>> This week the Walker administration released a draft
of the application to the federal government requesting a
waiver to make changes to the state's Medicaid or BadgerCare
Plus program.
This is healthcare for able-bodied childless adults
aged 19 to 64 who are at or below the poverty level.
Wisconsin is asking to require drug screening to be eligible,
limit benefits to 48 months if the person isn't working or
training for work, establish premiums up to $10 a month,
reward healthy behaviors and increase co-pays for ER visits.
The waiver wants to allow for full coverage of inpatient
substance abuse treatment.
The administration expects to submit its application next
month.
No one from the administration would join us to talk about the
sought after changes.
Medicaid advocate Robert Kraig, executive director of Citizen
Action of Wisconsin is here.
Thanks for being here.
>> Great to be with you Frederica.
>> In particular I understand you don't like the drug testing
piece of this.
Describe why not.
>> Yeah, we're opposed to most of it, by the way.
The drug testing part, forced drug testing, has gotten the
most attention.
In general we think this is designed to set up barriers in
order to force people off of BadgerCare at a time when more
people need healthcare, not fewer.
And the drug testing provision will do that as well but also
the work requirements do that.
The premium increases do it as well.
Quite frankly the motive is to force people off healthcare and
spend less money.
We think that's clear.
But as far as the drug forced drug testing part it's the
opposite of what medical experts and medical science tells us
we should do about the scourge of the opioid epidemic
in this state and other substance use.
It plays well politically.
It may be good for the governor's re-election in some
circles but actually sets us back as far as understanding the
causes of drug addiction and how best to address it.
>> I want to ask you a little more about that in a moment.
I understand at least 15 states have laws requiring drug testing
of people on public benefits.
More states are proposing it.
Is there a large number of people who have lost benefits as
a result of these drug testing requirements as you have
suggested is the motivation?
>> They're relatively new and have not been approved for
Medicaid before.
But in a lot of states that have tried them, actually they've not
even caught very many people with drug addictions.
In fact medical experts say it's fairly easy to avoid these
things and the only people who really get caught are people who
are so addicted they can't even not use the drug for a couple of
days in order to avoid detection.
So they're not even effective.
They're also very expensive.
>> For people who might have a drug addiction, a piece of this
is the state says it wants to help them get clean and is
asking for fully funding inpatient treatment.
That sounds like a good piece of this.
>> We'd go even further as far as treatment.
There are huge waiting lists right now that the governor
could have, over the whole term, actually done something about.
But in particular forcing someone, even if they go through
this whole process, to get treatment is not the way to go.
The way to go as far as medical experts concerned is to make
treatment and everything else, prevention.
It's better to prevent the addiction before it happens and
catch it early.
It's just like a medical disease like flu.
That's what the medical science says - or cancer or anything
else - you prevent it.
You try to catch it early.
Then if it's far along you do heroic intervention which is
treatment.
We should certainly do that but the way to do that is to make it
available, publicize it and make sure people who are doing it are
motivated to do it want to be cured.
Not a forced drug testing regime which sounds like red meat to
people who think that those on BadgerCare are doing the wrong
thing and just are immoral when in fact, someone with a
substance abuse problem has a disease.
It's that simple.
>> Other elements of Wisconsin's waiver request limiting Medicaid
to 48 months if the person isn't working or training for work.
What is your reaction to that?
>> We think it's appalling because it again plays off the
idea that people on BadgerCare are people who just are refusing
to work when we don't have enough family-supporting jobs.
When so many jobs don't provide health benefits at all or people
work part-time and want to work full-time can't find a good
full-time job when in fact medical care and health
insurance is so expensive even middle and upper middle class
people can't afford it on their own which is clear in the
current health care debate.
It's a way to force people off quite frankly and it's not
looking at reality of the economic economy we have right
now for people and the cost of healthcare, which even middle
and upper middle class people can't afford, let alone very low
income people.
>> Just briefly in a few seconds left, if people are forced off
Medicaid, then what?
>> Well, it costs us a lot of money, quite frankly, because
their only recourse is to wait until they're very, very sick
and then go to the emergency room where they're stabilized
and sent on their way.
Whereas giving them access to primary care prevents the
diseases in the first place and is much cheaper in the long
term.
They'll be a lot of uncompensated care at hospitals
which will raise everyone else's health insurance premiums and
quite frankly something like a substance abuse issue for
example, better they're seeing a primary care physician who helps
them deal with it and gets them to want to deal with it rather
than having this punitive approach where you force them to
take a drug test then you throw them off BadgerCare if they
don't comply with each part of the standard.
>> We need to leave it there.
Robert Kraig, thank you very much.
>> Always great to join you, Frederica.