MADISON (WKOW) -- Republican lawmakers this week sheared nearly 400 items out of the two-year state budget Democratic Gov. Tony Evers proposed in February.
While members from both parties of the budget-writing Joint Finance Committee agreed some of those items will return to the final budget, Republicans said they wanted to start at the base of the current budget and go from there, agency by agency.
Democrats were miffed that after three months of review, the GOP majority could not identify some items in the governor's budget they supported and simply kept in the budget.
"Many of these provisions that were removed are incredibly popular and we heard from hundreds or thousands of people about their positive impact," said Rep. Evan Goyke (D-Milwaukee).
The most contentious item in Thursday's meeting where the JFC eventually voted to remove more than 380 items in one swoop was the long-running question of whether Wisconsin should adopt the federal Medicaid expansion, which in this budget cycle, would give the state an additional $1.6 billion in federal dollars.
"We basically want the same thing; we want people to have good, quality health care," said Rep. Tony Kurtz (R-Wonewoc). "The argument is do you want the government or do you want public assistance to do the health care or do you want the private sector?"
Kurtz and other Republicans argue the expansion is not free money because the lower Medicaid reimbursement rates eventually get passed on to insurance companies, which then raise premiums.
Kurtz said under Wisconsin's current setup, where people between 100 and 138 percent of the federal poverty line can buy insurance through the Affordable Care Act marketplace, those individuals can pay even smaller premiums because of the American Rescue Plan Act.
"The federal government just basically, under this new program, just basically has waived a lot of those premiums," Kurtz said. "So it's almost next to nothing for the next couple years for those folks."
Goyke countered the ARPA also allowed for increased reimbursement rates to hospitals, adding one more incentive to states to opt into the Medicaid expansion.
"It's designed so that the state can invest those saved dollars in increasing reimbursement rates to providers like hospitals," Goyke said. "So the solution to that alleged problem is actually part of the entire program of expanding BadgerCare."
The rejection will deny BadgerCare coverage to about 90,000 Wisconsinites who earn between 100 percent and 138 percent of the federal poverty line, which is $17,240 a year for a couple and $26,200 for a family of four.
Wisconsin is one of 12 states, and the only one in the Midwest, to have not adopted Medicaid expansion. It is the only one of those 12 states to at least ensure Medicaid coverage for people making up to 100 percent of the federal poverty level.
Rebuilding the budget
Both Kurtz and Goyke said they were confident a number of items removed by Joint Finance on Thursday would eventually go back into the budget.
Democrats are miffed those pieces did not stay in the budget to begin with while Republicans said it was important to start from a clean baseline of the current budget before adding items from one agency at a time.
Kurtz said items like Disproportionate Share for Hospital payments, which help cover the costs of treatment for the poor, will eventually go back in the budget and there was never any doubt of that among those in the industry.
"All my hospitals, they're not calling me right now saying 'oh my goodness, what did you just do?' because they know we're gonna put that back in," Kurtz said.
Goyke said he was optimistic language regarding prescription drug costs would go back into the budget. Both he and Kurtz singled out water quality and PFAS issues as another subject that would either appear in the final budget or have enough bipartisan support to pass as standalone legislation.
Goyke also noted he was working with JFC co-chair Rep. Mark Born (R-Beaver Dam) on a juvenile justice reform package that would include addressing Wisconsin's current practice of charging 17-year-olds as adults.
"For me, personally, I think there is an enormous amount of opportunity to work together on a bipartisan fashion to reform our juvenile justice system and our adult criminal justice and prison system," Goyke said.
'Precipitous drop' in vaccinations
State health officials said on Tuesday Wisconsin was seeing a 'precipitous drop' in the amount of residents getting the COVID-19 vaccine.
It was an unwelcomed time to start hitting a wall with about 45 percent of the population having received at least one dose.
UW-Madison Epidemiologist Ajay Sethi said vaccination rate is one key metric in determining when local governments can lift more restrictions.
He added the best measure is the amount of new cases per day and said the current rate in Wisconsin, which has plateaued between 600-700 new cases per day over the last two weeks, was still too high.
"The best guide is the rate of cases that's occurring," Sethi said. "It's not really coming down. If we can drive that down further, we'll all feel safer."
Sethi said it was also important for public health officials to now monitor which pockets or communities in the state had particularly low vaccination rates and whether they were allowing large gatherings.
"Because if they do gather, there's a chance an outbreak might occur," Sethi said.
As for getting through any wall caused by vaccine hesitancy, Sethi recommended having conversations with close family and friends who are currently unsure or unwilling with regard to the vaccine. He added it would be important to listen to their concerns and calmly use studies and public health guidance to push back if they cite disinformation.
"We have to remember people need to convince themselves," Sethi said. "People have their autonomy, they deserve their autonomy to decide whether they should get the vaccine."
Sethi noted that could change to some extent if the FDA grants Pfizer full approval of its vaccine; that could potentially give legal clearance to some employers and schools to make vaccination madatory.
Sethi added the vaccination rate could also get a boost from Pfizer's imminent authorization to start using the vaccine in kids between 12 and 15 years old.