Dear Senators Baldwin and Johnson,
As a group of organizations that represent Wisconsinites whose lives and access to health care will be directly impacted by the “Better Care and Reconciliation Act,” we are writing to you to express our grave concern with the effect this bill will have on Wisconsin residents. We request that you vote “no” on this bill and develop a bipartisan bill that leaves Medicaid alone and addresses our real needs: stabilizing the marketplace and improving affordability.
Despite Senators’ assurances, the Senate bill does nothing to fix the House bill’s core problems. In fact, this most recent version only serves to hurt Wisconsinites more and erase the significant gains our state has made in increasing access to health care.
The Senate bill drastically cuts and caps the entire Medicaid program, putting coverage at risk for 1.2 million low-income children, parents, adults, people with disabilities, and seniors in Wisconsin. This bill makes a 35% cut to Medicaid nationally by 2036 and would reduce enrollment by 15 million people by 2026 – an even larger cut than proposed in the House bill. These cuts will have repercussions throughout Wisconsin, ultimately forcing our state’s lawmakers to cut eligibility and services for the 17% of people who rely on the Medicaid for health care, reduce our already inadequate provider payments, or raise taxes.
Every single version of the bill raises costs for Wisconsinites, leaves more people uninsured, and shifts massive costs to our state. The latest version of the bill attempts to appease non-expansion states by including increased disproportionate share hospital (DSH) funds, funds that help compensate hospitals that provide care for large shares of uninsured and Medicaid patients. However, under the proposed formula for allocation of those funds, Wisconsin would not benefit from this change. And the latest proposal to appropriate $200 billion to subsidize private insurance costs in Medicaid expansion states would not do a thing for our state, other than potentially divert funding from other programs.
BCRA will significantly weaken coverage for people with chronic health conditions, especially if the “Cruz amendment” is included. That proposal would eviscerate protections for people with pre-existing conditions, which the original version of the Senate bill already drastically weakens. It would allow insurers to sell plans that could vary premiums based on health status or deny coverage completely to people with costly pre-existing conditions, as long as they offered one plan that did not. This would further destabilize the marketplace and make premiums substantially more expensive for people who need healthcare.
The additional funding for the “long term state stability and innovation” grants are not enough to alleviate the negative ramifications that the barriers and cuts to coverage will have on access to affordable health care and the uninsured rate.
The Senate bill is fundamentally flawed and beyond repair. Of course, repealing the ACA without replacing it would be even worse in many respects. An analysis by the Urban Institute concluded that the repeal-only approach would increase the number of uninsured Wisconsinites by 431,000 in 2019.
The best way forward to serve the people of Wisconsin is by voting “no” on the motion to proceed and on the bill, if it reaches the Senate floor. Instead, of passing some version of BCRA or a repeal-only bill, we urge you to reach across the aisle to help stabilize the insurance market and promote strategies from both parties to improve the health care system as a whole.
Community Advocates Public Policy Institute
Disability Rights Wisconsin
End Domestic Abuse Wisconsin
Greater Wisconsin Agency on Aging Resources, Inc.
Mental Health America of Wisconsin
National Alliance on Mental Illness, Wisconsin
National Association of Social Workers, Wisconsin Chapter
Our Space, Inc.
The Arc Wisconsin
Wisconsin Aging Advocacy Network
Wisconsin Alliance for Women’s Health
Wisconsin Association for Perinatal Care
Wisconsin Board for People with Developmental Disabilities
Wisconsin Faith Voices for Justice
Wisconsin Family Ties, Inc.
Wisconsin Primary Health Care Association
cc: Wisconsin House delegation