Re: Interesting take on Wisconsin story

February 22, 2011

thank you. C Cindi

February 22, 2011

Maybe because those benefiting from Medicaid programs don't have a union? Or

don't have cash to travel to Madison?

I've heard reports from several online and radio sources that not all the

protesters are from WI. Some teacher unions in other states are encouraging

each other to go...sort of a " Help WI, or we're next " theory.

-Gail

________________________________

From: Jerue Family <jeruefamily@...>

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Sent: Tue, February 22, 2011 8:40:51 AM

Subject: Interesting take on Wisconsin story

a..

Vital Signs: Why such little outcry over bill's impact on Medicaid programs?

a.. SHAWN DOHERTY | The Capital Times | sdoherty@... madison.com | (40)

Comments | Posted: Sunday, February 20, 2011 8:30 am

Health reporter Doherty previously worked for Newsweek and the Los Angeles

Times. Vital Signs explores medical news, health-care tips, policies, and

politics, and reader comments.

Gov. 's budget repair bill proposes sweeping changes to the state's

Medicaid programs, changes that could affect many of the 1.2 million state

residents enrolled in public health programs like BadgerCare, Family Care, and

SeniorCare. The provisions would allow the administration to revamp and even gut

the programs without following state laws or the normal legislative processes.

But not many people seem to know or care, judging by the protests in the Capitol

this week.

Tens of thousands of protesters in Madison, including children, teachers,

firemen, police officers, and other union workers, have jammed the Capitol's

marble corridors and hung banners from balconies. But the issue that has

captured the attention of the entire country is workers' rights. Hardly any of

the signs or the slogans have had anything to do with Medicaid programs. In one

week of covering the rallies, Capital Times reporters found only one protester,

a self-employed worker named Church from Shorewood, who said he showed up

because he worried the bill might threaten his health benefits.

" Everybody who is controlling the message is only controlling it to be about the

unions, " says Molly Cisco, director of Grassroots Empowerment, an advocacy group

for people with mental illnesses. " I have been screaming about this. I've been

sending letters to the editor and calling the Democratic Party every hour. It's

been so frustrating. I don't want us to be pitted against the unions, but

they've been so loud we haven't been able to find our niche or get our voices

heard. "

Cisco and many other advocates say they appreciate the media coverage and public

support for workers' rights, but that their constituents, from infants and

mothers in poor neighborhoods to the disabled and the elderly, deserve a share,

too.

The first local story to delve into the bill's impact on state Medicaid programs

was our piece last Monday on how provisions in the measure would hand sweeping

new powers to the administration to circumvent normal legislative

processes, state rules, and public vetting, but for the rest of the week there

was scant other local coverage. (I did another piece Wednesday reporting that

the attorney who drafted these provisions raised constitutional issues about

them, and the Wisconsin State Journal has a story on the state Medicaid programs

today.) Even the New York Times, usually so thorough, has in most articles

totally ignored the fact that the bill is not just about labor, or the

budget---that it is also about changing how Medicaid is administered in this

state.

Many politicians have been as mum as protesters and reporters on this issue,

though not all. " Every time I have a reporter willing to listen to me I bring it

up, " says Rep. Sandy Pasch, D-Whitefish Bay, who got an column on the topic

published in the Milwaukee Journal Sentinel last week. And are the reporters

interested? " No, they're not, " she sighs. " There isn't that same indignation. "

Even many of the Democratic senators who have fled the state to stall a vote on

's bill have rarely used the M word in their recent media interviews,

including, surprisingly, Sen. Jon Erpenbach, D-Middleton, long a champion for

expanding health care coverage.

By the end of the week, frustrated providers and advocates had formed a

coalition of more than 30 organizations called the Medicaid Matters Alliance.

They have also organized a press event Sunday aimed at grabbing their share of

the spotlight. " We have been muted. We have been overshadowed by a lot of really

important issues that have to do with employee wages and benefits, " says

Pugh, communications director of Disability Rights Wisconsin. " But citizens

concerned for their children's teachers need to be aware that one of their

elderly neighbors down the street, or a child they know with a disability,

probably uses a program with Medicaid and will be equally affected by this

bill. "

Advocates are lobbying the Democratic Party and unions to bring up their

concerns when they talk to the press and public. Hugh , executive director

of Wisconsin Family Ties, sent an e-mail to Democratic party officials typical

of the thousands of e-mails advocates have been forwarding to legislators and

other power brokers: " Lost in all the media coverage about worker rights is the

fact that SB11/AB11 would grant unprecedented power to the administration to

change Medicaid in Wisconsin without going through the full legislature.

Allowing an unelected official (Department of Health Services Secretary Dennis

) to essentially make law in the state, is in my opinion, an egregious

violation of the separation of powers. Making law is the province of the

legislature. As state democratic leaders are being interviewed by members of the

media, please don't forget this onerous provision of the budget repair bill. "

But what took so long for these pleas to go out, and why have so few taken up

the cry?

I posed that question to more than a dozen people last week including

politicians, legislative aides, political party spokesmen, union demonstrators,

advocates, and policy experts. It has been an exhausting week, they say, so a

big reason people haven't been talking more about Medicaid is that the bill is

being moved so quickly through the Legislature that it took them some time to

catch up to its implications. " We're just trying to keep our heads above the

water, " says one Democratic staffer who hasn't slept for several days. Graeme

Zielinski, communications director for the state Democratic Party, says the

party is having trouble keeping up as well. " It's like we have gunshot wounds to

the head, to the belly and to our front. We're doing triage to a very, very bad

bill, " he says.

The Republican Party, for its part, was quick to respond to my questions about

the issue by claiming that the focus on workers' rights proves Democrats are

controlled by special interests. " There are all these serious issues, but when

it comes to priorities the unions are most concerned about their own pocketbooks

and how does it affect them specifically, " says GOP state director Mark

Jefferson.

Workers' rights is a simpler and more appealing message, too, than the

complexities of Medicaid policy and process. Take this pitch from Move On.org as

a typical example of how last week's political spin stuck to one theme only:

" Dear Wisconsin MoveOn member, Madison is electric right now. Tens of thousands

of middle-class Wisconsinites---teachers, nurses, firefighters---are

demonstrating at the capitol today. They're trying to stop the new, tea-party

governor from ramming through one of the worst union-busting bills in recent

history... " Why mess that up with the complications of public health programs

and attitudes about the poor?

And explaining exactly what this bill does to Medicaid is complicated, since the

bill is not yet calling for actual cuts to the program, it is laying the

groundwork to make such cuts easier for and Health Secretary , who

as I reported last month advocated that states walk away entirely from Medicaid

when he was a senior fellow at the conservative think tank The Heritage

Foundation. " They're going after these programs in a backdoor way by changing

the process, " explains Lamkin of AARP. " The impact and the implications are

almost worse because you can rally people around a cut. But when you try to get

people jazzed up over changes in the rule-making process, their eyes glaze over.

It's not an easy sound bite. "

Unions are well-organized with a big war chest and workers ready to mobilize.

The same isn't true for the one out of five Wisconsin residents who relies on

Medicaid programs, and that makes it hard to, say, bring thousands of them to

the Capitol. " Part of the problem...is that Medicaid recipients are recipients

by virtue of being very, very poor, " says a Buege, a patient advocate.

" Awful hard to arrange a rally, organize a bus and be prepared when you have no

money to do it. "

The difficulty in getting many of these people to be heard, says Pugh,

communications director with Disability Rights Wisconsin, is one reason her

organization opposes a clause in the bill that would do away with the

legislative process and public hearings now required to make changes in the

Medicaid programs. " It's hard to get the elderly and people with disabilities to

a march in Madison, " she says. " So when you take away the public and legislative

process, you're taking away the voices of a very vulnerable population. "

There remains some stigma about receiving Medicaid (some farmers Pasch asked to

speak out on the issue were too embarrassed) and even resentment toward

recipients, advocates say. " When I walked into the Capitol and went into the

Rotunda, and saw it jam-packed at all levels, " recalls, " the first thing

that went through my mind was wouldn't it be great if one day we could get this

kind of response and support for children with mental health problems? "

That is what advocates hope their press conference today can start to

accomplish. The delay over the measure caused by the senators who fled town to

avoid a vote will also give them much needed extra time to spread the word about

this overlooked aspect of the bill, they say.

Several legislators are busy drafting up what will be a raft of amendments aimed

at forcing the Assembly to at least look at and discuss the Medicaid provisions,

legislators say. " By slowing down the Republicans' rush to ram this bill through

to a vote, we hope the public will have more time to understand all the varied

impacts of this complex bill, particularly the negative effect it could have on

health care for our children, seniors, and most vulnerable citizens, " says

Minority Leader Barca, D-Kenosha, in an e-mail response to a request for

comment. " An ever greater hope is that after hearing from the public,

Republicans will be willing to make changes to this dangerous legislation. "

But that would seem to be a slim hope indeed, based on what Republicans have

done so far and the speed with which is trying to get the legislation

pushed through the Capitol. Which gets us to one last reason we haven't heard

much about the Medicaid provisions. Maybe we never were meant to.

's staff buried this stuff deep in a budget-repair bill that claims to be

about fiscal matters, advocates say, not major policy changes, which makes some

of them allege that the noise over workers' rights was intended all along to be

a sort of decoy. " One of my fears is that this might be a way of keeping our

attention on something else while they sneak something by, " Cisco says.

Last Friday, Assembly Republicans convened their floor session before its

scheduled start and took a voice vote to push the bill past the amendable stage

and toward final passage before Democrats even entered the chamber.

After outraged Democrats protested the action was illegal, members returned the

bill to its amendable stage. The Assembly will meet again on Tuesday. Whether

this means the Medicaid provisions will finally get some kind of attention

nobody knows.

February 22, 2011

Gail, I guess it depends on whether the WI personal care workers and community

service provider employees are unionized as they are in Illinois. From what I

could read on the WI ARC's website and blogs, there are some individuals feeling

pretty betrayed right now as the labor unions, in their opinion, are

single-issue focused on the bargaining rights/cost concessions of the WORKERS,

at the expense of shedding light on the needs of their CLIENTS who are being

thrown under the bus. According to what I'm reading.

Apparently this Governor 's bill also includes some significant reductions

to Medicaid, including their Waivers which have funded residents for home-based

and residential that we here in IL have envied for years.

But then I think we already knew about the 22 Governors who want to pull their

states out of federal Medicaid.

L.

From: G Mrozak

Sent: Tuesday, February 22, 2011 10:15 AM

IPADDUnite

Subject: Re: Interesting take on Wisconsin story