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sitting well below 90%, you
know, it's really almost

253
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something that is
inevitable. But it is by far

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one of the most contagious
things on this planet at

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this point.
kind of the symptoms of, of

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measles, but it can be
fatal.

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00:13:42,189 --> 00:13:45,025
1 to 2 people per thousand
are going to be killed by

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this. Probably 10% get
hospitalized. So it is, you

259
00:13:49,730 --> 00:13:52,799
know, really a very high
risk disease, especially in

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young kids, the elderly,
people with compromised

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immune systems. But even
people that survive it. I

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mean, it's a miserable
disease.

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>> And there are certain
groups that cannot get a

264
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vaccine. And any spread
would put those people at

265
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risk who who really does not
get the vaccine.

266
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>> Yeah. So this is one of
the few vaccines that's

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still considered a live
viral vaccine. So these are

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viruses that have been
essentially engineered to be

269
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less transmissible, but they
still can cause some

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symptoms in people that
don't have a good immune

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system. So people that have
had bone marrow or other

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00:14:25,399 --> 00:14:28,569
organ transplants shouldn't
be getting these vaccines.

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00:14:28,635 --> 00:14:32,139
Patients that are under
chemotherapy for other types

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00:14:32,206 --> 00:14:34,775
of cancers, people that are
on immune compromising

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00:14:34,842 --> 00:14:37,077
drugs, they just can't get
the vaccines. And so they

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00:14:37,144 --> 00:14:40,347
really do depend on the rest
of us to essentially build a

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00:14:40,414 --> 00:14:43,250
firewall for them.
>> Now, I learned that in

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00:14:43,317 --> 00:14:47,688
Milwaukee, the vaccination
75%. They are now giving out

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00:14:47,754 --> 00:14:51,625
800 doses of this vaccine.
But how at risk is a place

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like Milwaukee?
>> Yeah, so that's exactly

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00:14:54,061 --> 00:14:55,696
the worst nightmare.
Because, you know, one of

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00:14:55,762 --> 00:14:59,666
the things we need to
remember about measles is

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00:14:59,733 --> 00:15:00,734
people are contagious before
they have symptoms. So 3 or

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00:15:00,801 --> 00:15:04,271
4 days before you're
actually ill with obvious

285
00:15:04,338 --> 00:15:08,075
shedding that virus. And so
when you've got even 75 or

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00:15:08,141 --> 00:15:11,612
80% of people immunized,
that means 1 in 5 people are

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00:15:11,678 --> 00:15:14,047
vulnerable. Those get
transmitted. It's got a long

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00:15:14,114 --> 00:15:16,617
incubation period. So people
can be walking around for

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00:15:16,683 --> 00:15:19,753
weeks, not remember where
they got it. And so from a

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00:15:19,820 --> 00:15:21,455
public health standpoint,
chasing down where it

291
00:15:21,522 --> 00:15:23,757
started and getting people
into quarantine and

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00:15:23,824 --> 00:15:25,893
isolation is really a
nightmare.

293
00:15:25,959 --> 00:15:27,628
>> All right. Well, Doctor
James Conway, thanks very

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00:15:27,694 --> 00:15:30,497
much.
>> Thanks for having me.

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00:15:30,864 --> 00:15:33,834
>> On health care. We
continue our coverage on

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00:15:33,901 --> 00:15:38,505
prescription drugs. Over the
last month, Rx Uncovered has

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00:15:38,572 --> 00:15:42,042
looked at why patient costs
for drugs are going up and

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00:15:42,109 --> 00:15:46,013
coverage for drugs is going
down. In our final story,

299
00:15:46,079 --> 00:15:48,815
patients are not alone as
they try to afford their

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00:15:48,882 --> 00:15:52,886
specialty drugs and navigate
complex health insurance

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00:15:52,953 --> 00:15:55,489
policies. Here and now,
producer Marissa Wojcik

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00:15:55,556 --> 00:15:58,725
speaks with advocates
helping patients understand

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00:15:58,792 --> 00:16:03,430
their health plans and
challenge claim denials.

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00:16:03,497 --> 00:16:07,234
>> How far are they away
from bankruptcy?

305
00:16:07,301 --> 00:16:11,839
>> They pretty much billed
me $83,000 per infusion.

306
00:16:11,905 --> 00:16:16,143
>> They are as far away as a
chronic diagnosis.

307
00:16:17,778 --> 00:16:21,982
>> The right medication can
be expensive, but critical

308
00:16:22,049 --> 00:16:24,551
for chronic illness
patients. Advocates like

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00:16:24,618 --> 00:16:27,387
Nilsa Cruz know this all too
well.

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00:16:27,454 --> 00:16:32,359
>> The reason why I became a
patient advocate is it was

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00:16:33,160 --> 00:16:36,997
actually baptism by fire.
>> When she started as

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00:16:37,064 --> 00:16:39,633
administrator for the
Milwaukee Rheumatology

313
00:16:39,700 --> 00:16:42,536
Center, more than 20 years
ago, she also became the

314
00:16:42,603 --> 00:16:46,073
clinic's de facto patient
advocate.

315
00:16:46,139 --> 00:16:49,977
>> Patients coming back or
calling back because their

316
00:16:50,043 --> 00:16:53,680
medication is not covered,
perhaps they cannot afford

317
00:16:53,747 --> 00:16:58,051
the out-of-pocket expense.
After going through a very

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00:16:58,118 --> 00:17:01,522
tedious process of a prior
authorization, only to come

319
00:17:01,588 --> 00:17:06,226
and find out that it's
unaffordable, delays and

320
00:17:06,293 --> 00:17:08,662
denials. Some patients
suffering, too. Because the

321
00:17:08,729 --> 00:17:10,597
patients really don't
understand what's going on

322
00:17:10,664 --> 00:17:14,134
with their benefits.
>> Today, she's known and

323
00:17:14,201 --> 00:17:17,104
even sought out for her
ability to help patients

324
00:17:17,171 --> 00:17:19,973
navigate complex health
benefits.

325
00:17:20,040 --> 00:17:23,677
>> I come to this clinic
because of their patient

326
00:17:23,744 --> 00:17:26,313
advocate.
>> Janelle Zeihen came to

327
00:17:26,380 --> 00:17:29,283
Cruz when her last clinic
didn't know how to help her

328
00:17:29,349 --> 00:17:32,119
navigate her health plan
benefits. So she came to

329
00:17:32,186 --> 00:17:36,156
this rheumatology clinic for
her Crohn's, a type of

330
00:17:36,223 --> 00:17:38,959
inflammatory bowel disease.
>> It starts with like a

331
00:17:39,026 --> 00:17:41,662
like somebody sucker
punching me right up into my

332
00:17:41,728 --> 00:17:44,498
chest. And then. And that's
pretty much the inflammation

333
00:17:44,565 --> 00:17:46,567
starting.
>> Crohn's disease can be

334
00:17:46,633 --> 00:17:49,169
debilitating and life
threatening, especially when

335
00:17:49,236 --> 00:17:52,005
not treated.
>> It is extremely painful.

336
00:17:52,072 --> 00:17:55,843
I can barely walk when it
happens. Being on the

337
00:17:55,909 --> 00:17:58,445
entyvio that I get, it's
been life changing.

338
00:17:58,512 --> 00:18:02,216
>> When she got a new job,
her entyvio was no longer

339
00:18:02,282 --> 00:18:05,352
covered under her new plan.
>> They specifically carved

340
00:18:05,419 --> 00:18:09,556
out all tier four drugs,
which are chemo's HIV drugs

341
00:18:09,623 --> 00:18:13,260
and any infusions.
>> Tier four drugs are also

342
00:18:13,327 --> 00:18:16,029
referred to as specialty
drugs.

343
00:18:16,096 --> 00:18:18,999
>> When you have a complex
condition, what you get

344
00:18:19,066 --> 00:18:23,871
slapped with is this penalty
called specialty drug

345
00:18:24,438 --> 00:18:29,443
because a pharmacist might
have to monitor or look at

346
00:18:29,510 --> 00:18:31,645
something more closely,
which they should be doing

347
00:18:31,712 --> 00:18:34,848
for every drug anyway.
>> Ann Lewandowski also

348
00:18:34,915 --> 00:18:37,551
knows how difficult but
essential it is finding the

349
00:18:37,618 --> 00:18:41,321
right medication.
>> Accessing it because of

350
00:18:41,388 --> 00:18:44,825
insurance barriers and other
issues can also be as much

351
00:18:44,892 --> 00:18:48,195
or more challenging.
>> She has her own

352
00:18:48,262 --> 00:18:50,998
experience with autoimmune
disorders and healthcare.

353
00:18:51,064 --> 00:18:53,567
>> You're really in survival
mode and you're just trying

354
00:18:53,634 --> 00:18:57,905
to figure out, like, do I go
to work and make money? Or

355
00:18:57,971 --> 00:19:00,941
do I deal with this disease?
>> Part of her expertise.

356
00:19:01,008 --> 00:19:04,411
>> I am also a patient.
>> Comes from being a

357
00:19:04,478 --> 00:19:07,014
patient, and she uses that
knowledge to help others

358
00:19:07,080 --> 00:19:10,384
better understand these
complex systems.

359
00:19:10,450 --> 00:19:14,321
>> We have these market
distortions, right? We have,

360
00:19:14,388 --> 00:19:17,224
depending on what your
diagnosis is, who your

361
00:19:17,291 --> 00:19:21,862
insurance company is to
patients walking in with

362
00:19:22,829 --> 00:19:26,166
even the same diagnosis are
going to be charged

363
00:19:26,233 --> 00:19:30,337
completely different prices.
And I think that's really

364
00:19:30,404 --> 00:19:33,941
problematic.
>> I've seen plan documents

365
00:19:34,007 --> 00:19:38,045
where they're limiting, you
know, drug expenditure, like

366
00:19:38,111 --> 00:19:41,448
anything over 100,000 is
out. I've seen plan

367
00:19:41,515 --> 00:19:46,053
documents where cancer drugs
are not covered, where none

368
00:19:46,119 --> 00:19:50,057
of none of the rheumatology
drugs are covered.

369
00:19:50,123 --> 00:19:53,627
>> Often patients that can't
afford an expensive drug

370
00:19:53,694 --> 00:19:55,863
qualify for patient
assistance programs through

371
00:19:55,929 --> 00:19:59,299
the pharmaceutical company.
But these programs are

372
00:19:59,366 --> 00:20:01,768
usually for people with
little to no health

373
00:20:01,835 --> 00:20:04,771
coverage.
>> I am insured at $400

374
00:20:04,838 --> 00:20:07,441
premium cost.
>> Janelle was covered by

375
00:20:07,508 --> 00:20:10,777
her employer's self-funded
health plan, even though

376
00:20:10,844 --> 00:20:14,781
it's specifically carved out
her medication, leaving her

377
00:20:14,848 --> 00:20:18,252
to cover the cost.
>> Big time pharma is

378
00:20:18,318 --> 00:20:21,321
starting to say no, it's not
happening. Companies are

379
00:20:21,388 --> 00:20:25,759
saying these funds are
patients who are literally

380
00:20:25,826 --> 00:20:29,229
uninsured. Pharma will deny
that free drug for the

381
00:20:29,296 --> 00:20:32,165
patient because benefits
have been carved out and

382
00:20:32,232 --> 00:20:37,237
made non-essential by the
plan. And you're literally

383
00:20:39,006 --> 00:20:42,876
functionally uninsured.
>> Having coverage, at least

384
00:20:42,943 --> 00:20:47,748
on paper, disqualified her
for patient financial

385
00:20:47,814 --> 00:20:51,585
assistance. Why some drugs
are covered by some health

386
00:20:51,652 --> 00:20:56,056
plans and not others is an
opaque and complex system.

387
00:20:56,123 --> 00:21:01,128
>> The pricing structure in
this country when it comes

388
00:21:01,995 --> 00:21:04,865
to pricing these drugs and
reimbursement, and what

389
00:21:04,932 --> 00:21:09,403
actual costs are, is so
messed up. It's so messed

390
00:21:10,370 --> 00:21:13,307
up.
>> These carve outs to not

391
00:21:13,373 --> 00:21:17,110
cover expensive drugs are
becoming more common among

392
00:21:17,177 --> 00:21:20,013
self-funded health plans
like Janelle's, which are

393
00:21:20,080 --> 00:21:23,483
governed by different laws
than fully insured health

394
00:21:23,550 --> 00:21:25,519
plans.
>> We know health insurance

395
00:21:25,586 --> 00:21:29,089
can be complicated and
confusing.

396
00:21:29,156 --> 00:21:32,559
>> Secretary Nathan Houdek
oversees the office of the

397
00:21:32,626 --> 00:21:34,728
Commissioner of Insurance.
>> And what makes it even

398
00:21:34,795 --> 00:21:38,165
more confusing for people is
that health insurance is

399
00:21:38,232 --> 00:21:41,001
really regulated by a number
of different agencies at

400
00:21:41,068 --> 00:21:43,704
both the federal and state
levels.

401
00:21:43,770 --> 00:21:47,040
>> This state agency
regulates fully insured

402
00:21:47,107 --> 00:21:50,377
health plans. If a patient
wants to challenge an

403
00:21:50,444 --> 00:21:53,881
insurance denial, they come
here.

404
00:21:53,947 --> 00:21:56,750
don't understand if they
have employer sponsored

405
00:21:56,817 --> 00:22:00,120
coverage is whether that's
fully insured coverage or

406
00:22:00,187 --> 00:22:03,323
whether that is self-funded
coverage.

407
00:22:03,390 --> 00:22:07,027
>> Self-funded coverage is
regulated by federal law,

408
00:22:07,094 --> 00:22:10,464
but you can still start with
this office.

409
00:22:10,531 --> 00:22:13,700
>> If someone has health
insurance coverage through a

410
00:22:13,767 --> 00:22:18,105
self-funded plan, then we
will kind of hand them off

411
00:22:18,172 --> 00:22:20,974
to we like to refer to as
kind of a warm handoff to

412
00:22:21,041 --> 00:22:23,577
the Department of Labor,
because it's the federal

413
00:22:23,644 --> 00:22:26,146
Department of Labor that
actually regulates

414
00:22:26,213 --> 00:22:28,882
self-funded plans.
>> Because of this, no

415
00:22:28,949 --> 00:22:32,519
matter what kind of plan,
Secretary Houdek recommends

416
00:22:32,586 --> 00:22:35,722
reaching out.
>> Unfortunately, studies

417
00:22:35,789 --> 00:22:39,359
have shown that of all the
coverage and claim denials,

418
00:22:39,426 --> 00:22:43,530
only a small percentage are
appealed. And that's really

419
00:22:43,597 --> 00:22:45,866
because people don't know
what their rights are.

420
00:22:45,933 --> 00:22:48,902
People don't know that there
is a place where they can

421
00:22:48,969 --> 00:22:52,573
turn to answer questions, to
be a resource, and our

422
00:22:52,639 --> 00:22:55,709
office is here to help with
that.

423
00:22:55,776 --> 00:22:58,312
>> Fully insured versus
self-funded plans. Health

424
00:22:58,378 --> 00:23:01,915
experts say they both have
their own issues. The rules

425
00:23:01,982 --> 00:23:06,186
are just different.
>> I have a lot of empathy

426
00:23:06,253 --> 00:23:09,423
for employers, right? I
mean, if you are a

427
00:23:09,489 --> 00:23:12,025
manufacturer here in
Wisconsin. You're making

428
00:23:12,092 --> 00:23:17,097
cheese. You're making steel
parts, whatever. Making

429
00:23:17,164 --> 00:23:20,534
yachts. It really doesn't
matter. You are not a health

430
00:23:20,601 --> 00:23:24,238
care expert.
>> For Janelle, her case was

431
00:23:24,304 --> 00:23:28,141
even more complicated than
most. But Cruz was with her

432
00:23:28,208 --> 00:23:30,477
every step of the way.
>> First of the year go

433
00:23:30,544 --> 00:23:33,413
through.
conversation, Janelle, you

434
00:23:33,480 --> 00:23:38,151
literally told me I'm just
settle on not getting my

435
00:23:38,752 --> 00:23:41,421
treatment this year.
>> She helped Janelle file a

436
00:23:41,488 --> 00:23:43,724
complaint with the US
Department of Labor.

437
00:23:43,790 --> 00:23:48,128
>> Please keep in mind that
for any given patient to

438
00:23:48,195 --> 00:23:52,299
file a complaint with the
Department of Labor takes

439
00:23:52,366 --> 00:23:56,303
guts because you're now
dealing with filing a

440
00:23:56,370 --> 00:24:00,941
complaint against your
employer. And the fear of

441
00:24:02,509 --> 00:24:05,779
getting fired, even though
it's totally illegal.

442
00:24:05,846 --> 00:24:09,016
>> It does make it hard to
go into work, because I also

443
00:24:09,082 --> 00:24:12,052
don't know if I'm going to
be walking into work and

444
00:24:12,119 --> 00:24:13,754
being walked out because of
this. And for retaliation or

445
00:24:13,820 --> 00:24:15,756
whatnot.
>> There are still these

446
00:24:15,822 --> 00:24:20,661
very gray questions of law
that honestly make me a

447
00:24:20,727 --> 00:24:24,698
little scared to be a
patient and speak up and

448
00:24:24,765 --> 00:24:29,536
encourage people to exercise
their legal rights, which

449
00:24:29,603 --> 00:24:33,207
are to speak to their
employer and say, hey, this

450
00:24:33,273 --> 00:24:37,044
is a wrong denial.
>> During open enrollment,

451
00:24:37,110 --> 00:24:40,280
Janelle decided not to use
her employer's health plan,

452
00:24:40,347 --> 00:24:43,584
opting to find a fully
insured one on the

453
00:24:43,650 --> 00:24:47,254
marketplace.
my employer, I would be

454
00:24:47,321 --> 00:24:49,990
right back to where I would
start and that would be just

455
00:24:50,057 --> 00:24:53,694
that's not even an option.
>> She pays more in

456
00:24:53,760 --> 00:24:57,364
premiums, but her medication
is covered without the help

457
00:24:57,431 --> 00:25:00,267
of advocates. Many patients
are left deciding between

458
00:25:00,334 --> 00:25:03,604
their medication or their
savings.

459
00:25:03,670 --> 00:25:08,342
>> Can patients do this
themselves? Probably not,

460
00:25:09,176 --> 00:25:14,381
because the statistics have
shown that very few patients

461
00:25:14,448 --> 00:25:19,253
will take it to the next
level. It's too cumbersome.

462
00:25:19,853 --> 00:25:24,091
If you look at denial
letters, the steps are in

463
00:25:25,592 --> 00:25:30,264
there and it's Yvonne
cumbersome for me. However,

464
00:25:30,898 --> 00:25:35,569
having said that, I'm
constantly looking for ways

465
00:25:36,570 --> 00:25:40,774
to make it easier for my
patients to appeal.

466
00:25:40,841 --> 00:25:43,911
>> For her patients. Cruz
goes all in to help them

467
00:25:43,977 --> 00:25:46,847
find relief.
>> Thanks for everything.

468
00:25:46,914 --> 00:25:49,583
>> Relief from the physical
pain of a chronic illness

469
00:25:49,650 --> 00:25:52,419
and relief from the
financial pain of treating

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00:25:52,486 --> 00:25:56,523
it. Reporting from
Milwaukee. I'm Marissa

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00:25:56,590 --> 00:26:00,961
Wojcik for "Here& Now".
>> For more on this and

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00:26:01,028 --> 00:26:04,164
other issues facing
Wisconsin, visit our website

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00:26:04,231 --> 00:26:07,568
at PBS Wisconsin. Org and
then click on the news tab.

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00:26:07,634 --> 00:26:09,937
That's our program for
tonight. I'm Frederica

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00:26:10,003 --> 00:26:13,006
Freyberg. Have a good
weekend.

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00:26:13,073 --> 00:26:14,741
[MUSIC]

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00:26:41,869 --> 00:26:44,872
>> Funding for "Here& Now"
is provided by the Focus

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00:26:44,938 --> 00:26:47,174
Fund for Journalism and