Health care systems and physician groups in Wisconsin
have been vocal about their concerns over possible negative
impact of the Senate health care bill.
Concerns for both providers and for patients.
For more perspective on the Senate health care bill we turn
to Bobby Peterson, executive director of ABC for Health,
a public interest law firm that helps connect Wisconsin families
to health care coverage plans.
Thanks for being here. - Great to be here.
- Right now, out of Washington there is this discussion of just
repealing the ACA and not replacing it.
What's your reaction to that?
- Short-term, maybe it's a win,
but it's a loss for the people, I think.
We don't get to a situation where we actually
make things better.
Just repealing the Affordable Care Act doesn't get us
to the right place.
- On the Senate bill, there are many constituencies,
as you know, sounding the alarm over the proposed reduction
in Medicaid funding.
Who in your mind would this hit the hardest?
- Well, there's 1.2 million people in Wisconsin
on some form of Medicaid.
It affects a lot of people.
A lot of family, friends and relatives.
So seniors in long-term care, children with disabilities,
young children that need health care coverage,
low-income adults, people with disabilities.
So it has a broad impact.
And I think that's why there's been such vocal opposition.
These Medicaid changes are significant and alarming
for a lot of folks.
- Now is Wisconsin hurt more than states that expanded
Medicaid because it would be capped to what was spent
in 2016? - Sadly, yes.
I think that's one of the bad outcomes of the bill because
Wisconsin is penalized.
A lot of us thought Wisconsin should expand Medicaid
and we've lost a lot of money.
We've left a lot of federal money on the table that we could
be using, replacing GPR funds.
We could fix a lot of roads and improve K-12 education
with those funds.
But it's going to be a significant amount.
Missouri Hospital Association came out with a report that said
over the next, till 2026 it's over $30 billion
that Wisconsin loses out on.
- And yet here we sit and having perhaps the governor was
right when he said, "Well, I don't want to expand Medicaid
because I'm afraid the feds won't be good for that money"
and kind of here we are.
- Right.
But you always -- the feds -- we take $12 billion a year in
federal money.
So what category of federal money are we going to say
they're good for and they're not good for?
So that argument didn't carry a lot of weight with me because
we're heavily dependent on federal money in the state of
Wisconsin for a variety of things, our roads,
our education system.
So it was a bad decision and I think most people agree with
that.
- What are you hearing from clients that you help with
health care coverage about all of this?
- Well, the volatility, the dynamic of what's going to
happen.
Am I going to lose pre-existing condition coverages that I've
had.
Are we going to go back to high-risk pools where I feel
like I'm in health care segregation?
Those are some real concerns people have.
Are they going to cap Medicaid?
Is it going to lead to health care rationing?
Which you have a sum sufficient of money, and it ends,
that could be an outcome.
- Do you feel as though the policymakers in Washington are
hearing all of these concerns?
- I think they will over the break.
I think they need to get out of Washington to get back and
talk to their constituents and realize I think for a long time
Medicaid has just been considered a welfare program
for poor people, but it has a much broader impact.
It has expanded its spread at some point.
It's a fundamental core of our society
and cares for a lot of people.
- Isn't that one of the issues, though,
that it's just expanded so much and it's so expensive?
- Well, it's expensive, but in some ways it can be more
efficient than some of the other programs out there.
It depends on how it's operated.
But Wisconsin runs a very efficient Medicaid program in
many respects.
We have public/private partnerships with Badgercare
that extend coverage through managed care organizations,
that provide Badgercare plus commercial coverage.
I think there's some innovations in Wisconsin that are worth
looking at that make the program run more efficiently.
- So let's take a look at a potential Medicaid recipient.
You choose whom that might be. What are they looking at?
I mean, they're not looking at
immediately losing their coverage.
- No, and I think it's time to speak up
and say how important your coverage is.
But I think the people we represent.
And we've been representing people on Medicaid for the last
23 years.
Navigating systems, difficult coverage situations,
people with pre-existing conditions,
the fear is that they're going to lose important coverage or
services that they have that have helped them stay in their
community, stay in their home, work, transition into jobs.
So those are things that people are very concerned about that
we're hearing from.
- Now, framers of repeal and replace talk about Wisconsin
going back to its high-risk kind of insurance plans
and you mentioned that it was called HIRSP.
What's your reaction to putting people with pre-existing
conditions into that high-risk plan?
- Yeah.
It's going backwards.
In Wisconsin we like to move forward.
This is not the right direction.
We're segregating people with pre-existing conditions.
It's difficult to manage in some ways because self-funded plans
don't have to pay into the pool.
It's a small group of insurance companies,
as it was set up previously, that help support the pool.
And premiums were very high for people.
You had a six-month waiting period to get into it,
so people end up dying before they become eligible for
coverage.
It's an anachronism of the past.
I think most people have moved on from that to say we're going
to find a better way to cover people with pre-existing
conditions than to segregate them.
- We need to leave it there.
Bobby Peterson, thanks very much.
- Thank you.