DHS health care cuts offer wrong set of choices

Some 400 years ago in England, there was a livery stable owner named Thomas Hobson, who became famous for the “choice” he offered his customers: You can take the next horse in the rotation I’ve arbitrarily established, or you can take a hike. Since then, this type of “take it or leave it” proposition has been known as a “Hobson’s choice.” The term applies very well to the “choice” now being offered by the Wisconsin Department of Health Services (DHS) regarding massive cuts to the state’s BadgerCare and Medicaid programs.

On Thursday, November 10, the Joint Finance Committee is expected to meet to review a waiver request DHS must submit to the federal government in order to carry out major changes to BadgerCare and Medicaid. These changes, which conflict with current state law, would dramatically increase health care costs for thousands of low-income individuals and families, and would certainly result in thousands more losing their coverage entirely. If the federal government does not approve the waiver by a self-imposed end-of-the-year deadline, DHS says it will have “no choice” but to automatically end coverage for 53,000 adults, as required by the state budget bill passed earlier this year. Mr. Hobson would be proud of Wisconsin policymakers for concocting such a scenario, which results in thousands of people dropping from the program regardless of what happens with the waiver. But as with Hobson’s horses, the DHS dilemma is manufactured. There are better options available that are not being considered.

The real choice facing the state is this: Do we address the growing cost of our state’s highly effective, successful, and popular health care programs by kicking tens of thousands of struggling families and individuals off of the BadgerCare and Medicaid rolls? Or do we avoid this disaster by adopting a more balanced, humane approach? For example, we could avoid the changes to BadgerCare that will result in tens of thousands of children and parents becoming uninsured by rolling back less than one fourth of the $210 million in new tax cuts for corporations and the wealthy the legislature enacted this year for the current biennium.

In choosing to drop people from the program, policy makers made an error in judgment that is completely at odds with the priorities of the vast majority of state residents. DHS compounded this mistake by waiting until just a few weeks ago to unveil its plan for implementing these draconian cuts. This allowed woefully inadequate time and opportunity for the public to understand and respond to the proposal, and far less time than it ordinarily takes for the federal government to review the plan and negotiate any necessary alterations. Regardless of the outcome of Thursday’s Joint Finance meeting (which is NOT a forum for public comment) and the federal government’s decision on the waiver, the damage will be severe. DHS tries to frame it as a lesser-of-two-evils decision, saying we should make these “modest” changes so that 53,000 don’t have to be booted from BadgerCare. They argue that low-income households should be happy to pay more—in some cases 10 times more—for worse coverage than they currently receive because it’s still a “good deal.”

Those of us who value the health of Wisconsin residents more than the bottom lines of large corporations see it differently. We know that neither of these “choices” is acceptable or necessary. We know that struggling families who can’t afford to pay more will end up going without coverage. We also know that if the number of uninsured people in Wisconsin increases significantly, it will ultimately cost everybody more because people will get sicker, seek care in more expensive emergency rooms, and those costs will be passed on to those fortunate enough to still have insurance. And finally, we know that there are sources of revenue being left untapped that could have reduced the amount of money that needed to be cut.

Please don’t be fooled by horse dealers who offer you only a choice between a broken-down nag and a long slog on foot. There are better horses in that stable, and Wisconsin families deserve access to them.

The Wisconsin Council on Children and Families is a private, non-profit, non-partisan statewide organization with offices in Madison. It was established in 1881 as the Wisconsin Conference on Charities and Corrections.

Tags: opinion, editorial, health