Governor Tony Evers released a $91 billion state budget proposal on Feb. 16, 2021, the first step in a nearly five-month process between the state Legislature and the governor to enact a biennial budget for the next two years.
The budget bill proposed by Governor Evers provides for a reauthorization of Wisconsin’s Medicaid Disproportionate Share Hospital (DSH) program at the most recent state fiscal year appropriation. Without this action, Wisconsin hospitals would otherwise face a cut of at least $100 million over the following two-year budget period.
While the governor encouraged the state’s citizens to not “let anyone tell you we can’t afford” many new increases in spending, Republicans in the Legislature quickly balked at the governor’s proposal, calling the bill “irresponsible and unrealistic.” According to budget documents provided by the state Department of Administration, the governor’s budget proposal includes a 7.3% increase over adjusted base-level state general purpose revenue spending in the first year of the biennium and a 9.4% increase in the second year.
Republican leaders in the Senate and Assembly specifically cited proposals by the governor that would expand Medicaid, legalize recreational marijuana and overturn changes to state law related to state and local government employee compensation and benefits—known as Act 10—as “poison pills,” with Assembly Speaker Robin Vos saying they are “dead on arrival” in the Assembly.
Besides new funding increases for the Medicaid DSH program, the governor’s proposed budget bill includes several provisions now being evaluated by the Wisconsin Hospital Association (WHA) government relations and public policy teams. Many are expected to be removed by the Legislature as “non-fiscal” policy in a state budget bill. These include:
- Requiring the Department of Health Services and/or the Office of the Commissioner of Insurance to create an actuarial study of a Wisconsin government-run “public option” health plan;
- Creating new state-level mandates and regulatory reporting requirements for safety-net hospitals that participate in the federal 340B prescription drug discount program;
- Creating a state-level prohibition on balanced billing for out-of-network emergency care;
- Creating new state-level family and medical leave act mandates qualifying conditions for caregivers; and
- Creating duplicative and unnecessary state-level regulations and mandates requiring hospitals to take certain acts related to a designated caregiver for a patient.
In the months ahead, WHA’s government relations team will continue working with state lawmakers as they consider the Governor’s budget proposal and work to advance policies that support hospitals and health systems in Wisconsin.