The following program is a PBS Wisconsin original
production. >> Wisconsin Governor Tony
Evers here. incumbent calls it quits for
the next round, leaving a long list of governor
wannabes on both sides. While in Washington, summer
recess starts early. [MUSIC]
I'm Frederica Freyberg. Tonight on "Here& Now", a
wide open race for Wisconsin governor. Republican U.S.
Representative Bryan Steil on federal budgets. We
continue our series uncovered, looking at
pharmacy decline and an old bridge in western Wisconsin
will soon be closed and replaced. How many other
bridges in the state need work? It's "Here& Now" for
July 25th. >> Funding for "Here& Now"
is provided by the Focus Fund for Journalism and
Friends of PBS Wisconsin. >> Big news in state
politics. Wisconsin Governor Tony Evers announced this
week he will not run for reelection to a third term.
His announcement means Wisconsin will see the first
open race for governor in 16 years. A crowded field of
Democrats are expected to vie in a primary next
August. Likewise, several Republicans have either
declared or expressed interest in running for
governor. The election is November 3rd, 2026. Head
spinning feints and fights in Washington this week, and
the Republican House speaker cut short the legislative
session as some congressional members
demanded votes on releasing the Jeffrey Epstein files.
Our next guest was among those who got an early
recess Wisconsin first Representative Bryan Steil
joins us. And thanks very much for being here.
>> Thanks for having me on. >> So first off, what is
your reaction to Toni? Evers not running for a third term?
>> I think what you're going to see is a large number of
Democrats get in the race and run to the left, but
what we have to do is get our state back on track, not
measuring things like education by just how much
money we're spending, but on how well we're doing,
whether or not students are being taught how to learn,
not what to know, whether or not we're getting the
spending. And in Wisconsin, under control and money back
to hard paying taxpayers, I think you're gonna have a
robust debate. I think at the end of the day, we have
a great opportunity to have a conservative governor once
again. candidate at this point?
>> No, I'm not running. I'm going to be running for
reelection to the House of Representatives. We'll watch
the Republican field play out. But I think we have a
large number of great, strong candidates who will
in one of them will ultimately be successful.
session was cut short, as we said by the speaker,
attributed to what the Wall Street Journal called,
quote, furor over disclosures from the Epstein
investigation. What's your reaction to the distraction
that the whole Jeffrey Epstein file is causing.
>> The broader media landscape loves to talk
about Epstein. They don't want to talk about the
president's success of securing the border, about
the positive impacts of the tax package that was just
passed. I think it's a lot to do about nothing. I think
I lean on the side of more. Disclosure is always a good
thing. The sunlight is the best disinfectant. And I
think actually we should just move forward with this,
disclose what's legally permissible. It's obviously
under a court seal. It's not under the direct control of
Congress. And then get really back and try to draw
the attention of the media, who loves to be distracted
by this. Back to the most important issues of the day.
>> Now, a new Marquette Law School national poll shows
that 41% of respondents support the reconciliation
bill that President Trump signed into law, while 59%
oppose it. Of course, with sharp, partisan divides, why
did you vote in favor? >> Look at the underlying
provisions inside the bill. Let's talk about what we got
done. Almost every single thing is not popular. Once
the American people understand what's in the
bill. This is about doubling down and making sure that
the border is secure. Wildly popular. The president's
moves to do that and then building to make sure that's
permanent a good thing. Investing in the military at
a period of time of dangerous global
instability, making sure the 2017 tax cuts are permanent,
to build on the economic growth that we saw leading
into the pandemic, and then doubling down on that, in
particular for seniors, those working overtime or
those who are earning tips. And then finally getting
spending under control. And this is where the
demagoguery has been probably the most
challenging. Putting in place work requirements for
able bodied, childless adults is an 8020 issue in
the state of Wisconsin, as indicated by the not so long
ago referendum. That's what this bill does. It actually
secures the program for those it was designed for
permanently disabled adults, children, pregnant women.
And it simply says if you're an able bodied, childless
we're asking you to be looking for work,
volunteering or working a minimum of 20 hours a week.
And so the provisions of the bill, as American people
learn more and more about them, I think will only
become more popular because to get this country back on
track. >> So the Congressional
Budget Office did estimate that this law will cut
federal spending on Medicaid and Chip benefits by $1
trillion, due in part, the CBO says, to at least 10.5
million being eliminated from the program.
>> But let's dive into those numbers, right, because the
numbers to try to scare people in the state of
Wisconsin. Wisconsin has had work requirements for many
of our welfare programs, in particular Snap benefits
since the 1990s, when Governor Tommy Thompson put
them in place in Medicaid. We don't have the exact work
requirements that the federal government has or
that this law passes. What this law does is simply say,
if you're an able bodied, childless adult, we want you
to be looking for work, going to school,
volunteering, or working 20 hours a week. This is an 80
over 20 common sense issue. If you say if you dig
further into that, who is the CBO examining the
positive view that as those people find themselves, find
themselves with an opportunity to get a job, to
volunteer, that we won't see folks losing their, their
their health benefits, what we'll see is people getting
into a good or a better paying job with the ultimate
goal of many of these able bodied, childless adults
getting into the workforce and receiving their health
care from from their employer. Like many
hardworking, hardworking families in the state of
Wisconsin do. >> What about changes to the
Affordable Care Act that I understand, and according to
Congresswoman Moore, will raise premiums and also
impose other restrictions, restrictions potentially
causing people to lose their coverage.
>> Give me give me the details on that. I think
what what you're taking there is national analysis
on the state of Wisconsin that doesn't apply.
Wisconsin didn't expand Medicaid. And so some of the
reforms are made in other states apply differently.
dangerous about the demagoguery that some
individuals want to engage in. They want to take a
national narrative and apply it to Wisconsin. Wisconsin,
I think very thoughtfully, did not expand Medicaid
further into the able bodied, childless working
age population. And so, again, of the 1.2 million
individuals in the state of Wisconsin who currently are
on Medicaid, Tony Evers appointee noted that there's
about 163,000 of them that are that are of the
demographic that we should look at, able bodied,
childless adults. Well over half of those are already
already working 20 hours a week, going to school,
volunteering, 63,000 are not or are not documenting it.
And so this is about making sure that we're
strengthening the program for those that it's designed
for no changes. And in fact, in my opinion, strengthening
Wisconsin after the passage of the state budget will
actually receive about $1 billion a year more in
federal money. We have a whole debate about that, but
more money is coming in. And so the left is trying really
hard to demagogue on this issue. As the facts got out,
you saw a quick pivot into Epstein, which was the lead
question of your interview. So what we need to do is to
dive in, get the information out to the American people
about how we're strengthening the program.
And I think as the American people learn more and more
about this, it's only going to be more popular. Again,
the work requirements in the state of Wisconsin had a
referendum 8020, popular. >> As to the recent
Rescissions package that stripped appropriation
funding from USAID and the Corporation for Public
Broadcasting. Do you expect and support additional
Rescissions as a way to cut costs going forward?
>> Washington has a massive spending power. We're
spending almost $2 trillion a year more than we're
taking in in the debt as well over $30 trillion. I
think we need to go through the federal budget with a
fine tooth comb to remove waste, fraud and abuse, look
at programs that could find either other sources of
funding or aren't necessary. And so I think it's
appropriate to make sure that we're combing through
the federal budget, looking for ways to save taxpayer
dollars. And again, in a period of time where every
extra dollar we spend is effectively a dollar
borrowed from China, I think it's absolutely appropriate
to dig through the federal budget and look for ways to
save funds for hard working families.
>> U.S. Representative Bryan Steil, thanks very much.
>> Thank you. >> On health care, we
continue our coverage of prescription drug prices,
which continue to climb for patients and pharmacies,
while coverage of them continues to plummet. In RX,
uncovered "Here& Now", producer Marissa Wojcik
examines the complex systems driving these trends. This
week, we look at the impact on pharmacies, both big and
especially small, and why their disappearance is
hurting patients. >> We have been in business
for over 70 years. >> The local drugstore was
once upon a time a staple in communities across the
country. every month and it's scary,
and we think about how how long can we last?
>> Today, whether it's the local drugstore or a chain
pharmacy, the brick and mortar presence is dying.
>> The feasibility of having an independent pharmacy is
becoming very challenging. >> Nicole Schreiner is the
new CEO of Streu's Pharmacy in Green Bay and president
elect on the board of the Pharmacy Society of
Wisconsin. >> We get up in the morning
because we want to truly help serve our patients.
>> Alongside her commitment to the mission, she takes on
her new dual roles in one of the most challenging times
for pharmacies. From 2010 to 2021, 30% of drugstores in
the US closed. Last year alone, 2300 pharmacies
closed, half of them being independent or mid-sized
businesses. issue for patients. We
oftentimes talk about in rural areas. You know,
patients having to travel, you know, perhaps 20 miles
to a find a pharmacy that would be able to provide
their medications. And but we're having that even in
urban city areas. >> For some, a visit to the
pharmacy is a quick step. Picking up 1 or 2
prescriptions. But for many patients, it's much more
than that. >> Your pharmacist a lot of
times will be a critical component of your medical
care team. >> Senate President Mary
Felzkowski authored legislation trying to help
local pharmacies keep their doors open.
>> We saw our small, independent pharmacy
starting to go out of business in rural Wisconsin.
When it may take months for a patient to get a clinic
visit. Pharmacists say they bridge that gap. Available
for anyone to walk in and ask questions at any time.
And prevention leads to healthcare savings.
>> For patients with asthma. We did a study with the
Pharmacy Society of Wisconsin and showed that
when they sat down with a pharmacist on two 30 minute
interventions, that they reduced the number of ER
visits, the number of hospitalizations. These
things are making a difference in overall
reducing health care dollars spent.
>> Like with most retail stores, it'd be reasonable
to assume that internet sales are putting pharmacies
out of business. And while mail order and online
retailer giants like Amazon do compete with on site
service advocates, diagnose a much deeper and chronic
issue. >> PBMs pharmacy benefit
managers have been around for a very long time.
>> Pharmacy benefit managers or PBMs act as middlemen
between drug manufacturers, wholesalers, providers,
insurance companies and pharmacies.
>> And they've monopolized and they've gotten in
between prescribers and the delivery of drugs, driving
up the cost of drugs instead of lowering them.
>> The three largest PBM companies accounted for 80%
of prescription claims last year.
>> They'll claim that they negotiate with drug
manufacturers and prescription drug costs.
However, despite these claims, PBMs regularly
inflate what patients pay and force pharmacies to
operate a loss. >> It's become very
powerful, and independent pharmacies like myself have
no negotiating power anymore. With these PBMs.
>> The impact of PBMs that PBMs are having on rural
pharmacy is staggering. >> The legislation takes aim
at a number of their practices, including not
allowing patients to fill prescriptions at certain
pharmacies. >> PBMs dictate where
prescriptions can be filled. >> Punitive audits against
pharmacists who inform patients of lower cost
options. >> What to charge a patient.
>> And perhaps the biggest of all for pharmacies.
>> What they will reimburse a pharmacy.
>> Reimbursing the price of medications below cost.
>> And when they'll pay the pharmacy.
>> Forcing them to take losses. At a Senate health
committee hearing, numerous local pharmacies attested to
this issue. >> My pharmacy is currently
operating in the red right now solely due to PBM
reimbursement rate margins estimated to PBMs have
increased by 46%, and during the same time, margins to
pharmacies have decreased by 47%.
>> The contracts have become basically take it or leave
it. They've continued to erode year after year after
year, and it's estimated that independent pharmacies,
depending on your particular location in the country, can
have anywhere from 20 to 40% of their claims are actually
reimbursed below cost. >> But not all health
industry experts agree. >> We believe all these
provisions will be associated with increased
costs to health plans and sponsors.
the bill, such as health insurers, say it will
increase prices for health plans. Employers and
patients. The exorbitant cost of drugs, they say,
begins with the drug manufacturers.
>> Instead of taking away the few tools that health
plans and employers use to address ever increasing drug
prices, the legislature should focus on fixing the
market distortion caused by drug manufacturer pricing
schemes. hard on showing them through
data from other states that have allowed that have the
same legislation, where it's actually lowered the cost of
health care. >> Whatever the cause, the
impact on the patient is real, like the ability to
obtain diabetes medications. >> GLP ones, those. Some
pharmacies are just choosing not to carry them because
they get reimbursed below their cost.
>> Or having your insurance accepted.
choosing not to carry particular plans because of
the poor reimbursement. >> Every day in my pharmacy,
I witness patients facing exorbitant co-pays,
sometimes exceeding $500 for medications they cannot
afford. These patients are confused. They're
overwhelmed, and they're forced into impossible
decisions about their health.
>> For a patient having to fill prescriptions at
multiple pharmacies, the consequences can cost them
their lives. >> Recently, when
learned that they had a duplicate prescription that
was at another pharmacy from a different doctor. If they
had gone home and taken both, they would have needed
emergency care and it could have been fatal.
>> From the extremes of the pandemic to the work they do
every day, independent pharmacists say their
commitment is to their community.
>> What happens if PBMs continue to drive us out of
business? Who will step up during this crisis? Who's
going to be doing seven day a week testing? Who's going
to deliver meds late at night for a hospice patient
who's going to get a call at 2 a.m? I just got that last
week. It won't be a mail order pharmacy in another
state that's doing that. >> Being able to provide
that service to patients and to be part of making sure
that they are taken care of, is really what we want to
ultimately do. >> Reporting from green Bay,
I'm Marisa Wojcik for "Here& Now".
>> In other news. Imagine you're running late for
work, but you have to take a water taxi or ferry over the
river instead of driving over a bridge. That's what
will confront people in western Wisconsin when the
bridge over the Mississippi River that connects De Soto
to Lansing, Iowa, is removed this fall and replaced in
2027. As Erika Ayisi reports, the Lansing bridge,
also named the Black Hawk Bridge in Crawford County,
has been under repair while still in use, but soon it
will close altogether for replacement.
>> Closure, demolition and rebuilding are the new plans
for the Black Hawk Bridge. >> The initial plan for the
new bridge was that the old Black Hawk Bridge would
remain open until the new bridge was completed.
>> But that plan has changed. The village of De
Soto President Timothy Gillespie says the
announcement of the upcoming bridge demolition has
residents worried about crossing the Mississippi
River into Lansing, Iowa. >> Unfortunately, the Black
Hawk Bridge will have to be closed in October, and so
it'll be about two years before the new bridge is
ready. >> The new bridge is being
constructed along the existing bridge. According
to the Iowa and Wisconsin Departments of
Transportation, the east side of the existing bridge
is posing a risk to the new bridge's completion.
>> And they said it's becoming a safety issue. And
they have to continue to drive the pilings down. And
so it's going to weaken. They think the existing
bridge. And that'll become a safety issue a hazard.
>> The livelihood of local businesses on both sides of
the river are at stake. >> There's just going to
have a very negative effect on a lot of businesses, not
only in De Soto, but certainly in Lansing,
Ferryville, Genoa, Harpers Ferry, New Alvin, Iowa. All
of those communities are going to be affected by
this. >> The bridge has been
closed temporarily, briefly in the past. How were
passengers impacted during those times?
>> Well, they had a people ferry that they started and
that was working pretty well. It you know, it's
still pretty difficult for people to use a people ferry
to, to, to get to work. >> A people ferry and car
ferry like this one could help business owners like
Erwin Buckmaster sustain his Lansing restaurant with
Wisconsin customers. and more people would want
to be involved and indulge in that car ferry, as
opposed to just shuttling, busing and getting trucked
across the river. >> Transportation officials
are exploring a car ferry service, but Gillespie says
it will not meet the daily demand of cars crossing the
bridge. able to bring 1214 cars at a
time over, and that's certainly not going to take
the place of the traffic that was on the Black Hawk
Bridge. >> Justin Shepherd of Shep's
Riverside Bar and Grill says customers need multiple
crossing plans for businesses to stay afloat,
especially through winter. >> As far as business goes,
you know they'll run a shuttle hopefully until the
ice comes through and then after the ice is in, you
know, we don't really know how that's going to work
because they don't have a plan for in place for that
either. closest bridge is U.S.
Highway 18, connecting McGregor, Iowa, to Prairie
du Chien, about 45 minutes away from the Lansing De
Soto Bridge crossing. >> And there's also a
medical clinic over in Lansing. And so if we can't
get over there, then the people are going to have to
go to Prairie du Chien or La Crosse, which is 30 miles in
either direction. the new bridge's signature
singing sound, wider width and indigenous name
reference to Chief Black Hawk will remain the same as
Gillespie and other area village presidents seek
government aid. >> Going to be looking for
some kind of a federal or state aid to help support
the loss of revenue that's going to occur. So hopefully
we can get some some assistance.
>> Reporting from De Soto I'm Erica Ayisi for here.
And now. >> That bridge opened in
1931. How aged are other bridge crossings in
Wisconsin? According to the National Bridge Inventory,
of the more than 14,000 bridges in this state,
nearly a thousand are classified as what they call
structurally deficient. We turn to Wisconsin Dot Bureau
of Structures Director Josh Dietsche for more. And
thanks very much for being here.
to join. a bridge to be structurally
deficient? >> So it's a term that
probably sounds a little scarier than it is really.
It just means that there is something, some kind of
deterioration that's been noted with the bridge. We
always try to stress that. That doesn't mean it's
unsafe. If there's a bridge open in the state, open to
travel on. You can feel safe traveling across it.
>> So does Wisconsin have a lot of older bridges, like
the one like the Lansing Bridge?
>> Not many that are quite as old as.
>> The. average age of the bridge is
about 42 years old. So yeah, something as old as the
Lansing is a little bit atypical.
>> In Wisconsin. What specific bridges need
immediate repair or removal? Are there any?
>> Again, I would stress that if it's open, it's
safe. So we always have a program where we're going in
and rehabilitating or replacing bridges. So you
mentioned that there's over 14,000 bridges in the state.
About 2% of those are classified as being in poor
condition. Kind of at a high level. We as we inspect
bridges, they get rated as either good, fair or poor.
And so again, with about 2% of those bridges in poor
condition, those are the ones that we're focusing on.
Again, not because they're unsafe, not because you
shouldn't be traveling over them, but just because
they're going to need some work to keep them in
service. In the near future. So those are the ones that
we've got in the program that are in the planning
stages for, you know, again, getting some kind of
rehabilitation or potentially being replaced.
>> How heavy of a lift is it to inspect all of these?
More than 14,000 bridges across the state of
Wisconsin? are surprised when we talk
about it that we do have that many bridges in the
state. You know, about the big ones that you travel
over. But there's so many that are over just small
creeks or small rivers that you probably don't even
realize where you're going over a bridge. So yeah, of
those 14,000, about 5000, a little over 5000 are owned
by the state, and the remainder then are owned by
local municipalities, cities, villages, towns, and
so on and so forth. So the state bridges are inspected
by mostly by state forces, although we do use
consultant engineers as well. And the same thing on
the local side, the local side, they do have some
local staff that will inspect bridges, but they
lean heavily on consultant engineers as well. So when
the bridges are in good condition, basically new,
they can be inspected on as much as a four year cycle.
But for the most part, bridges are required to be
inspected on a two year cycle or as they get in that
worst condition, into poor condition on a on an annual
basis. So yeah, it's a heavy lift depending on the size
of the bridge, it the larger bridges may take up to a
week to inspect some of the larger bridges. Like you
referenced the Lansing Bridge or some of our more
signature bridges. Others, you know, it can be done in
a morning or an afternoon. But yes, it's definitely a
pretty big effort. >> We took a look at the
work that's happening on that bridge from De Soto to
Lansing, and it made me wonder, how tricky is it to
repair bridges while they're still in use?
>> Yeah, it depends on the situation. You know,
obviously the traffic is a big thing that plays into
that, plays into that on. You know, if you're trying
to repair a bridge on the interstate, there's going to
be lane closures. There's a there's a large bridge over
the Wisconsin River just north of Portage that's
being replaced right now. If you've driven through that
area. And in that case, you'll see lane closures or
lane shifts. So it's definitely possible. But
yeah, it does present some complications for sure. But
again, we make we make sure to do it in a way that is
safe for sure. And as we try to minimize the disruption
to the traveling public as much as we can.
>> All right. Well, we are all glad to know that the
bridges are safe. John Dietsche, thank you so much.
>> No problem. and other issues facing
Wisconsin, visit our website at PBS Wisconsin. Org and
then click on the news tab. That's our program for
tonight. I'm Frederica Freyberg. Have a good-
[MUSIC] weekend.
>> Funding for "Here& Now" is provided by the Focus
Fund for Journalism and
Friends of PBS Wisconsin. Friends of PBS Wisconsin.