Gov. Scott Walker was a strong supporter of good health care policy even before he took office in 2010, as WHA President/CEO Eric Borgerding noted in his introduction of Walker before an audience of over 1,000 hospital advocates April 19 in Madison.
In his time serving on the Assembly Health Committee, then Rep. Scott Walker laid the groundwork for what is one of the most stable medical malpractice environments in the country. As Milwaukee County Executive, Walker worked with WHA on the General Assistance Medical Program.
"Today, we can look back on his term as Governor and point to numerous examples of his leadership on health care, but also to his partnership with WHA and our members," Borgerding said.
Wisconsin has been at the forefront in the ongoing debate over repealing and replacing the ACA, working together to preserve and strengthen and be rewarded for the Wisconsin model of coverage expansion that has delivered a 38 percent reduction in the state’s uninsured rate.
"Wisconsin has been a leader in transforming health care, enabled by good public policy," Borgerding said. "There is much more to do in both Madison and Washington. Our partnerships with our elected officials are more important today than ever before."
Walker Touts Health Care as Wisconsin Asset: Accessible, Affordable and High Quality
The Governor felt right at home before the Advocacy Day crowd on what was his sixth appearance before the group. He began by saying he appreciates working with the WHA staff and Board of Directors and with all the hospitals and health systems across the state. He also recognized the dedication of the health care advocates and members of hospital boards who were in attendance.
"Health care, in general, is about three core things: quality, access and affordability," Walker said. "Hopefully in this state, we have shown how to do that in a way that is effective for the rest of the country." He thanked hospitals and health systems for their commitment to quality and mentioned that Wisconsin consistently ranks in the top three states in the nation based on quality.
Walker said since 2011, his Administration has put $3.25 billion worth of new state GPR into the Medicaid program to make sure that it was accounting for not just the people hospitals serve, but make sure that it is not "dished off to everybody else, which becomes a hidden tax on employers."
"When a state does not fully or adequately fund Medicaid, it just becomes a hidden tax on other employers and individuals who have health care plans. They have to pick up the difference, and you have to raise more money to compensate for uncompensated care," according to Walker.
Referencing his days in the Legislature, Walker said ensuring liability protections, not just individually for health care professionals, but also for hospitals and health systems, is important to ensure they are protected from unnecessary liability burdens. Good regulations that ensure public health and safety, which are not obsessively beyond that which place an unnecessary burden on providers, also allow providers to focus on improving quality and increasing access.
"Health care is not only good for quality of life, it has a tremendous economic impact. I say that when you think about it logically it makes sense. We, particularly in government, talk about things in silos. Health care here, taxes there, education over there. It’s interrelated," he said. "When an employer looks to bring a business into a community, or tries to hire talent they need to serve a particular position, they look at a variety of things. It’s good to have reasonable taxes, a good regulatory environment and a limited lawsuit environment, but there are core things they need—access to a great workforce, a good education system and right at the top of the list is a good health care system. No matter how much they pay you, if there is not access to good health care and education system, it is not worth it. It has a direct impact. It’s not just quality—we rank third—but affordability and access are tied together to economic vitality and growth."
On extending Wisconsin Works for Everyone to other programs, including Medicaid, the Governor said people with physical and intellectual disabilities are sometimes hesitant to work for fear they will lose their benefits. He said his plan is to "spread that time out, make the transition longer" so people who are receiving state benefits, such as Medicaid, do not "fall off a cliff." He said his plan, for example, is if an individual’s income reaches 200 percent FPL, for every $3 you make over that, you pay $1 more in copay for child care.
On the Medicaid waiver, he said Wisconsin will ask the federal government if it can charge a premium even at low income levels, at $1 a month.
"Skeptics in the capitol have asked me why you would do that when it costs more to collect that dollar. It is not about saving money," Walker said. "As they churn people off Medicaid, we are getting people ready for the workforce."
Everyone pays some kind of premium for health insurance, according to the Governor; starting to pay even a small premium reduces the shock of paying one. He said the state will also request to put filters in place that allow the state to screen for addiction. Along with that, the Governor put money into the state budget for rehabilitation.
"We didn’t do this to create more uncompensated care. We have more people who are not on Medicaid because they can pay for their individual plan," he said.
On the ACA, Walker said the discussions are all over the board, and there is much work to do. However, he said when he is in Washington he consistently tells people, "If you want to make a change, make a change that goes along with what we did in Wisconsin."
Wisconsin has a better rate of coverage than 43 other states, he said.
"The discussion earlier this year was around reimbursement, but the talk needs to be around not just the cost of health care and reimbursement, but what are we doing to make health care better, and what are we doing to help our constituents live healthier, better lives," Walker said.
Employment and jobs have always been a key priority for Walker. The unemployment rate in Wisconsin has hit an all-time low, 3.7 percent. Good news for job seekers, but not so positive for employers. The Job Center of Wisconsin now has more than 95,000 job openings posted. Walker said workforce shortages are a huge challenge, but if Wisconsin can "connect the dots between skills, education and the qualifications to match the positions," there will be endless opportunities for family-supporting jobs.
Walker’s support for graduate medical education has helped create residencies in rural areas, while Fast Forward grants are encouraging health systems to partner with the state to match those who are looking for employment with the training they need to be successful.
"It is a moral imperative they have access to education or it can be an economic impairment," Walker said. "The biggest barrier to creating more jobs going forward is this one thing: workforce.
The Governor pointed to Project SEARCH as a great example of getting people with disabilities into the workforce. He acknowledged that of the 27 Project SEARCH job sites across the state, all but a couple are sponsored by health systems.
"I was just out in your hospitals on a tour. There is nothing more fulfilling that visiting a Project SEARCH site," he said. "The inspiration they provide makes people want to work harder themselves. When I have 95,000 job openings, I can’t afford to have anyone on the sidelines. We have to have everyone working."