The dust is settling after passage of the federal tax and spending reconciliation bill,
which is now law.
What stands out for its impact in Wisconsin?
We turn to Democratic U.S. Representative Gwen Moore of Milwaukee for her take on what
it means for people in her district.
And thanks so much for being here.
Always good to be with you, Frederica.
So what does stand out for its impact in your district and across Wisconsin?
Well, I think the thing that is most outstanding in this bill is the impact that we'll have
on health care, on the Medicaid cuts, Badger Care, as we call it in Wisconsin, the Affordable
Care Act, Ebola Care, cuts.
And when you combine the work requirements to receive Medicaid, and when the confluence
of all those forces means that they'll probably be something like 276,000 people in Wisconsin
who will not receive any kind of health care.
And when you just the work requirements themselves, we'll call 68,000 individuals with no dependence
to lose health care.
And so the theory of the case is that these are just lazy boys in their mama's basements
playing video games, and there'd be no harm and no foul to cut them off.
Notwithstanding the fact we believe that this is not a real person, this is just a trope,
we're saying that in Wisconsin, a person who, say, has two minimum wage jobs working at
fast food restaurant, they will, at minimum wage, work in full time, they will make too
much money to be eligible for Medicaid.
So they'll be throwing, whether they work or not, they won't receive Medicaid.
And then there are numbers of people who are truly eligible, they have children, they're
already working, most people who receive Medicaid are already working, but the numbers of the
bureaucracy and the paperwork that they have added into the bill is really something that
they have monetized, they have monetized people's mistakes, so that if you don't re-up or come
in every six months to reconfirm that you're still disabled or that you will find yourself
off Medicaid.
And then those of you, you remember, Frederica, Wisconsin was one of those states, I believe
it was about 11 states that hadn't taken advantage of the expansion of the Affordable
Care Act.
And those people will see their premiums go eight, nine times the amount that they're
currently paying.
So say, for example, they were able to get a silver plan and for the purposes of keeping
the math simple of $100 a month, they might find themselves with $6, $7, $800 a month
health care payment premiums in order to stay on the program, and thereby, of course, being
disenrolled because it's unaffordable.
And I think one of the other things that's going to happen is that people who do have
employer-provided health care will find their premiums going up.
In Wisconsin, the payer mix of people, you know, you have Medicare payments and Medicaid
payments and private payers, and less than 30% of the patient mix consists of people who
are funded through their employers or through government work.
And those premiums as well will go up.
And what we will find is that people will be much sicker.
We also see some real big hits in the education area.
Our calculation is that about $72 million will be taken from Wisconsin with regard to
Title I programs, reading programs, and so on, really big hit in that area.
And of course, food supplements, we're thinking that the food share cuts, snap cuts, not
only will it cost thousands, hundreds of thousands of people to be cut off food share, but it
will also mean that the state itself would have to pay 75% of the administrative costs
of the food stamp program, the snap program, as well as if there are an error rates in
excess of 6%, they'll find themselves having to pay for portions of the food stamp program,
which today, that burden has never been an unfunded mandate that will be placed on not
only Wisconsin, but statewide.
So it is really a bad bill.
One of the things that I didn't mention about health care is that our hospital association
is very concerned about this because there is a provision in law where providers, hospitals,
pay a provider fee, which enables them to draw down more federal funds.
Well, the federal government is sort of curtailing the ability of states to have help to bring
down federal dollars so as to reduce the amount of federal dollars available.
It's a hot mess in one sentence.
Let me just back up a little bit and talk about health care and Medicaid.
And people who fall off Medicaid because of the provisions of this bill and potentially
the burdensome kind of paperwork, what will they do for health care then?
Well, like I said, people will continue to work as I indicated before, about 40% of people
in the country don't have employer-based health care.
And I mean, people work in all kinds of industries.
They work for fast food, they work for farms.
Some of them are entrepreneurs, some people work gig jobs, and people work for small,
very teeny tiny businesses that don't provide employer insurance.
They'll be working and they'll have no health insurance.
That will increase the amount of uncompensated care that hospitals have to pick up.
And it also means that hospitals will have to make decisions about what kind of health
care they will or will not provide.
We've seen in the past, just recently in our own community, maternity awards closing,
where hospitals will decide we aren't going to do cardiac catheterizations anymore.
Community health centers may close or merge in order to keep going.
And we do know that this bill also defunds any kind of clinic that provides any sort
of abortion care or counseling or about birth control.
And so we'll see Planned Parenthood clinics closing and other clinics that may provide
that kind of health care close as well.
One of the things is that, you know, the president predicts that people won't even
pay any attention, they won't even notice.
Some of these provisions don't come into effect until after the 2026 election.
But that doesn't mean that hospitals won't have to start planning how to not deliver
services now.
Because in fact, 276,000 people in Wisconsin will lose care out of the 17 million, minimally
nationally, they will lose health care.
Now, in the state budget just passed, it increased these provider taxes or fees to 6%,
which delivers, I understand, 1 billion more federal Medicaid dollars to Wisconsin.
So how heads up do you think that was, having served yourself on the Joint Finance Committee
here in the state of Wisconsin, how heads up for the legislature and governor to pass
the state budget just ahead of the passage of this reconciliation bill to get that kind
of extra federal money because of raising this fee on providers?
Well, I'll tell you, I did have communication by phone with leadership in the Democratic
caucus, and they were trying to figure out when the one big, beautiful bill was going
to pass and they were literally racing to get the votes and to pass it before we did.
And, you know, asking me, well, isn't there 72-hour rule, because I testified before the
rules, because it's kind of a wave in any reading of the bill, for 72 hours, you had
better hustle and get that provision passed, because otherwise, I think that they've reduced
those provider tax benefits down to less than 2%, so that the state, even though they're
willing providers, the state won't be able to access, as you indicated, that billion
dollars that Wisconsin really is going to rely on to take care of the most needy.
And I'm not going to be just saying, there are certain mandatory services that Medicaid
will have to pay for, like the people in nursing homes.
Perhaps we will continue to take care of children and hospital admissions, but everything else
will be on the table.
Rides to dialysis, home, you know, elders being able to get care in their homes, when they're
eligible, and when they don't need nursing home care, all that will be on the chopping
block, and the state will have to make some hard decisions.
You touched on education funding, and we know that the Trump administration is apparently
making good on its promise to dismantle the U.S. Department of Education, and with it,
as you suggested, funds that go to high poverty, K-12 schools, and special education, how pointedly
will that be felt in Milwaukee?
Oh, my God.
You know, when you think about their last on death, there's waste, fraud, and abuse.
I mean, that, to cut education, it's like cutting the lifeline of a community.
When you think about preparing the future workforce, I can see it causing employers to
flee the state and even the country.
I mean, if you can't rely on employees having basic skills to be able to add, subtract,
and read, and write, something that has always been a challenge, given the dearth of monies
that are available for reading and special education, and this stuff works.
I mean, I just had a meeting earlier today where we talked about the Mississippi Miracle,
where people had assumed that the kids in Mississippi were just so dumb they couldn't
be taught.
But when you wrap resources around them, you know, voila, they moved up like 30 percentage
points in terms of the outcomes for those students.
And so, you know, we're cutting off our noses despite our faces.
This administration, these Republicans have demonstrated a real distaste for education.
I mean, everything from K through 12 to higher education, where they're, you know, conditioning
Pell grants in a way that's never been done before, cutting off those, the ability for
parents to borrow money, to send their kids to college, it is like a really big mistake
that's going to put not only Milwaukee, but the nation behind.
You've said that their quote is truly no bottom to this bill's cruelty.
But what can you and other opponents do about it?
Well, you know, Frederica, I, you know, I did not have a good 4th of July.
I was very, very upset, but you know what, it ain't over until it's over.
I think now as we go through this process, we're going to continue to talk about it.
We're going to continue to try to win the midterm elections, win the hearts and souls
and minds of people.
I know I've talked to several people who confessed to me that they voted for Donald Trump, but
they had no idea that he was going to do the kinds of things that he has done to them,
because indeed, the president's base needs Medicaid almost more than anybody.
The president's base needs SNAP, and they certainly need educational opportunities.
They're not, you know, and I think that many people who sort of thought that he was
going to focus on throwing out violent criminals who were immigrants and they were going to
get rid of the waste fraud and abuse, and of course nobody wants waste fraud and abuse.
But no one knew that that all these cuts were just going to result into a big bonanza,
you know, four and a half trillion dollars for wealthy people who don't really need it.
While there are debates about whether or not we should serve breakfast and lunch to school
children, nobody knew that that was to trade off.
Congresswoman Gwen Moore, thanks very much for joining us.
And thank you.
You be well for Drithill.
Thank you.
How was that?
It was great.
So we're putting