Tuesday, August 28, 2007

Time to Pull Healthy Wisconsin from the Budget

The budget impasse is starting to make an appearance in the media -- see here and here -- as the summer comes to a close and schools begin to start-up. And the distinct flavor of the media coverage is shared guilt between Dems and GOPers for the stalling.

This is notably different than the way conference committee deliberations started off. After the Assembly released its budget in July, media accounts -- see here and here -- held that an impasse was likely because of how distant the Assembly budget was from the other three versions released up to that point (the Senate version was different in terms of total spending, but that difference was entirely due to the Healthy Wisconsin proposal).

From a political perspective, recent media accounts suggest that the Dems have largely lost that upperhand when it comes to focusing blame for an impasse on the GOP.

That being the case, the Dems need to find some way to jump start negotiations and regain some form of an upperhand -- not only because it will benefit them politically, but also because it's just time to get something accomplished with the budget.

And as much as I want to see fundamental health care reform get passed in Wisconsin, everyone has always known that 2007 isn't the year it's going to happen, which means it's time to pull Healthy Wisconsin from the budget.

Adding the proposal to the budget -- although certainly questionable in terms of timing -- has encouraged this state to both heighten and broaden the discussion of health care reform in important and positive ways. But that aim has run its course, and a plan like Healthy Wisconsin could now serve as much good in terms of raising awareness and furthering discussions as a standalone bill as it does in the budget.

If Healthy Wisconsin is pulled from the budget, the Dems could use the move as leverage to retain BadgerCare Plus, which is a solid short-term plan, along with a variety of other proposals included in the JFC budget and the governor's budget as well as focus public pressure on the GOP to also move to the middle with its positions.

The turn from restless to impatient is clearly coming in the media coverage of the budget, and just as it's in the best interest of the state to get something accomplished, it's in the best interest of the Dems to be ahead of the curve rather than being pulled under it.

Labels: ,

15 Comments:

Blogger Erik Opsal said...

You know I'm still wondering how there's a $9 million (or is it $11 million? I can't quite remember) gap between the Senate and Assembly budgets, but Healthy Wisconsin costs $15 million.

Shouldn't the difference be at least $15 million of the Assembly cut it?

August 28, 2007  
Blogger Seth Zlotocha said...

Healthy WI wouldn't be implemented until roughly halfway through the 07-09 budget, so the full cost wouldn't be seen until the 09-11 budget.

August 28, 2007  
Anonymous Anonymous said...

Erik - you are off a few decimal points. The difference between the budgets is billions with a "B."

Healthy Wisconsin will cost over $30 billion in the next full session. Seth is right, since the plan is enacted later in this budget - its impact is less.

The Senate Dem budget is $66 billion for two years. The Assembly budget is $56 billion for two years.

And yes - it is time to take HW out of the budget.

August 28, 2007  
Blogger Seth Zlotocha said...

Actually, due to rising health care costs, the price tag would be closer to $40 billion over the next biennium, which is less than the cost of not enacting any reform before the next budget.

If the reform was the WHP, Lewin estimates (see page 56) the total spending in 2009 and 2010 combined would be $45.6 billion, whereas no reform would run $46.2 billion in those years.

August 28, 2007  
Anonymous m.z. forrest said...

I'm not sure what the benefit for the dems is of pulling at this point. Don't get me wrong, it will be negotiated away. I just don't see much upside to unilaterally withdrawing a relatively populist item. I'm not seeing a populist uproar over the budget not being passed yet. If it isn't done by March, then you'll start seeing some anger in the populice.

August 28, 2007  
Blogger Seth Zlotocha said...

If there isn't, in fact, any public hostility until March, then you'd be right.

But I doubt it'll take that long, especially considering no budget means no shared revenue figures for local governments along with no property tax limitations when local unit budgets are due in November. Even if local governments don't raise property taxes through the roof -- in fact, I'm sure they wouldn't -- I can't imagine the press passing up on the opportunity to stir up some populist fear over the prospect, just as it's doing now over the start of school.

And my point is that the Dems should consider dropping Healthy WI before they need to do so. Take Healthy WI out of the equation, and there's little significant difference between the governor's budget, the JFC budget, and the Senate budget -- that leaves the Assembly budget clearly out there on its own as a roadblock.

Plus, Healthy WI really isn't serving any purpose in the budget anymore; the Dems put it in there to kick start a discussion, knowing it wouldn't pass. Well, that discussion has started and, for the most part, run its course over the past two months. Enrolling HW -- or something like it -- as a standalone bill that can be brought before the public at individual hearings throughout the winter and spring would be more valuable at this point than leaving it in the budget.

August 28, 2007  
Blogger Erik Opsal said...

Yes, I meant billion. Sorry.

August 28, 2007  
Blogger Jack Lohman said...

Yeah, the Dems clearly planned to pull it and now's a goot time. Let's get HW out there as a stand-alone bill so we can watch the R's squirm.

And of course, that the insurance industry has given $800,000 to legislators (with $600K going to Republicans) is going to make this a very interesting battle. We are either going to have healthcare reform in 2008 or a new assembly. I'm not sure which I want more.

August 29, 2007  
Blogger Jack Lohman said...

I'd add that the "spending" that Lewin projects is offset by the 10.5% taxes on wages which is offset by the 15% corporations currently pay for health insurance premiums. Thus the spending is really a $1.2 billion savings.

August 29, 2007  
Anonymous Anonymous said...

I agree that it's got to go -- but no, not just "pulled" but swapped for something pulled back by the other side.

This is politics, the art of compromise -- not the art of caving. Not considering the Huebsch mentality. Pulling this will not provoke a like response from the Republicans, not unless it's negotiated.

I do hope they're negotiating at all. Doesn't sound like it from the Eau Claire media reports on the most recent meeting of the committee there, which had to end early so the leggies could get to fundraisers for their campaigns.

August 29, 2007  
Blogger Seth Zlotocha said...

I agree it needs to be pulled as part of a package deal -- retaining BadgerCare Plus should be a must, along with a cigarette tax hike (maybe not $1.25, but probably at least $1.00), and possibly even the hospital assessment (although I have my questions about that assessment as a long term solution to poor Medicaid reimbursement levels).

The WisPolitics Budget Blog gives the most complete picture of the conference committee hearings, at least based on what I've seen. This, of course, doesn't cover what happens behind closed doors -- where deals often go down -- but, then again, nothing covers that.

August 29, 2007  
Anonymous John P said...

Seth:

The Hospital tax is a bad idea. The Wisconsin Hospital Association (www.wha.org) has an article on why it is comming under attack in Illinois.

Medicare reimbusement should be raised, but assessing a tax on a hospital is not the way to go about it.

August 30, 2007  
Blogger Seth Zlotocha said...

I have concerns about the hospital assessment, too, John, but I'm not sure those concerns are entirely the same as the WHA.

My concerns are with the assessment as a long-term solution, as I discuss in this post and this post. I think the WHA is concerned about that, as well, but I think it's mostly concerned about the way in which the assessment puts a roadblock in the direction that many of the big hospital systems have been heading in recent years -- toward privately insured patients and away from the uninsured and those in Medicaid -- since the assessment significantly benefits hospitals that have high Medicaid populations.

Children's Hospital is one of those system that hasn't shied away from Medicaid patients, and it has even said that the assessment would prompt them to lower health care costs across the board. Of course, not all systems would benefit; then again, those are the systems benefiting today from low Medicaid populations and, probably, low uninsured populations (e.g., suburban systems like ProHealth Care in Waukesha).

August 30, 2007  
Blogger Real Debate said...

Thus the spending is really a $1.2 billion savings.

Who has an ounce of faith that the state of Wisconsin could do this on budget?

Why should we?

They can't even do a computer upgrade. A 10% cost over-run would eat up that $1.2 billion in a second.

I've been trying to get someone, anyone, to answer this question.

No one is willing to tackle it.

August 31, 2007  
Blogger Seth Zlotocha said...

The operational costs in terms of what state government would be contributing to Healthy WI are miniscule. The major costs of the program would be determined in the private sector -- negotiated between private payers and private providers.

And, not like your question really can be answered since it's completely dependent upon how you perceive an ambiguous entity like state government, but, out of curiosity, who have you asked? Have you emailed anyone associated with the creation of Healthy WI or the WHP, such as David Riemer? I'm sure he'd be glad to respond to any questions for you. Or is the "No one is willing to tackle it" just rhetoric like the question itself?

August 31, 2007  

Post a Comment

Links to this post:

Create a Link

<< Home