Robin Vos blocks invoice increasing postpartum Medicaid protection

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The destiny of postpartum Medicaid enlargement, a bipartisan effort within the state Legislature, but once more falls within the arms of Meeting Speaker Robin Vos, who mentioned Tuesday that it’s “unlikely” his chamber will get to vote on it.

Congress beforehand gave states a everlasting choice to simply accept federal funds for 12-month extensions of postpartum Medicaid protection. Wisconsin and Arkansas at the moment are the one two states which have turned down the federal extension. Wisconsin’s protection at the moment lasts 60 days after delivery, far shorter than what well being specialists advocate. 

Extending the protection has emerged as a method for states to struggle maternal mortality charges. Although pregnancy-related deaths are uncommon,  a 3rd of them in Wisconsin happen past the 60-day protection window, in keeping with the Division of Well being Companies. 

Rep. Patrick Snyder, R-Weston, on Tuesday reintroduced a invoice that may increase protection to 12 months. The laws mirrors the extensions which have been launched in earlier periods, but have did not go the Legislature. That very same day, Vos, R-Rochester, mentioned a vote on the 12-month extension can be “unlikely.” 

“Our caucus has taken a place that increasing welfare just isn’t a sensible thought for anybody concerned,” Vos advised reporters. 

Republican lawmakers beforehand agreed to a three-month protection interval. Democratic Gov. Tony Evers’ 2021-23 state funds proposal requested for a 12-month extension, however Republican lawmakers on the highly effective Joint Finance Committee amended it to as a substitute require DHS to request federal approval to increase postpartum Medicaid eligibility to 90 days as a substitute of the 60 mandated by federal legislation. 

Vos accused the Evers administration of not making use of for the 90-day extension the Legislature already granted, which isn’t true — one thing Vos acknowledged in response to a follow-up query to his workplace. DHS submitted the applying for the extension, however the federal Facilities for Medicare and Medicaid Companies final yr mentioned it will not approve a waiver request for protection shorter than one yr. 

“I’m glad that I used to be incorrect and it has been submitted,” Vos responded. “The waiver request ought to be resubmitted to the Trump administration.”

“Going from the 60 to 90 days is fairly negligible,” mentioned Rep. Clint Moses, R-Menomonie, chair of the Meeting Committee on Well being, Getting older and Lengthy-Time period Care.  

Over the last legislative session, the Republican-controlled Senate handed a bipartisan invoice in a 32-1 vote that may have prolonged postpartum protection to 12 months. The lone opponent was Duey Stroebel, who misplaced his re-election bid in November. In whole, 73 lawmakers cosponsored the invoice — over half of the state Legislature. The invoice authored by Snyder this session is at the moment circulating for cosponsors. 

Curiosity teams from each side of the aisle got here out in help of the earlier laws, together with Professional-Life Wisconsin, the Wisconsin Catholic Convention, the American School of Obstetricians and Gynecologists, and Children Ahead.

“It made sense to me as a result of if I’m pro-life and I don’t need individuals to abort their infants, why would I not do every part I might to help these moms to have the infants,” former Republican Rep. Donna Rozar, who authored the invoice final session, advised Wisconsin Watch. 

However regardless of bipartisan help, the Meeting by no means scheduled it for a listening to earlier than adjourning for the remainder of the session in February final yr. 

Rozar mentioned she and different lawmakers couldn’t get Vos on board. “He dug his heel in, there was little question about it,” she mentioned.

Moses put the invoice on the agenda for a listening to. However along with Vos blocking it, the committee was jammed close to the tip of the session and didn’t have time to schedule it, he mentioned. 

“There’s 132 individuals on this constructing. I don’t assume we must always legislate by one,” Sen. Mary Felzkowski, R-Tomahawk, mentioned of Vos. “It’s as much as his caucus to elect a distinct speaker or change his thoughts. So his members must put sufficient stress on him to get it executed.” 

With out Vos’ approval, Moses mentioned it’s not going that lawmakers will safe a 12-month extension, however he’s hopeful that an extension of not less than six or 9 months could be agreed to on this yr’s state funds, regardless of the Facilities for Medicare and Medicaid Companies’ indication that something lower than 12 months wouldn’t be accredited. Moses is keen to schedule a listening to for the upcoming invoice, but when Vos stays opposed, it might not get referred to him, he mentioned. 

“On the subject of the funds, if there’s one thing that we would like that may be engaging to barter this out with, I feel that’s a chance,” Moses mentioned. 

A fiscal estimate final session estimated the invoice enlargement would value $21.4 million per yr, together with $8.4 million in state taxpayer funds with the remaining coming from federal taxpayers. It will enhance month-to-month Medicaid enrollment by 5,290 members. Felzkowski, who sponsored the Senate model, mentioned it’s an extension for many who are already lined relatively than an enlargement that places extra individuals on Medicaid. She additionally mentioned it’s good for taxpayers. 

“The explanation states have executed this — blue states, purple states, purple states — is it’s a return on funding for the taxpayers and it is sensible to do it,” Felzkowski advised Wisconsin Watch. “We see the variety of issues that occur in that first yr, and people issues, by not being lined, value cash — value some huge cash.” 

Wisconsin’s 306% Medicaid revenue eligibility restrict for the 60 days of postpartum protection is among the highest within the nation — one thing Vos has pointed to. 

“While you make a option to have a baby, which I’m glad that folks do, it’s not the taxpayers’ accountability to pay for the supply of that little one,” Vos mentioned in 2023. “We do it for people who find themselves in poverty. We’ve made the choice to go to 300%, that’s the legislation. However to now say past 60 days, we’re going to provide you free protection, no copayment, no deductible, till a yr out, completely not.”

A 2021 model of the invoice did not get a ground vote in each the Senate and the Meeting, but had just one lobbying group registered towards it.

That group was Alternative Options Challenge, the lobbying arm of the Florida-based Basis for Authorities Accountability. The conservative advocacy group didn’t reply to Wisconsin Watch’s requests for remark. FGA has a observe file of lobbying towards Medicaid enlargement and different payments in Wisconsin. 

“I feel it’s just a little untimely to have any discussions concerning the Medicaid funds proper now. We’ve got a model new administration coming into D.C.,” Rep. Tyler August, R-Walworth, mentioned in a Tuesday press convention with Vos. “I feel the Trump administration is definitely going to place some frequent sense into a few of these packages federally.”

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