You As we discussed earlier cuts and changes to social safety net programs figure prominently in political discourse right now in Wisconsin by the numbers nearly 1.3 million children and adults are enrolled in Medicaid and 700,000 received food share for a closer look at how congressional changes to these programs could look in Wisconsin. We turn to bill Hannah Medicaid director at the Wisconsin Department of Health Services and thanks for being here. Thank you. Happy to be here. Well, we know what the house did on Medicaid and nutritional assistance cuts could go deeper under the Senate provisions. As it stands before Senate action some analyses show nearly 230,000 people in Wisconsin could lose affordable care act and Medicaid coverage. Is that what your analysis is showing? We're going to put analysis on Medicaid. That's where we have the specific data. Wisconsin's part of the national ACA plan and really rely on national experts on the ACA data. But for Medicaid specifically, we estimate that 63,000 adults without children under the age of 18 would be at risk of losing their Medicaid coverage. I think it's important to note that the coverage won't just impact those individuals. It really impacts all of us because those individuals still need to see their doctors or go to the hospital. They'll just be uninsured and those additional costs get passed on to all health care consumers. What is it in the bill that prompts people to lose that coverage? Yeah, the House bill creates a lot of additional red tape for this population to maintain their eligibility. First, it requires them to complete their Medicaid application or renewals every six months instead of once a year as it is today. And it requires them to submit documentation to prove that they are meeting work requirements. So what cost do provisions of the bill add for the state of Wisconsin now fashioning its own budget? Yeah, we take eligibility enrollment very seriously here in Wisconsin. We run a very efficient program. We have one of the lowest eligibility error rates in the country. But this will require additional costs. We are really doubling the amount of work in a year to do eligibility for the 195,000 adults that this would subject to, meaning the state and county eligibility workers will need to hire more workers and we will need to make changes to our system in order to verify and collect that work requirement information. We estimate it'll cost us about five and a half million dollars each year to implement these changes in Wisconsin. On food share, the House bill would mean about 90,000 people would lose that assistance according to your office. How does the bill result in those people losing those benefits? Yeah, there are already work requirements in food share today, but the bill drastically changes who's required to meet the food share requirements. Today, it's adults between 18 and 54 who do not have dependent children. What the bill does is expands that to adults between 18 and 65. And includes adults with children if their children are not under age seven. So you really increase the number of adults that need to meet work requirements in order to maintain their food share benefits. And we estimate that about 90,000 individuals would likely lose their food share benefits because of this expanded requirement. So the bill would also start penalizing the state for SNAP error rates costing Wisconsin $207 million annually. What are those errors? Yeah, errors are just that. They're errors, right? It's not fraud. Determining Medicare food share eligibility, it's complex. And occasionally there are mistakes. If you think about doing your taxes and occasionally there, there's a mistake. There's a lot that changes in people's lives. You think about this population. They're often doing gig work, meaning their income can change. There's a lot of deductions that go into calculating it. So it's, it's, it's complex in getting it to the dollar accurate. We already have one of the lowest error rates in the country. And in fact, error rate went down last year. We're well below the national average. The national average is 11.7 Wisconsin is at 4.4. But the bill continues to sort of narrow that tolerance for any even $1 error in calculating payments. It also is an incredible cost shift, not just for the error rate, because what it does for the first time is requires states to contribute towards food share benefits, which at a minimum will cost us $69 million a year in Wisconsin. It also changes the amount of the administrative costs that the federal government will pay. Today, they pay 50% of those costs split 50 50 with the state going forward. They would only cover 25% of the costs. So that's an additional $51 million for us to just run the program that we run today that is a well run program. And the bill gives us no additional tools to control costs or any other flexibilities to try to really control costs in the, in the food share program. Well, we appreciate your information, Bill Hannah. Thanks very much. Thank you. Yeah, that whole, that whole food share thing is a lot. And I, I mean, I, I didn't want to get go down this road, but state budget writers right now, right, or having to look at this and say, okay, where's this coming from? We are having those conversations right with both obviously the governor and the legislature are going to have to figure this out. And it is a cost that. Again, we don't have a lot of control over how we do the food share program. Well, thank you for your information and we'll be watching that. Do you do you know when those provisions come up before joint finance. Or how that's working. So there's still, there's still talking about this because there's still so much uncertainty at the federal level, right, which is really hard for us to budget, but we want the state budget done by the end of June. And the Senate's talking about not having this federal bill done until July, if they get it done. So a little tricky right now, I think, and with all the uncertainty at the federal level. Yeah, indeed, all around. All right. Thank you. Thank you so much. Thank you. All right. Bye.