Jackson Thomas moderates a town hall discussion with former Lt. Gov. Mandela Barnes. (Photo by Baylor Spears/Wisconsin Examiner)
Madison West High School brought Democratic candidates seeking the governor’s office to town halls last week where they answered questions from students.
While Jackson Thomas and Clark Schrager, members of the school’s civics club, will not be old enough to vote in the upcoming election, they said students started hosting events with candidates a few years ago, seeking to give young people a voice and a way to participate in the electoral process. In 2024, West students hosted U.S. Sen. Tammy Baldwin for a town hall during her reelection bid.
Thomas said not all of their peers, especially freshmen and sophomores, are necessarily paying attention to politics unless they are already interested in it, but they hope the events can bring more awareness. Many seniors heard from the candidates, Schrager said, and some will be 18 and eligible to vote in the August primary and in the November general elections.
“There’s a lot of passion in our school about issues,” Schrager said. “I think if you ask people if they cared about politics, they may say, no, but if you ask them if they cared about education or health care or gun reform, any of those issues, they would say yes. It’s kind of a generational thing for us that there’s a lot of disillusionment with the system as it is, but there’s not a movement away from participating in the political process. There are still people that care about a lot of the issues and want their voices to be heard.”
The students asked the candidates about some of the key issues that the next governor will shape, including affordability, the state’s stewardship program, health care accessibility, abortion, and funding for K-12 schools and the University of Wisconsin system.
Thomas, who is a member of March For Our Lives, said gun violence is among the issues he cares most about, and he hopes to see candidates take a stand on it and propose solutions.
“It’s unfortunately an issue that I have to think about every day when I go to school,” Thomas said. “That’s something that’s normalized because many people feel it, but it’s a really terrifying thing to have to think about.” He said it’s an issue he wants to see elected officials “not just take a stand on, but put legislation towards changing.”
Schrager said many students are also thinking about democracy and freedom.
The students also asked candidates to name one thing that they agreed with Republicans on.
“Digging into issues has kind of always been something that’s been taught to me, and I think seeing both sides is something really important to me,” said Schrager, whose parents are both journalists. “There’s been a lot of polarization that I think has moved us away from real policies that actually help everybody, and there’s been a lot of focus on hate and bigotry that I think drive us away from making actual changes that could help people.”
The race to succeed Gov. Tony Evers, who opted not to run for a third term, has become crowded on the Democratic side. Candidates who participated in the forums included Lt. Gov. Sara Rodriguez, state Sen. Kelda Roys (D-Madison), state Rep. Francesca Hong (D-Madison), former Wisconsin Department of Administration Secretary Joel Brennan, Milwaukee County Executive David Crowley, former Wisconsin Economic Development Corporation CEO Missy Hughes, former Lt. Gov. Mandela Barnes and former state Rep. Brett Hulsey.
Schrager said something that gave him hope is “the fact that all these candidates came here and they seem genuinely curious about what students had to say.”
Wisconsin U.S. Rep. Tom Tiffany, the Trump-endorsed Republican candidate for governor, was not one of the participants last week, but the students said they hope to host him in the future.
“We’re really committed to getting everybody’s viewpoint on all sides,” Schrager said. “We know Madison is a blue bubble. We know West High School is part of that blue bubble, but there are a lot of students here who will vote for him in the fall and will vote along Republican lines and they deserve to have their voices heard as well and hear somebody who aligns with them,” Schrager said.
Thomas said he thinks that is especially important when they are “trying to bridge the gap between political polarization.”
Schrager agreed, adding that there are “students who will be voting for Democrats who will still fully benefit from hearing the other side.”
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Dental hygienist Lexi Rusnak cleans a patient’s teeth at the Eastern Iowa Health Center in Cedar Rapids, Iowa, on March 26, 2026. (Photo by Tony Leys/KFF Health News)
States are paying contractors such as Deloitte, Accenture, and Optum millions of dollars to help them comply with the One Big Beautiful Bill Act — a law that will strip safety-net health and food benefits from millions.
State governments rely on such companies to design and operate computer systems that assess whether low-income people qualify for Medicaid or food aid through the Supplemental Nutrition Assistance Program, commonly referred to as food stamps. Those state systems have a history of errors that can cut off benefits to eligible people, a KFF Health News investigation showed.
These benefits, provided to the poorest Americans, can mean the difference between someone obtaining medical care and having enough to eat — or going without.
States are now racing to update their eligibility systems to adhere to President Donald Trump’s sweeping tax and domestic spending law. The changes will add red tape and restrictions. They are coming at a steep price — both in the cost to taxpayers and coverage losses — according to state documents obtained by KFF Health News and interviews.
The documents show government agencies will spend millions to save considerably more by removing people from health benefits. While states sign eligibility system contracts with companies and work with them to manage updates, the federal government foots most of the bill.
The law’s Medicaid policies will cause 7.5 million people to become uninsured by 2034, according to the nonpartisan Congressional Budget Office. Roughly 2.4 million people will lose access to monthly cash assistance for food, including those with children.
In five states alone, company estimates developed for state officials and reviewed by KFF Health News show that changes will cost at least $45.6 million combined.
“This is a pretty big payday,” said Adrianna McIntyre, an assistant professor of health policy and politics at Harvard’s T.H. Chan School of Public Health.
The law, which grants tax breaks to the nation’s wealthiest people, requires most states to tie Medicaid coverage for some adults to having a job, and imposes other restrictions that will make it harder for people with low incomes to stay enrolled. SNAP restrictions began to take effect in 2025. Major Medicaid provisions begin later this year.
Documents prepared by consulting company Deloitte estimate that a pair of computer system changes for Medicaid work requirements in Wisconsin will cost nearly $6 million. Two other changes related to the state’s SNAP program will cost an additional $4.2 million, according to the documents, which Deloitte drafted for the Wisconsin Department of Health Services.
In Iowa, changes to its Medicaid system are expected to cost at least $20 million, according to an estimate prepared by Accenture, a consulting company that operates the state’s eligibility system.
Optum — which operates the platform Vermont residents use for Medicaid and marketplace health plans under the Affordable Care Act — estimated that it could cost roughly $1.8 million to evaluate and incorporate new health coverage restrictions.
Initial changes in Kentucky, which has had a contract with Deloitte since 2012, have cost the state $1.6 million. And in Illinois, Deloitte estimated modifications will cost at least $12 million.
For six decades after President Lyndon Johnson created the government insurance program in 1965, Congress had never mandated that Medicaid enrollees have a job, volunteer, or go to school.
That will change next year. The tax and spending law enacted by Trump and congressional Republicans requires millions of Medicaid enrollees in 42 states and the District of Columbia to prove they’re working or participating in a similar activity for 80 hours a month, unless they qualify for an exemption. The CBO projected, based on an early version of the bill, that 18.5 million adults would be subject to the new rules — nearly half of those enrolled.
Vermont Medicaid officials expect it will cost $5 million in fiscal 2027 to implement changes in response to the federal law, said Adaline Strumolo, deputy commissioner of the Department of Vermont Health Access. About $1.8 million is for Optum to make eligibility system adjustments. Optum is a subsidiary of UnitedHealth Group.
The One Big Beautiful Bill Act will subject nearly 55,000 Vermont Medicaid recipients to work requirements — about a third of the state’s enrollees.
The law forced the state “to essentially drop everything else we were doing,” Strumolo said in an interview. “This is a big, big lift.”
Optum’s contract with the state was worth $125.6 million as of October.
Nearly two-thirds of adult Medicaid enrollees nationally are already working, according to KFF. Advocacy groups for Medicaid recipients say work requirements will nonetheless cause significant coverage losses. Enrollees will face added red tape to prove they’re complying. And eligibility systems already prone to error will have to account for employment, job-related activities, and any exemptions.
An estimated 5.3 million enrollees will become uninsured by 2034 due to work requirements, the CBO reported.
In Wisconsin, state officials estimate roughly 63,000 adults could lose coverage after work requirements take effect. Not covering those people would save $532.6 million in Medicaid spending for one year.
Wisconsin’s eligibility system for Medicaid and SNAP — known as CARES — was implemented statewide in 1994, and initially was a transfer system from Florida, according to a 2016 state document.
Deloitte submitted its cost estimates for Medicaid and SNAP changes to the state in September and December. Elizabeth Goodsitt, a spokesperson for the Wisconsin Department of Health Services, declined to answer questions about whether additional changes will be needed, how much it will cost to make all eligibility system changes to comply with the new federal law, and whether the state negotiated prices with Deloitte.
Bobby Peterson, executive director of the public interest law firm ABC for Health, said Wisconsin has invested “very little” to help people navigate the Medicaid eligibility process, which soon will become more difficult.
“But they’re very willing to throw $6 million to their contractors to create the bells and whistles,” Peterson said. “That’s where I feel a sense of frustration.”
Medicaid work requirements are only one change required by Trump’s tax law that will make it harder to obtain safety-net benefits.
Starting in October, the law prohibits several immigrant populations from accessing Medicaid and ACA coverage, including people who have been granted asylum, refugees, and certain survivors of domestic violence or human trafficking. Beginning Dec. 31, states must verify eligibility twice a year for millions of adults — doubling state officials’ workload. And the law restricts SNAP benefits by requiring more adult recipients to work and by removing work exemptions for veterans, homeless people, and former foster youth.
Days after Trump signed the bill in July, Kentucky health officials raced to make changes to the state’s integrated eligibility system, which verifies eligibility for Medicaid, SNAP, and other programs. Deloitte operates the system under a five-year contract worth more than $157 million. According to documents obtained by KFF Health News, initial changes costing $1.6 million were labeled a “high priority” and approved on an “emergency” basis, with some of the changes to the nation’s largest food aid program going into effect almost immediately.
Officials with Kentucky’s Cabinet for Health and Family Services declined to answer a detailed list of questions, including how much it will cost to make all the modifications needed.
Deloitte spokesperson Karen Walsh said the company is working with states to implement new requirements but declined to answer questions about cost estimates in several states. “We are delivering the value and investments we committed to,” Walsh said.
In most states, government agencies rely on contractors to build and run the systems that determine eligibility for Medicaid. Many of those states also use such computer systems for SNAP. But the federal government — that is, taxpayers — covers 90% of state costs to develop and implement state Medicaid eligibility systems and pays 75% of ongoing maintenance and operations expenses, according to federal regulations.
“Five, 10 years ago, I’m not sure if you would hear much mention of SNAP from a Medicaid director,” Melisa Byrd, Washington, D.C.’s Medicaid director, said in November at an annual conference of Medicaid officials. “And particularly for those with integrated eligibility systems — as D.C. is — I’m learning more about SNAP than I ever thought.”
The federal law was the topic du jour at last year’s gathering in Maryland, held at the Gaylord National Resort and Convention Center, the largest hotel between New Jersey and Florida.
Consulting companies had taken notice. Gainwell, an eligibility contractor and one of the conference’s corporate sponsors, emblazoned its logo on hotel escalators. Companies set up booths with materials promoting how they could help states and handed out snacks and swag.
“Conduent helps agencies work smarter by simplifying operations, cutting costs and driving better outcomes through intelligent automation, analytics, and innovation in fraud prevention,” read one such handout from another contractor. “Together, we can better serve residents at every step of their health journeys.” Conduent holds Medicaid eligibility and enrollment contracts in Mississippi and New Jersey, their Medicaid agencies confirmed to KFF Health News.
In handouts, Deloitte touted its role in “building a new era in state health care” and as “a national leader in Medicaid program and technology transformation, building a strong track record across the federal, state, and commercial health care ecosystem.” KFF Health News found that Deloitte, a global consultancy that generated $70.5 billion in revenue in fiscal 2025, dominates this slice of government business.
“With Medicaid Community Engagement (CE) requirements, states are tasked with adding a new condition of Medicaid eligibility to support state and federal objectives,” added another brochure. “Deloitte offers strategic outreach and responsive support to help states engage communities, lower barriers, and address access to coverage.”
Before Trump signed the One Big Beautiful Bill Act, Iowa lawmakers wanted to impose their own version of work requirements. They would have applied to 183,000 people before any exemptions. The new law would necessitate a change to Iowa’s Medicaid eligibility system, according to documents prepared by Accenture, which operates Iowa’s system through a contract worth more than $60 million.
Adding the ability to verify work status would cost up to $7 million, an Accenture estimate from March 2025 showed. By July, the cost to implement the One Big Beautiful Bill Act’s work requirements and other Medicaid provisions skyrocketed to roughly $20.3 million. Accenture’s analysis said the federal law necessitated additional changes to Iowa’s system. Making employment a condition of Medicaid benefits could cause an estimated 32,000 Iowans to lose coverage, according to a 2025 state document.
Cutting 32,000 people from coverage could save $183 million in one year, a fraction of the $8.9 billion Iowa and the federal government spend on Medicaid in a given year.
In Cedar Rapids, most of Eastern Iowa Health Center’s patients rely on Medicaid, CEO Joe Lock said. He questioned the government’s logic of spending tens of millions of dollars on a policy to remove Iowans from Medicaid.
Most of the health center’s patients live at or below the federal poverty level — currently $33,000 for a family of four.
“There is no benefit to this population,” Lock said.
Danielle Sample, a spokesperson for Iowa’s Department of Health and Human Services, did not answer questions about how much it will cost to implement changes to the state’s separate SNAP eligibility system.
In Illinois, the state’s work this year is largely focused on meeting major provisions of the One Big Beautiful Bill Act. The state estimates that as many as 360,000 residents could lose Medicaid, largely due to the work requirements, said Melissa Kula, a spokesperson for the Illinois Department of Healthcare and Family Services.
Kula confirmed that most of the work detailed in one of Deloitte’s estimates — priced at $12 million — is related to Trump’s law. The estimate also mentions other work. Kula said Deloitte is charging the state a $2 million fixed fee related to work requirements.
The Trump administration has acknowledged that the work is coming at a cost. In January, top officials for the Centers for Medicare & Medicaid Services said government contractors, including Deloitte, Accenture, and Optum, have promised to offer discounts and reduced rates through 2028 to help states incorporate system changes.
“The companies were extremely excited to do this,” said Daniel Brillman, the top CMS Medicaid official. “Everyone’s really focused on getting to work.”
CMS spokesperson Catherine Howden declined to answer questions about the discounts.
Goodsitt, the Wisconsin Medicaid spokesperson, declined to answer questions about whether Deloitte has discounted its rates. Officials with Kentucky’s Cabinet for Health and Family Services did not answer a detailed list of questions, including whether Deloitte extended discounts to make these changes.
It’s unclear what discounts, if any, Deloitte and Accenture have offered to individual states. Walsh, the Deloitte spokesperson, declined to answer detailed questions about the discounts the Trump administration announced this year. Accenture did not respond to repeated requests for comment.
Strumolo, the Vermont health official, said state officials discussed the announcement with Optum “in detail.”
Optum pledged to offer discounts for a specific module related to Medicaid work requirements. That product is unworkable for Vermont because it would mean “moving to a new system when we don’t have to.” When asked about whether the company offered discounts, Strumolo said “not explicitly.”
In a statement, UnitedHealth Group spokesperson Tyler Mason said Optum supports state implementation of new federal requirements “with a range of options to meet their unique cost and policy needs.”
He declined to specify whether Optum discounted Vermont’s rates and how it calculated the costs of doing its work. “Optum is helping mitigate upfront implementation expenses so states can focus on approaches that reduce duplication, accelerate implementation, and manage costs over time — supporting better outcomes for individuals covered by Medicaid,” Mason said.
Strumolo said Optum’s initial changes in Vermont cover items that take effect this year and in 2027 — Medicaid work requirements, checking eligibility every six months, and prohibiting certain immigrants from qualifying for health programs.
“There’s a lot more that could come,” she said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Student borrowers enrolled in the federal Saving on a Valuable Education, or SAVE, plan must find a new repayment plan or be automatically enrolled in one. (Getty Images)
WASHINGTON — A federal court order last month to effectively axe a Biden-era student loan repayment plan capped years of chaos for more than 7 million student borrowers enrolled in the program.
The Saving on a Valuable Education, or SAVE, plan marked a cornerstone of the Joe Biden administration’s loan forgiveness efforts but became mired in legal challenges from several GOP-led states.
On July 1, federal loan servicers will start sending notices to borrowers instructing them to enter into a legal repayment plan within 90 days, the department said. Borrowers who do not switch within the 90-day window outlined by their servicer will be automatically placed into a new plan.
The agency issued guidance to borrowers in late March instructing them of the timeline and urging people to switch into a new plan.
Here’s what borrowers need to know as they navigate next steps:
The program, introduced in 2023, sought to lower monthly loan payments for borrowers and forgive remaining debt after a certain period of time.
But millions of borrowers experienced chaos and confusion as they were forced to navigate complex court rulings, interest accrual on their debt and continued uncertainty over the plan’s fate.
Borrowers were placed in an interest-free forbearance in 2024 amid legal limbo, and the department resumed charging interest on the debt of those in the program in August 2025.
President Donald Trump’s administration in December announced a proposed agreement to end the plan.
The agreement stemmed from a legal challenge to the plan brought by Missouri, Arkansas, Florida, Georgia, North Dakota, Ohio and Oklahoma in 2024.
A federal judge dismissed that lawsuit in late February, striking down the administration’s efforts to axe the plan.
But a federal appeals court reversed the lower court’s decision in March, effectively putting an end to the SAVE plan.
Congressional Republicans’ mega tax and spending cut bill signed into law by Trump in July 2025 includes a sweeping overhaul of the federal student loan system.
Part of the GOP’s “big, beautiful” law phased out the SAVE plan by July 2028.
Borrowers have several new repayment options, and can switch to a new plan prior to receiving the incoming notice from their federal loan servicer.
One option includes the Income-Based Repayment, or IBR, plan, which ties borrowers’ loan payment to their earnings.
Borrowers also have the option to enter into two repayment plans stemming from the GOP’s “big, beautiful” law — the Repayment Assistance Plan, or RAP, and the Tiered Standard plan — which will both launch July 1.
Preston Cooper, senior fellow in higher education policy at the American Enterprise Institute, a right-leaning think tank, noted that whether IBR or RAP is a better deal for borrowers depends on their particular circumstances.
“I would recommend that if you are kind of earlier in your repayment journey, and you have a lot more interest because your balance is higher, the Repayment Assistance Plan is going to be your best bet,” Cooper said.
“If you’re later in your repayment journey, you’re closer to that 20 or 25-year mark for forgiveness, Income-Based Repayment is probably going to be your better bet,” he added.
Borrowers could also opt into a handful of other repayment options, such as the Pay as You Earn and Income-Contingent Repayment plans.
However, those two plans will be eliminated by July 2028 under Republicans’ “big, beautiful” law, meaning borrowers would have to switch plans again in two years.
Michele Zampini, associate vice president for federal policy and advocacy at the Institute for College Access & Success, said the best thing for a borrower to do is “just be proactive.”
“Make sure, from a very base level, you can access your account, you know all the basics of where you stand, and then do some comparisons across what plan options you’re going to have,” said Zampini, whose organization aims to advance affordability, accountability and equity in higher education.
Zampini also pointed to Federal Student Aid’s loan simulator as a good resource for borrowers to get specific numbers to compare across plans.
“If there’s a plan that you want to move into that’s already open and available, if it’s one of the older plans, start moving now, if you can afford it,” she said. “And then, if you want to wait for the new plan to open … know what that payment estimate is going to look like, and then set yourself a reminder for July to check back and look at the enrollment process once that plan opens.”
Amid the “total dissonance and chaos” borrowers in SAVE have experienced, Zampini said the department “has really shirked its responsibility in at least keeping borrowers updated and giving them clear information on what’s happening, when it’s happening, and what the implications are going to be for their payments and kind of their budgets and what they have to do and when they have to do it.”
Persis Yu, deputy executive director and managing counsel at the advocacy group Protect Borrowers, told States Newsroom she is “incredibly worried about borrowers not being able to figure out what to do, missing the deadline, getting put into a plan that they can’t afford, and then falling into default, which has, of course, incredibly onerous consequences.”
The end of SAVE also comes as the Trump administration continues its efforts to dismantle the Department of Education, including through a series of interagency agreements that transfer several of its responsibilities to other departments.
Under the most recent agreement, the Treasury Department will take over Education’s responsibility for collecting on defaulted federal student loan debt — the first step in a multiphase process toward Treasury taking on Education’s entire, roughly $1.7 trillion federal student loan portfolio.
“The specifics of the plan with Treasury right now are about debt collection, but the overarching mission of dismantling the Department of Education at this moment means that there are not the people in place to oversee the servicers,” Yu said.
Part of the administration’s efforts to do away with the agency included a reduction in force initiated in March 2025 that hit wide swaths of the department, including Federal Student Aid, or FSA.
Yu also highlighted a March report from the nonpartisan Government Accountability Office, which found that staffing reductions at FSA affected the government’s ability to determine how well student loan servicers are doing their jobs.
Wisconsin was one of the first places where the farm-to-table movement really took root. But now that movement is changing, becoming more urgent in the face of the flooding, droughts, and changing weather patterns that are taking a toll on our food systems.
In this episode, Amy welcome Madison's 2025 Chef of the Year Evan Danells of Cadre to talk about why these days chefs are adding protecting the planet to the menu.
Host: Amy Barrilleaux
Guest: Chef Evan Danells, Cadre
Resources for You:
2026 Epicurean Evening Menu & Tickets
BMW unveiled a radically redesigned and all-electric 3-Series last month, but the sports sedan isn’t the only machine with a blue and white propeller badge that’s getting its first EV makeover. So is the big X7, as these spy shots of the new iX7 prove.
We first saw this upcoming electric flagship a few months ago, but in the wake of the arrival of the smaller Neue Klasse cars we now have an even better idea of what to expect when it it comes to the onboard tech.
Related: BMW’s Largest SUV Is About To Get A Lot More Interesting
Visually, don’t expect a revolution. The iX7 and combustion X7 are heading into BMW’s Neue Klasse design era, but way less aggressively than the i3 and iX3, which are targeting a younger audience. That means a familiar shape, now with Neue Klasse surfacing and flush handles, but still with an older-style big grille and split headlights rather than the visor-style nose treatment seen on its iX3 little brother.
SH Proshots
Flush-type grille kidneys, iX7 badges and of course the absence of tailpipes will help other drivers distinguish it from the X7, but otherwise, like the 5-Series and i5, and 7-Series and i7, the two differently-powered SUVs will look almost identical.
And like the i7, both versions of the X7 will ride on an updated version of BMW’s existing large SUV platform, so the company can build petrol and electric models side by side. It’s a pragmatic move, even if it means the iX7 won’t go full futuristic like the smaller Neue Klasse EVs.
800-Volt Fast Charging And A Long Range
But that doesn’t mean it’ll miss out on all the good NK tech. BMW’s latest battery know-how should make an appearance, with more energy-dense cells and faster charging thanks to 800 volt architecture. If the smaller iX3 can manage over 500 miles (805 km) of WLTP range, expect the iX7 to go equally far, helped by a much larger, probably 100+ kWh battery pack.
Dual motors and all-wheel drive will be standard, and as for power, don’t be surprised if a range-topping version pushes well beyond 800 hp (811 PS), because even those kind of numbers look pretty ordinary in the electric SUV world these days.
Grab a seat inside and you’ll be met with BMW’s latest tech-heavy cabin, including its Panoramic iDrive media setup and head-up display. But the price of admission to that cabin is going be hefty when sales start in 2027, so don’t think you’re going to take one home for less than six figures.
SH Proshots
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