Legislation introduced in the U.S. Senate would order the U.S. Department of Agriculture to resume frozen payments to farmers on contracts that have already been signed. (Photo by Gregory Conniff for the Wisconsin Examiner)

A group of U.S. Senate Democrats introduced legislation Monday that would order the agriculture department to resume paying farmers on contracts already signed.

“Donald Trump and Elon Musk are stiffing our farmers and processors — taking away resources these folks were guaranteed, threatening small businesses’ ability to stay open and people’s livelihoods,” said Sen. Tammy Baldwin (D-Wisconsin), one of 17 cosponsors.

In addition to 15 Democrats, two independent senators who caucus with them, Sens. Bernie Sanders of Vermont and Angus King of Maine, signed on to the bill.

The U.S. Department of Agriculture (USDA) has stopped reimbursing farmers and farm organizations for money they’ve spent, despite contracts they have already signed with the agency. The contracts call for farmers to be reimbursed for expenses they incur under the contracts.

Honor Farmer Contracts Act, introduced by Sen. Cory Booker (D-New Jersey), would require USDA “to release illegally withheld funding for all contracts and agreements previously entered into by the U.S. Department of Agriculture,” Baldwin’s office said in a statement announcing the legislation.

Under President Donald Trump, “USDA has refused to make reimbursement payments to fulfill signed contracts, without any indication of when or whether farmers will be paid the money they paid out and are owed,” Baldwin’s office said.

Farmers and organizations serving them contract with the USDA for various programs to connect with local markets and improve their productivity. The department then pays farmers back for the expenses they incur under those contracts. The department’s failure to pay strains finances both for the individual farmers and for the organizations that work with them under the programs, Baldwin’s office said.

The legislation would require USDA to unfreeze all signed agreements and make all past due payments as quickly as possible. It would also bar the department from canceling agreements or contracts unless there has been a failure to comply with their terms and conditions.

The bill would prohibit the department from closing county offices, field offices or centers of the Farm Service Agency, the Natural Resources Conservation Service or the Rural Development Service without notification at least 60 days in advance and justifying the closing to Congress.

On March 7, Baldwin said the USDA had resumed another previously stalled stream of funding, $6.5 million in grants for dairy businesses to diversify and market their products.

Baldwin has also demanded the Trump administration to reverse its cancellation in March of a program connecting farmers to local food banks.

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Jack Kelly of Wisconsin Watch waits with reporters outside the state Capitol for a press conference to begin in September 2023. (Wisconsin Examiner photo)

Journalists at Wisconsin Watch — a nonprofit news organization that includes the Milwaukee Neighborhood News Service — have ratified their first union contract.

The agreement, signed on Friday, March 28, includes minimum salary guarantees and annual cost-of-living increases along with layoff restrictions, severance pay and benefits as well as “just cause” protections against arbitrary terminations, according to the Wisconsin Watch Union. The contract also includes provisions for medical, parental, caregiver and bereavement leave.

The union is a subunit of Milwaukee NewsGuild Local 34051, which also represents newsroom employees at the Milwaukee Journal Sentinel.

“I’m really proud of the outcome,” said Jack Kelly, a Wisconsin Watch reporter and union bargaining team member. Staffers represented by the union were active in advocating for their priorities during contract negotiations, giving personal testimony about issues important to them, he said.

“They put some faces and names to the numbers we were asking for,” Kelly said in an interview Monday.  “I think the contract is going to make Wisconsin Watch and Neighborhood News Service better places to work.”

Kelly also commended Wisconsin Watch management’s handling of the bargaining process.

“We certainly had meetings that were long and stressful, but I think in general we were able to engage a collegial approach to bargaining,” Kelly said.

“We’ll continue to do great journalism knowing our workplace is more structured, secure and protected,” said Phoebe Petrovic, a Wisconsin Watch investigative reporter who was among those who initiated the union organizing effort, in a statement released by the union.

Wisconsin Watch journalists announced their union organizing campaign in October 2023, and the organization’s board subsequently agreed to voluntarily recognize the union. Protection against arbitrary firings was among the goals employees cited.

Wisconsin Watch was founded in 2009 as the Wisconsin Center for Investigative Journalism, still its legal name. The Milwaukee Neighborhood News Service became part of Wisconsin Watch in July 2024 and its employees became part of the bargaining unit.

Devin Blake, a Milwaukee Neighborhood News Service reporter who joined the bargaining team, said that in addition to tangible gains the union brought him closer to coworkers. “I have such a clearer sense of what matters to their lives and work,” Blake said in the union’s statement.

Digital news outlets and nonprofit news organizations have seen growing union representation in the last several years, with outlets including ProPublica and The Marshall Project joining the ranks of unionized newsrooms. 

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A new Wisconsin Hospital Association report finds continued challenges for hospitals seeking health care workers. In this January 2024 photo, an information screen for visitors at Sauk Prairie Hospital displays a recruiting message directed at health care workers. (Photo by Erik Gunn/Wisconsin Examiner)

As more Wisconsinites need more hospital care, the supply of health care workers to provide that care remains slim — and to change that outlook will take concerted effort, according to a new report released Monday.

“Wisconsin’s health care workforce must grow faster,” says the 2025 Wisconsin Health Care Workforce Report, produced by the Wisconsin Hospital Association (WHA).

“Health care employers are working hard to retain current employees, re-recruit those who left for what they thought might be greener pastures and attract new talent to health care fields in Wisconsin,” the report states.

The report finds some glimmers of improvement and promising pathways for hospitals to further address their need for more trained staff. Over the last two years hospital job vacancies have fallen slightly and employment has increased.

But filling jobs remains a challenge and will remain that way for years, the report states. It suggests  a combination of strategies to overcome current trends.

Some of the strategies involve  how hospitals themselves structure jobs and hiring practices. But the report contends other sectors — government, educational institutions, and the insurance companies and government programs that pay the lion’s share of health care bills — will also need to shift their policies.

Reimbursement rates are not keeping up with increased costs as hospitals and other providers weather rising payroll and supply expenses, for example, the report finds.

By far the dominant contributor to the workforce challenges hospitals and health systems face, however, is demographic, according to the report. Wisconsinites continue to get collectively older.

“Only Wisconsin’s population over 65 has grown between the 2010 and 2020 census,” said Ann Zenk, senior vice president of workforce and clinical practice for the hospital association. The working-age population ages 18 to 65 decreased in that same period.

Those younger than 40 go to the hospital once a year on average. From ages 40 to 65 that ticks up to three times a year. After 65, “it doubles to six visits a year,” Zenk  said.

“As we age, we need more health care,” she said. “That is going to be a double challenge for hospitals because our available workers are a smaller pool and our demand is even greater.”

The population preparing to enter the workforce — people ages 19 and younger — “is not large enough to replace retiring baby boomers,” the report states. “Growing the health care workforce needed to respond to this demographic challenge will require increasing in-migration, ensuring access to career pathways and increasing interest in hospital careers.”

That starts with giving students in high school or even earlier “the opportunity to have exposure — you’re walking in the shoes of what it’s like to be a health care professional,” Zenk said.

Then there’s the education process itself — “making sure that educational pathways remain accessible,” Zenk said. The report urges policymakers not to add requirements to training programs that would make them longer, more complex or more expensive.

One promising training innovation, said Zenk, is the use of an apprenticeship program to prepare new registered nurses, pioneered in the last few years in Wisconsin by UW Health and the state Department of Workforce Development.

While the program stretches over four years for the equivalent of a two-year associate degree, she said, it also allows the participating students to “earn while you learn.” The concept is being expanded to prepare respiratory therapists.

The report also identifies generational shifts in what people expect from their jobs. Zenk said addressing demands for more flexible and family-friendly schedules can make it possible to hire and retain more successfully. But those changes may also mean demand for even more personnel.

“So where you need a roster of 10 nurses, you need 15 now to cover the exact same shift,” Zenk said.

The report also sees technology offering some relief.

Some of that might be replacing people for tasks such as registering at the front desk for a medical visit, Zenk said. But another example is monitoring equipment that could go home with a patient and be checked remotely, with nurses and clinicians visiting the patient at home every day, she observed.

Zenk said some regulations in health care can be reexamined and streamlined without endangering safety or the quality of care.

Physician assistants, for example, collaborate with and are overseen by a medical doctor. Zenk said in the past a physician could supervise no more than four PAs. That has since been relaxed, making it less burdensome for both doctor and PA alike, she said.

Zenk said another form of regulation has gotten worse, however: When health insurers interpose an increasing number of steps for them to sign off on the care a doctor or hospital provides.

“That requires staff to make those phone calls or enter that data, or requires physicians to document more and more and more to justify the care that they want to provide and that the patient needs,” she said.

She’s seen insurer-driven requirements increase in the last five years.

“That’s a major tug-of-war on clinicians’ time,” Zenk said, “and for patients also very frustrating.”

In the end, however, there’s no single silver bullet to resolve what is likely to be a persistent challenge for hospitals or their employees.

“There’s no one answer. We’re more than likely not going to be able to grow ourselves out of this one fast enough,” Zenk said. “But anything we can do to grow the workforce faster is going to help.”

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Gov. Tony Evers speaks at a round table discussion on the state budget in February. On Friday, Evers' office said the state will lose $210 million in federal funds for health care previously approved by Congress but part of $12 billion cut this week by the Trump administration. (Photo by Erik Gunn/Wisconsin Examiner)

Wisconsin will lose more than $210 million in federal funds that were to be used for mental health, substance abuse prevention and bolstering emergency medical services, state officials said Friday.

The money involved is Wisconsin’s share of $12 billion to combat infectious disease and other serious health problems that the U.S. Department of Health and Human Services has summarily cut off, NBC News and the New York Times reported this week.

In Wisconsin, the funds were to be used for suicide prevention; substance abuse prevention; public health departments, programs and laboratories, including EMS services; and the Wisconsin Immunization Registry, the office of Gov. Tony Evers said Friday.

The governor’s office discussed the health funds cutback along with  other programs targeted for reductions or considered vulnerable under the Trump administration, including education funding, farm programs and in the Department of Veterans Affairs. On Thursday, the Trump administration announced it will cut 10,000 employees from the U.S. Department of Health and Human Services.

“Reckless cuts by President Trump and Elon Musk to help pay for tax cuts for millionaires and billionaires are causing devastating consequences for Wisconsin’s kids, families, and communities and services they depend on every day,” Evers said in a statement released Friday.

“With threats to Medicaid and Medicare, cuts to researching cures for Alzheimer’s disease and cancer, efforts to undermine food and drug safety, and continued attacks on the Affordable Care Act, the Trump Administration is jeopardizing health and access to health care in Wisconsin and across our country,” Evers said.

State Rep. Greta Neubauer (D-Racine), the Assembly minority leader, said Friday that the cuts “will be devastating for Wisconsinites who rely on these essential programs.”

“President Trump and Elon Musk are selling out Wisconsin families and communities, threatening our health and safety just to pay for unnecessary tax cuts for their billionaire friends,” said state Rep. Lisa Subeck (D-Madison), the ranking Democrat on the Assembly Health, Aging and Long-Term Care Committee and chair of the Assembly’s Democratic caucus.

“This reckless move by the Trump Administration, coupled with cuts to vital medical research and threats to the future of Medicaid and Medicare, will have a devastating impact on the health of our state,” Subeck said.

Evers said his administration will explore “every legal option available to us” to fight the cuts.

The $12 billion that HHS cut this week was authorized by Congress through COVID-19 relief bills enacted in the first two years of the pandemic. The funds were later allowed for public health needs outside the pandemic, the New York Times reported this week.

The World Health Organization reports that “COVID-19 continues to circulate widely . . . presenting significant challenges to health systems worldwide. Tens of thousands of people are infected or re-infected with SARS-CoV-2 each week.”

The UN-affiliated public health agency emphasizes continued surveillance of the viral pandemic. “It is vital that countries sustain the public health response to COVID-19 amid ongoing illness and death and the emergence of SARS-CoV-2 variants, adapting it to the requirements based on the current COVID-19 situation and risk,” WHO says. 

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ABC for Health, a public interest law firm, argues that a Dane County health assessment should have addressed the problem of medical debt. (Getty Images)

ABC for Health, the public interest law firm, has filed a complaint with the IRS, charging a team of hospitals led by UW Health of falling short of federal standards when they filed a Community Health Needs Assessment required of health nonprofits under federal law.

Late last year, the hospitals  released their report on the health needs of Dane County.

Federal law requires nonprofit health care providers to file such a  document every three years. The December report covered reproductive care, chronic illness, mental health and substance abuse, along with special sections about health concerns for children and youth as well as the elderly.

But in 63 pages, the report included no discussion of how the cost of care and medical debt have burdened people without money and hampered their access to the health care system.

For Bobby Peterson, that was a glaring omission — and on Thursday, Peterson and ABC for Health, the firm he founded and directs, filed a complaint with the IRS, charging the report doesn’t live up to the federal law’s requirement for a Community Health Heeds Assessment (CHNA).

ABC for Health focuses on health care access along with helping people overcome or avoid medical debt.

The organization’s complaint argues that failing to address that issue in the Dane County health needs document violates the collective responsibility of UW Health and the other three nonprofit hospital systems that produced it.

“Their insistence to exclude medical debt from consideration during the CHNA betrays many principles and requirements of non-profit hospitals,” the complaint states. “We maintain that UW Health’s intentional indifference towards the medical debt epidemic stems from a value for their own revenue at the expense of their community. That value is at odds with UW Health’s duty towards its community.”

Sara Benzel, media relations manager for UW Health, defended the report Thursday as well as the hospital system’s handling of medical debt.

“UW Health stands behind the priorities identified in the community health needs assessment process,” Benzel told the Wisconsin Examiner in an email message.

“Regarding the UW Health Financial Assistance Policy, we are proud of the work we do every day to make this support accessible, and the work we have done to simplify the process and lower barriers to accessing financial support.”

She said the hospital system’s financial assistance program is posted online in English and Spanish.

“The application has been simplified over the years using an equity lens, requires minimal supporting documents, and goes up to 600% of the federal poverty level, well above others in the state,” Benzel said.

Medical debt critic

ABC for Health has been a longstanding critic of hospitals’ handling of medical debt and has published several reports finding fault with how hospital systems address the problem of patients unable to pay their health care bills.

While hospitals have programs for financial help when a patient has no insurance and can’t afford to pay out of pocket, ABC has argued those programs are too often needlessly complex. The organization also contends that hospitals’ financial counselors don’t take actions that could circumvent a problem — such as helping patients enroll in Medicaid if they qualify.

The requirement for a Community Health Heeds Assessment is a little-noticed provision in the 2010 Affordable Care Act — the legislation nicknamed Obamacare that has helped drive down the numbers of uninsured Americans since its passage 15 years ago. Nonprofit health care systems must  produce a CHNA report for their communities every three years.

“The IRS is regulating this because they are looking at their tax-exempt status,” Peterson said Thursday. “And to be a tax-exempt organization, to be able to step away from all the property tax requirements that many of us face, they have a responsibility then to give back.”

He sees a hospital’s approach to medical debt as a direct measure of how they give back.

“They have a community benefit that they need to provide, and part of that benefit is making sure that they’re providing enough charity care and services to the vulnerable in a community,” Peterson said.

The 2025-2027 CHNA report, like several previous editions, was the work of Healthy Dane Collaborative, a coalition of the county’s four hospital systems: Unity Point-Meriter, SSM Health-St. Mary’s Hospital, Stoughton Health and UW Health. The report’s drafters conducted a survey, collected and analyzed data, met with a variety of community organizations and held focus groups

The final report included discussions of health care disparities by race, income and gender. It called attention to the health care needs of the LGBTQ and immigrant communities, including undocumented migrants.

Early on, the text of the report emphasized concern for health equity — “ensuring fair distribution of health resources, outcomes, and opportunities across different communities.”

Seeking a voice

At an ABC for Health symposium Thursday on Medicaid and health care access, Peterson said the report’s priorities were “good things” and were all important.

“But what we wanted to see was access to health care coverage,” Peterson said, along with a discussion about improving financial assistance policies and better coordination among providers. “It wasn’t there. That’s not part of what they wanted to give out to the community.”

Peterson said ABC started reaching out more than a year and a half ago to offer input for the CHNA report.

“We wanted to make sure that the people that are in the planning process understand what the access to health care coverage needs are, what the barriers in the financial assistance process are, and how can we make it better. What can we do to improve that process?” Peterson said.

“We thought this is a real opportunity for us to make sure that all these issues that we see every day can be put up in this Community Health Needs Assessment process,” he added. “We wanted our voice and the voice of our clients to be heard.”

The IRS complaint includes email messages ABC Health sent various people about the assessment process starting in mid-2023.

In a message Aug. 13, 2024, Peterson told Adrian Jones, UW Health Director of Community Health Improvement, “ABC remains eager to engage in Dane County’s 2024 CHNA process.”

The message asked for updates on the CHNA “process and timeline” and mentioned that ABC for Health was “preparing a report with recommendations to provide input, from the perspective of our clients, to inform Dane County’s CHNA process.”

In her Aug. 14 reply, Jones invited Peterson to “share your report with us.” She wrote that “we have also held our own community input sessions and survey and have analyzed a lot of quantitative and qualitative data.”

Peterson followed up with an email Aug. 16 that included a half-dozen questions about the data being collected, when and where community meetings had been conducted, whether more community meetings were planned and the timeline for completing the assessment document.

“ABC for Health is eager to continue engagement with the Dane County CHNA process,” Peterson wrote. “Please keep us posted about future community input sessions and meetings.”

Correspondence ends

There was no further response, and “the Dane County hospitals quietly released the CHNA report in late 2024, without ABC’s input that we maintain failed to take into account the perspective of the many communities we represent,” the complaint to the IRS states.

“Unsurprisingly, this report ignored access to health care coverage issues. The report lacks any recommendations to improve financial assistance policies, practices, and processes to equitably serve populations negatively affected by health disparities. It fails to address the impact of medical debt on Dane County patients,” the complaint states.

“It lacks broad community input and instead reflects a hospital-driven marketing piece that ignores and sidesteps Affordable Care Act requirements. ABC was largely shunned despite our multiple efforts over the past 2 years to provide client-based input.”

ABC for Health released its report shortly after Peterson learned that the CNHA report was published. Its critique was unsparing.

“Dane County hospitals must do more to justify extensive tax breaks and better serve patients impacted by health disparities,” the report states. “In 2023, Dane County hospitals spent an average of only 0.7% of their gross patient revenues on charity care. The national average is 2.3%.”

ABC for Health bases its calculations for Dane County charity care on Wisconsin Hospital Association data, and the national average on a 2022 Wall Street Journal report.

Peterson sent a letter reiterating ABC for Health’s concerns and the organization’s complaint about its lack of input in the CNHA report to UW Health’s CEO, Alan Kaplan, in January. He said there was no response.

ABC for Health also invited Kaplan and other hospital leaders to the ABC for Health event Thursday. The invitations were ignored or declined, Peterson said.

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Dr. Sterling Johnson of the University of Wisconsin-Madison speaks at a forum on NIH funding cuts conducted by U.S. Senate Democrats on Wednesday. (Photo courtesy of Sen. Tammy Baldwin's office)

Drastic funding cuts at the National Institutes of Health (NIH) have disrupted biomedical research, potentially setting back projects that could advance treatment and prevention efforts for cancer, Alzheimer’s disease and other major causes of illness and death, researchers and patients told Democratic Senators Wednesday.

“We are hearing from researchers, research institutions, and patients about the ongoing attacks on NIH,” said Sen. Tammy Baldwin (D-Wisconsin), at the start of a  two-and-a-half hour forum she chaired as the ranking Democrat on a Senate subcommittee that oversees NIH.

“Understandably, most are reluctant to publicly speak out because the Trump administration is actively extorting institutions of all types, including major research universities,” Baldwin said. “This administration is seeking to dismantle the NIH and destroy the hopes of millions of Americans who are counting on life-saving treatments and cures.”

Witnesses who testified Wednesday warned that with projects being canceled in midstream, years of research data would likely be wasted and the role of the NIH as the world’s leading funder of biomedical research was at risk of being displaced.

NIH-funded advances have contributed to reductions in death rates from cancer, heart attacks and stroke in the U.S., said Dr. Monica Bertagnolli, who was director of NIH in the Biden administration and stepped down in January.

“This progress would not have happened without taxpayer support,” Bertagnolli said.

But in the first two months of the Trump administration, she said, more than 300 grants have been terminated and $1.5 billion in funding has been delayed.

In the last year, Bertagnolli told Sen. Patty Murray (D-Washington), NIH identified women’s health as “a high priority area” and “launched many new programs to really begin to address the deficiencies that we’ve had in women’s health.” Since the change in administration, however, “nothing new has moved forward.”

Dr. Sterling Johnson, the associate director of the Wisconsin Alzheimer’s Disease Research Center and a professor at the University of Wisconsin, said NIH funding over the last two decades helped make it possible to diagnose Alzheimer’s disease through blood tests and brain imaging scans rather than having to wait until after the patient’s death to be certain.

The NIH also funded clinical trials on surgical procedures involving the brain that can slow symptoms of the condition, he said, as well as trials on potential preventive therapies.

“These discoveries are changing the way we diagnose and treat Alzheimer’s and related causes of dementia,” Johnson said, but there is growing concern about how to sustain those gains.

In the last few months, he said, there have been delays in peer review and funding approvals for some projects.

“There are proposed cuts that threaten major ongoing studies, including treatment trials, risking the loss of millions of dollars already invested and setting our patients back,” Johnson said. With cuts threatening to slow down studies, “we will lose ground on hard-won progress.”

Senators as well as witnesses recounted stories of research that was cut off that involved investigations of health disparities.

Poorer counties across the country have “a persistent problem with poorer outcomes for all kinds of health issues,” Bertagnolli said, with maternal and fetal health among the most visible. “And without targeting those particular populations to understand the reasons behind the disparities, how can we ever even begin to overcome them?”

Research that considered members of the LGBTQ+ community and how illness affects racial and ethnic groups differently have been recurring targets in the Trump administration NIH, several said.

Dr. Whitney Wharton, an Alzheimer’s researcher at Emory University, said the Trump administration’s NIH has canceled research projects that she and other colleagues were conducting on Alzheimer’s in racial and ethnic minority groups, including LGBTQ+ people.

Previous research by her lab found Black Americans were 64% more likely than non-Hispanic whites to get Alzheimer’s disease and are living with the disease longer, she said.

“The systematic elimination of these high-risk” groups of patients from research “will only serve to increase the total number of [Alzheimer’s] patients every year,” Wharton said. Understanding those disparities is especially important, she added, because with shifting demographics racial and ethnic minority groups will represent the majority of the population.

“These terminations will have very grave consequences for patients, for families, for communities, and for taxpayers,” Wharton said.

Wharton read from a letter she received Feb. 28 that canceled another project she was in the midst of.

“It cites transgender issues,” Wharton said. “And it says, ‘Research programs based on gender identity are often unscientific, have little identifiable return on investment and do nothing to enhance the health of many Americans. Many such studies ignore rather than seriously examine biological realities. It is a policy of NIH not to prioritize these research programs.’”

Sen. Sheldon Whitehouse (D-Rhode Island) said the cancelation of grants, such as one on mental health therapies for LGBTQ people and other on LGBTQ cancer survivors, appear to violate a federal court order blocking the NIH from withholding grants that were already in progress.

He urged panelists to let the senators know if funds aren’t released when they’re supposed to be. “We need to know when they’re jammed because you can’t believe anything that the Trump administration tells you about the progress of the funds unless the funds are actually flowing,” Whitehouse said.

Wharton and Johnson both said the turmoil for NIH-funded research was at risk of driving away a generation of researchers.

“These cuts are very, very devastating and they’re very scary for young investigators, for students, whether they’ve been affected or not,” Wharton said. “These young scientists may leave research altogether because they’re nervous.”

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U.S. Rep. Mark Pocan (D-Black Earth) addresses union members at a weekend rally in support of federal workers whose jobs are on the line under the administration of President Donald Trump. (Photo by Erik Gunn/Wisconsin Examiner)

Moves by the Trump administration to cut the federal workforce have caused chaos and fear inside agencies ranging from the U.S. Forest Service to the Social Security Administration, advocates for federal employees say.

Some two dozen Forest Service employees in Wisconsin returned to work Monday, five weeks after receiving termination notices and being walked out, as a result of a court order March 13 holding the termination notices issued on Valentine’s Day were illegal.

Wisconsin is home to some 18,000 federal workers, U.S. Rep. Mark Pocan (D-Black Earth) said at a rally in Madison Saturday — workers whose jobs are on the line under orders from Washington, D.C.

“I am getting record numbers of calls in our office, literally thousands of calls every single week,” Pocan said. “People are pissed. They’re upset about cuts to the Veterans Administration. They’re upset about what’s happening with the Social Security Administration. They’re upset about Medicare and Medicaid potential cuts. They’re upset about cuts to agriculture and education.”

At the Social Security Administration, the acting Social Security commissioner has announced plans to close regional offices and cut 7,000 jobs “through buyouts, layoffs, resignations and terminations,” said Jessica LaPointe, president of American Federation of Government Employees (AFGE) Council 220, who joined the Saturday rally at the headquarters of the South Central Federation of Labor. The council represents Social Security field office employees.

Social Security operations have been “historically understaffed,” LaPointe said, and the planned reductions “will lead to longer service delays, systems failures, and even inevitably benefit disruptions.”

In an interview with the Wisconsin Examiner during a Wisconsin visit in October, Martin O’Malley, Social Security commissioner at the time, said staff at the agency’s Madison field office has dropped by 40% since 2019. O’Malley said he told members of Congress they should increase staffing at the agency to restore “at least an adequate level of customer service.”

The cuts the agency has announced are “exacerbating the chaos, confusion and anxiety felt by workers under siege,” LaPointe said Saturday. She added that the Trump administration and Elon Musk’s project to slash operations across the federal government “are destroying the public’s ability to access timely and effective service from the Social Security Administration, with the intent — let’s be real about their intent — of turning the American people against Social Security.”

William Townsend, president of the AFGE local at the Department of Veterans Affairs VA hospital in Madison, said the department’s plan to cut 80,000 or more positions nationwide would be detrimental to the health care of veterans counting on the agency.

AFGE also represents employees at the Transportation Security Administration. The union and the Biden administration signed a new contract in 2024, but Trump administration TSA leaders told the union last month they were canceling the contract and would no longer recognize the union.

Nevertheless, said TSA worker and AFGE Local 777 president Darrell English, the union will continue to stand up for its members’ rights while conducting a legal battle to restore their union contract. “We know it’s going to be a long fight, but we’re here,” English said at Saturday’s rally.

At the U.S. Forest Service, 24 Wisconsin employees were fired on Feb. 14 — part of a wave of thousands of “probationary” employees let go, said Carl Houtman, a union official.

Houtman works at the Forest Service Products Laboratory in Madison and is president of the National Federation of Federal Employees union local there. He is also the national negotiation chair for the union’s Forest Service Council. In an interview Monday, he stipulated he was speaking strictly as a union leader, not as a Forest Service representative.

About 170 of the Forest Service’s 672 Wisconsin employees work at the laboratory, researching the use of wood as a building material and wood chemistry for papermaking and in a variety of new applications. Most of the other Forest Service employees in the state are associated with the Chequamegon-Nicolet National Forest in northern Wisconsin.

After a series of legal challenges, a federal judge in California ordered the Trump administration to reinstate the fired probationary workers, ruling that Trump administration officials hadn’t followed required procedures.  

The fired workers returned Monday, said Houtman, including a colleague who was among those who had been dismissed.

“It’s crazy the inefficiency that has caused,” he said Monday. “They walked her out the door, took her computer and her door card, and they basically had to hire her back. In this intervening month she could have been reasonably doing her job, but the agency was forced” by the federal Office of Personnel Management, now under the Trump administration’s control, “to fire these people.”

The federal judge’s ruling requires the administration to follow the legal procedures for reducing the federal workforce. Houtman said federal workers and their unions involved in the February firing expect to learn more about the administration’s intentions in the next month.

“We anticipate about the middle of April getting an idea about what’s going on,” he said. “It’s possible that a large number of people in Wisconsin will get wiped out — we just don’t know.”

Houtman said there are concerns among employees that “this administration wants to wipe out the science arm of the Forest Service” and possibly sell most or all federally owned forest land, harming the nation’s natural resources.

Established in 1910, the forest products lab remains a vital source of research, he said. Its findings help shape codes and standards for building as well as for product manufacturing — such as a project currently underway to develop a consistent test for how recyclable consumer packaging is.

The lab also plays a role in training new scientists, he added.

“Most of the probationary employees were new hires, starting to learn wood science from us,” Houtman said. “You basically have wiped out the next generation of scientists. It’s going to do irreparable harm.”

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A 2011 photo shows an exhibit at the Franklin D. Roosevelt Presidential Library & Museum that commemorated the 75th anniversary of the signing of the Social Security Act in August 2010. (FDR Presidential Library & Museum/via Flickr)

The Social Security Administration has summarily closed a federally funded consortium of research centers, including one at the University of Wisconsin-Madison, that studied demographic trends and the impacts of policy on the federal retirement system.

Terminating the program has sharply limited the program’s research sources at a time when the Social Security Administration is poised to cut 7,000 workers, close field offices across the country and cancel the ability for people to file for benefits by telephone.

“It’s very, very frightening,” said Nancy Altman, president of the advocacy group Social Security Works. “I’ve been working on this issue for 50 years and I think this is the most destabilized I’ve ever seen the administration of Social Security.”

The UW center was one of six members of the Social Security Administration Retirement and Disability Research Consortium. The consortium was established in its current form in 2019, a successor to retirement research centers established in 1998.

The Trump administration announced Feb. 21 that the consortium was being dissolved in keeping with an executive order President Donald Trump signed Jan. 22 gutting diversity activities across the federal government.

Shutting down the consortium canceled 19 research projects that were underway at the UW’s Social Security research center, said its director, J. Michael Collins. Collins, a specialist in family economics at UW-Madison. Collins holds positions at the university’s School of Human Ecology, The La Follette School of Public Affairs and several other university offices.

Research by the center and its consortium partners in collaboration with Social Security represented an important collaboration that has helped shape policy for the 90-year-old Social Security program, Collins said. Studies on the income and expenses of older Americans, for example, have helped guide the formulas that the Social Administration uses to develop its annual cost of living adjustments.

“It really is a collaboration, and that is hard to build,” Collins said — and may be difficult to recreate.

Along with canceling the consortium agreements, the Social Security Administration has relocated its own research operations while also cutting staff.

“They’ve greatly reduced their ability to conduct research internally,” Collins said. “Why would they want to eliminate their research capacity to that degree?”

Established during the Great Depression to lift seniors out of poverty, the Social Security program is primarily funded by payroll taxes. As each generation retires, its members’ benefits are paid by the generation of workers behind them.

Social Security provides retirement benefits as well as income for people with disabilities. About 73 million people in the U.S. receive benefits from the system, according to the Social Security Administration. Three out of four are 65 or older. Another 15% are people with disabilities under the age of 65.

One project underway at the UW center when the research consortium was canceled was looking at the impact of state mandates requiring employers to provide sick leave for employees — a law on the books in about a half-dozen states. (Wisconsin is not one of them.)

That study could have provided evidence whether or not mandated sick leave policies reduce the need for future permanent disability claims. “Either way, that’s an important question for Social Security” to understand, Collins said.

Another project cut off was a study of Long Covid — the lingering collection of health-hampering symptoms reported by millions of COVID-19 patients. Understanding how the condition affects trends in work, health and disability could inform the projections Social Security actuaries must make as they look at the program’s prospects 75 years into the future, Collins said.

The UW center was also contributing research to help structure Wisconsin’s ABLE account — a savings account for people with disabilities that the state is in the process of establishing.

The UW center was launched with a five-year grant for $12 million. The grant was renewed in 2024 with another five-year grant that was supposed to be for $15 million. About $2.3 million of that has been spent, but with the termination there will be no reports or final studies, Collins said.

Altman of Social Security Works said research has been integral to the Social Security system from when it was established in the Great Depression, spearheaded in part by people with ties to UW-Madison.

“They’ve always done research to determine how the program should be structured, what the needs of the American people are, how economic security can be improved and what other countries are doing,” Altman said. “You have to be informed to have legislation that will work and have administration that will work.”

The Feb. 21 Social Security Administration press release announcing the termination of the research consortium said the research center agreements “included a focus on research addressing DEI in Social Security, retirement, and disability policy” and that ending them was in line with ending “fraudulent and wasteful” initiatives.

“The reality is that Social Security is gender neutral, racially neutral,” Altman said. Nevertheless, she said, various social differences are important in understanding how disparate impacts might affect the long-term operation of the program. For example, an accurate projection for the program’s resources and ability to pay benefits in the future requires considering the differing labor force participation rates of men and women.

Altman said contrary to the claims of the Trump administration, its actions with the Social Security Administration are “the opposite of rooting out waste, because it’s creating it.”

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Vivent Health conducts tests for HIV and other sexually transmitted infections. Federal funds that cover the cost of those tests and other HIV prevention services are being considered for drastic reductions. (Photo courtesy of Vivent Health)

Wisconsin stands to lose at least $1.2 million a year to help prevent the spread of HIV if the federal government follows through on reported plans to drastically cut HIV prevention.

The Wall Street Journal reported this week that the administration of President Donald Trump was planning sharp reductions at the U.S. Centers for Disease Control and Prevention (CDC) and the Division of HIV Prevention housed there.

The U.S. spends about $1.3 billion annually on HIV prevention. That includes just over $1.2 million that goes to the Wisconsin division of Vivent Health, a multistate nonprofit specializing in care for people who have HIV or are at risk of being infected.

Vivent Health’s federal HIV prevention grant comes through the Wisconsin Department of Health Services. A department spokesperson said the agency could not provide the total it receives each year in federal HIV prevention funds by the end of the day Thursday.

At Vivent, the money has helped reach tens of thousands of people across the state to help them avoid infection with the human immunodeficiency virus, said Bill Keeton, Vivent’s vice president and chief advocacy officer.

The funds are used for outreach to people who are vulnerable for HIV, he said. They cover the costs of testing for HIV and other sexually transmitted infections. They also cover services to help people who are candidates for medication that can prevent HIV infection as well as medication after being exposed to the virus.

“We do thousands of tests a year throughout the state,” said Keeton. Vivent has 10 clinics around in Wisconsin and additional mobile clinics for outreach to people who use drugs. Drug use can heighten the risk of transmitting HIV, he said.

In addition, HIV prevention funds cover condom distribution and other methods of  harm reduction, Keeton said, along with education to help people learn how to use condoms properly and other ways to protect themselves from HIV infection.

“These are services and programs that are designed to reach out and provide education, testing and resources  designed to prevent HIV from occurring,” Keeton said. “These dollars that we get from the federal government comprise the lion’s share of the resources we get to do this work.”

In 2024, Vivent in Wisconsin provided 2,200 HIV tests, about half that number for Hepatitis C and nearly 1,900 for other primary sexually transmitted infections. The organization distributed 300,000 condoms and 2.7 million clean syringes for drug users. 

Vivent assisted 369 people with navigating the decision to use pre-exposure prophylaxis, or PrEP, daily medication to ward off the HIV virus in a person who is not already infected. Vivent has 678 patients in Wisconsin using PrEP.

The CDC has reported HIV infections have fallen by 12% nationally, from 36,300 in 2018 to 31,800 in 2022. Cutting off prevention funds could reverse that trend, Keeton said, and would be a setback to efforts to end HIV — an objective that has been embraced by the last three presidential administrations, including Trump’s in his first term.

“New diagnoses will increase,” Keeton said. “New transmissions will occur — unfortunately, that means people will take on $500,000 in lifetime health care costs managing their HIV.”

People will get sick, deaths will increase along with the difficulty of managing chronic illness that would otherwise be avoidable, he said, along with increasing health costs.  

“American taxpayers and health care consumers will bear the brunt of these shortsighted policy changes,” Keeton said.

With continued support, however, those outcomes can be avoided. “We have the tools, we have the science, we have the interventions that can work to end HIV,” he said. “What we lack is the resources.”

Keeton told the Wisconsin Examiner that Vivent and other providers of HIV-related care started getting word earlier this week that the HIV prevention division was “getting a lot of attention” in the White House.

He acknowledged that replacing the federal money would be a challenge given the $1 billion price tag it would carry nationally. Other organizations involved in HIV health care and advocacy are looking at mounting a court challenge if the Trump administration follows through on the proposal to cut the prevention programs.

For now, however, Vivent’s focus is on heading off the potential cuts. Keeton said the organization is advocating with members of Congress and encouraging them to “weigh in with the administration” to keep prevention programs funded. 

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The Blatnik Bridge under construction in 1958. (Minnesota Department of Transportation)

Gov. Tony Evers is leaning on U.S. Transportation Secretary Sean Duffy to release stalled federal highway money along with $78 million in promised funding to build out a network of electric vehicle charging stations in Wisconsin.

The governor’s office on Thursday released a letter Evers sent Duffy last week, urging the former Wisconsin congressman “to take immediate action to end the unlawful and harmful obstructions to federal approvals and federal funding for crucial transportation projects across the nation and here in your home state of Wisconsin.”

Federal delays will slow down projects across the state, Evers wrote, including a railroad bypass in Muskego, outside Milwaukee, that is planned for improved freight movement; a grant for highway improvement in Menominee County that will help forestry shippers; and numerous rural road and bridge projects in Wisconsin.

A pause in the National Electric Vehicle Infrastructure (NEVI) program — part of the bipartisan infrastructure law enacted during the Biden administration — is “threatening at least 15 already-approved electric vehicle infrastructure projects for private entities, utilizing approximately $7 million in NEVI funding, including multiple projects located in the congressional district you used to represent in the U.S. Congress,” Evers wrote.

Duffy represented Wisconsin’s 7th Congressional District, covering the northwestern part of the state, until he stepped down in late 2019.

“More than $56 million that Wisconsin has been allocated in future rounds of the NEVI program is also at risk due to the uncertainty caused by unnecessary delays at USDOT,” Evers wrote.

“These delays and obstructions hurt Wisconsinites and Wisconsin communities,” he added. “As a fellow Wisconsinite, I urge you to end these obstructions and support states in implementing lawful federal funding and needed approvals.”

Evers’ letter follows one written March 4 from the American Association of State Highway and Transportation Officials also calling for an end to the delays.

Federal dollars awarded to states according to established federal formulas are “legally binding obligations,” wrote the association’s president, Garrett T. Eucalitto.

The funds go to repay states for expenses they’ve already incurred under the terms set by the federal highway program. That letter demands reimbursement requests “be paid immediately for construction and related costs already incurred.”

After President Donald Trump took office Jan. 20, he issued executive orders halting the distribution of funds as well as other federal administrative actions across a wide range of federal programs. The orders have led to a raft of lawsuits challenging them.

Highway programs are among those caught up in the Trump administration’s freezes. In addition to financial payouts owed the states, the administration has also put a hold on issuing approvals, such as environmental reviews required by law, related to pending projects.

“These interruptions—whether directly or indirectly related to funding—have the effect of freezing essential construction and planning activities including those involving roadway and bridge projects,” wrote Eucalitto, who is also the Connecticut transportation commissioner. “Delays like these leave state DOTs at serious risk of losing the upcoming construction season for many projects. This will not only add to overall costs to the American people but also deprive communities from receiving those economic, safety, and quality of life benefits.”

The late Jonathan Brostoff, photographed during his time as a state representative in the Wisconsin Assembly. The Assembly and state Senate approved a resolution in Brostoff's memory March 18, 2025. (Photo by Greg Anderson)

Editor’s note: If you or someone you know is contemplating suicide, call or text 988 or chat 988lifeline.org.

On a day of contentious legislative debates and an annual ceremonial custom to recognize Wisconsin’s tribal communities, members of the Wisconsin Legislature united to remember a former colleague this week.

More than one lawmaker made clear it was an event they fervently wished would not have been necessary.

Former State Rep. Jonathan Brostoff took his own life on Nov. 4, 2024, with a gun he had purchased just an hour earlier. He was 41 years old. Brostoff served in the Assembly for eight years, leaving in 2022 after he was elected to the Milwaukee Common Council. 

Tuesday, the Wisconsin Assembly and Senate each voted unanimously to pass a resolution in Brostoff’s memory. The votes were cast in each chamber in a two-part secular memorial service of sorts, with heartfelt eulogies from Brostoff’s former colleagues. Many wore green ribbons in recognition of mental health awareness.

“Jonathan was well known for his honesty,” said Assembly Minority Leader Greta Neubauer. “He never held back if he thought we were heading in the wrong direction or missing something important — often crossing his eyes and staring you down. With Jonathan, you always knew where you stood, and he helped us grow as a caucus and as individual legislators.”

Sign language bill

One story was told repeatedly: Brostoff’s campaign to pass a bill that would tighten state standards for American Sign Language interpreters. The legislation established a tiered licensing system to ensure that people interpreting between doctors and patients or lawyers and clients had a higher level of skill, Brostoff said at the time.

Frustrated when the legislation stalled, he vowed not to cut his hair until it was signed into law. In an April 2019 Wisconsin Public Television interview, Brostoff — who normally favored a close-cropped cut — sported a curly afro that surrounded his face.

It wasn’t a protest, exactly, he told interviewer Frederica Freyberg. “Especially for the deaf community, it’s a visual indicator saying I’m with you and we’re not going to stop until we get this done,” Brostoff said.

“I would send him pictures of Richard Simmons,” Rep. Lisa Subeck said on the Assembly floor Tuesday. “He sent me back pictures of Bob Ross.”

Gov. Tony Evers signed the bill in July 2019. Sen. Dianne Hesselbein was a member of the Assembly at the time. In the Senate Tuesday, she recalled Brostoff’s Assembly floor speech on the day the measure finally passed.

“He signed the entire thing, and it was long, and he could do sign language of the entire thing without looking at notes,” Hesselbein said. “He knew what he wanted to say, and he was careful, and there was silence, absolute silence and respect.”

Colleagues described the diminutive Brostoff as intense, funny, passionate about causes and smitten with his four children.

In the Assembly, Rep. Jodi Emerson recalled hearing Brostoff break into the “Itsy bitsy spider” song while changing a diaper in the midst of one of their phone calls discussing their work in the Capitol.

Those phone calls were a regular feature of her drives home to Eau Claire from Madison at the end of a busy week in the Capitol. She said she spoke before Tuesday’s session with Brostoff’s father about those calls.

“I was thinking about that last week, and really wish I would have been able to talk to Jonathan last week,” Emerson said. “I had my own version of a conversation with him,” she added wistfully, “but the reception wasn’t clear from wherever he was.”

Passion and compassion

Brostoff was first elected to the Assembly in 2014. Rep. Christine Sinicki related a memory from Brostoff’s campaign that year. She had not endorsed him in the four-way Democratic primary, and at a neighborhood parade both attended that summer, a Brostoff volunteer sidled up to her and made a “snide remark,” she said.

“I went over to Jonathan and I said, ‘I really did not appreciate that.’ The next day, that volunteer was at my door, apologizing,” Sinicki recalled. “That was the kind of man that Jonathan was. He had so much integrity.”

Rep. Supreme Moore Omokunde, who met Brostoff when both were at the University of Wisconsin-Milwaukee, nicknamed him “JoBro.” But Brostoff had his own self-applied nickname: Honey Badger, after a viral YouTube video and internet meme — “Honey Badger Don’t Care.”

“He’s getting into like, messing with bees and snakes and all types of things, because Honey Badger don’t care and he’s gonna do what he wants to do anyway. That’s Jonathan Brostoff,” Omokunde said.

Brostoff was passionate about the causes he adopted, his colleagues agreed.

Omokunde referred to a comment moments earlier, when Subeck “called him tenacious.” He paused. “However, let’s be honest,” he continued. “Jonathan was annoying … and everybody in this body who ever came across him knows he was annoying.”

Affectionate laughter greeted his candor.

“Sometimes he could make me crazy,” Sinicki said. “That’s only because he had such passion and such conviction for the things that he wanted that nothing was going to change his mind, nothing at all.”

For all his fervor as a Democratic lawmaker, Brostoff endeared himself to Republican colleagues.

GOP Rep. Paul Tittl found Brostoff, who was Jewish, to be “a deeply spiritual person” who asked to attend a regular Capitol Bible study that Republican lawmakers, all Christian, organized. “He always added to the  conversation.”

In the Senate, Sen. Andre Jacque recalled both Brostoff’s participation in the Bible study program as well as his enthusiasm for the gaming community. “One thing that always struck me about Jonathan is that he was somebody who was unafraid to put himself out there and have conversations,” Jacque said. “I’m going to miss him.”

Vetting candidates and repairing the world

Brostoff took it upon himself to vet prospective candidates.

One was Rep. Robyn Vining, ahead of her first election to the Assembly in 2018. At a Colectivo Coffee near UWM, “Jonathan grilled me with questions, and was very clear on his priorities,” Vining said. “He was also very clear that he would not be supporting me if I did not pass his test.”

They talked. “What I didn’t realize was that after I did pass that test, Jonathan was going to jump on board and fight for me, which is exactly what he did,” Vining said. “We finished my vetting, and he said, ‘OK, let’s go knock some doors.’”

First-term Rep. Sequanna Taylor was another such candidate. Friends from before she decided to run for the Assembly, she and Brostoff and their families were dining together early in her campaign.  

“In the middle of him eating, he was like, ‘Give me your spiel,’” Taylor said. She was caught off guard, but he persisted.

“And so, you know, I went into my little spiel, and he took a moment and he looked at me. He was like, ‘You’ll be good,’” she said. “Then he was like, ‘Next time somebody asks you this, though, I want you to be able to say this in 30 seconds flat.’”

Brostoff was always straightforward, Taylor said. “You never had to worry about a gray area with JoBro, because there was no gray area with him.”

Sen. LaTonya Johnson recalled a riot in Milwaukee’s Sherman Park neighborhood, part of her district, after an officer-involved shooting 10 years ago. She was visiting the scene the second night of unrest — “I was not brave enough to go that first night,” she confessed — when Brostoff showed up with big packs of chewing gum.

“This is de-escalation gum,” Johnson recalled him saying. She was skeptical, “but lo and behold the longer we were out there, when things became confrontational, Jonathan would walk up and he said, ‘You want gum?’ And people would stop, and they would take it.” And, she said, it helped redirect people’s attention.

Subeck said she and Brostoff were two of three Jewish members of the Assembly when they both took office in 2015. She described the Jewish value of Tikkun Olam, to repair the world.

“This is a concept that is built on our guiding principles of social justice, of making the world a better place, of taking care of our world and taking care of its people,” Subeck said. “And Jonathan, more than just about anybody else I know, lived up to that principle.”

Acknowledging struggles, seeking change

Brostoff was candid about his own mental health history, Subeck added. “He brought his own struggles, and he shared his very personal struggles with all of us here in the Legislature, and I believe that they made me, and hopefully made many of you, a better legislator.”

There were also calls to address directly how Brostoff’s life had ended.

“I hope that we will recommit ourselves to preventing needless deaths in this state and to doing what Jonathan would want us to do, and enacting policies that will save other lives, even though we are too late to save his,” said Sen. Mark Spreitzer. “I will miss my friend Jonathan Brostoff, may his memory be a blessing.”

“Jonathan’s story is one that too many Wisconsin families know the pain of,” said Sen. Jodi Habush Sinykin. “In 2022 alone, 530 Wisconsinites died by suicide with firearms.”

Habush Sinykin read to her colleagues a statement from Brostoff’s widow, Diana Vang-Brostoff, and his parents, Alan and Phyllis Brostoff. Earlier, Rep. Deb Andraca read the same statement in the Assembly.

“Once again, we want to thank the Wisconsin Legislature for today honoring the memory of our husband and son,” the statement began.

Their statement recounted the circumstances of Brostoff’s death as well as a commentary Brostoff wrote in October 2019 that was published in the Wisconsin State Journal and Urban Milwaukee about his failed suicide attempts as a teenager. Brostoff had just served on a Legislature task force on suicide prevention. 

They quoted Brostoff’s column, in which he wrote that access to a firearm for someone contemplating suicide “is like having your own personal permanent delete button.” In the essay he had acknowledged that if had had access to a gun at the time of those teenage attempts to kill himself, “I would not be here today.”

“Our family believes that had Jonathan been required to wait perhaps a day or two or any amount of time after entering that gun store last November to make that purchase, his life may have been spared,” their statement concluded.

“And so now, in the interest of saving other lives at risk for mental health issues, domestic violence or other circumstances, it is our hope that you find the collective will to reinstate a reasonable waiting period for finalizing gun purchases. Doing that would enhance your thoughtful and kind honoring of his memory today.”

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The Wisconsin Assembly voted along party lines Tuesday to pass legislation penalizing counties with sheriff's departments that don't cooperate with ICE, the federal Immigration Customers and Enforcement agency. (Photo via ICE)

Legislation passed the Assembly Tuesday that would claw back state aid from counties where the sheriff doesn’t cooperate with the federal Immigration and Customs Enforcement service (ICE).

The legislation would require sheriffs to check the citizenship status of people being held in jail on felony charges and notify federal immigration enforcement officials if citizenship cannot be verified.

The state Senate, meanwhile, approved a bill that would block a judicial investigation of a police officer involved in the death of a person unless there’s new evidence or evidence that has not been previously addressed in court.

The immigration-related bill, AB 24, passed the Assembly on a straight party-line vote.

In addition to requiring citizenship checks, the bill would also require sheriffs to comply with detainers and administrative warrants received from the federal Department of Homeland Security for people in jail. Counties would be required to certify annually that they were following the law and would lose 15% of their shared revenue payments from the state if they were not.

Proponents described the measure as enhancing safety.

“We have the opportunity to emulate in many ways the best practices that are already happening across our country,” Assembly Speaker Robin Vos (R-Rochester), the bill’s author, said at a news conference before the floor session. “We have seen since [President] Donald Trump took office that we have had a dramatic reduction in the number of illegal crossings that are happening at the southern border.”

Opponents said the bill would divert local law enforcement resources while driving up mistrust and fear among immigrants, regardless of their legal status.

Rep. Ryan Clancy (D-Milwaukee) said the legislation was “big government” and interferes with local counties’ policy decisions. It also undermines the presumption of innocence for a person charged with a crime, potentially strains resources for local jails, and could lead to holding people “longer than is necessary,” he said.

But he added that those weren’t his top reasons for opposing the bill.

“I’m voting against this because it’s wrong, because this legislation rips people from our communities and families based on the mere accusation of a crime, because our Republicans colleagues’ eagerness to make themselves tools in Trump’s attacks on immigrants, refugees, visitors and those who oppose him is vile,” Clancy said.

On the floor, Vos replied that he agreed with Clancy about the presumption of innocence, and that he also agreed with other lawmakers who said the vast majority of immigrants are not guilty of any crime.

“But I would also say that there is a burden of proof on both sides,” Vos said. “It’s not entirely on just the side of the government to ensure that you follow the law.”

Claiming broad bipartisan support for the measure, Vos said Democratic opposition was “clearly out of step, even with your base.”

Rep. Christian Phelps (D-Eau Claire) responded that  he hasn’t heard constituents ask for the legislation or anything like it.

“They are asking us explicitly to make life tangibly easier for working class Wisconsinites,” he said, “and they have not been asking me to engage in redundant acts of political theater to satisfy the whims of a rogue president engaging in a campaign of intimidation and mass deportation that includes constituents in western Wisconsin.”

Senate approves John Doe exemption

The state Senate voted Tuesday to pass a bill that makes an exemption to the state’s John Doe law for police officers involved in a civilian’s death.

In Wisconsin, if a district attorney chooses not  to file criminal charges,  a judge may hold a hearing — known as a John Doe investigation — on the matter and file a complaint based on the findings of that hearing.

The legislation, SB 25, “simply says, if that case goes before a DA, and then the DA  justifies their actions and they are deemed to be innocent of any wrongdoing … that case is closed and it is in a file never to be seen again,” said the bill’s  author, Sen. Rob Hutton (R-Brookfield), on the Senate floor.

Hutton said the legislation allows a judicial investigation to proceed, however, “if a new piece of evidence is presented that wasn’t known before, or an unused piece of evidence is found.”

But Sen. Dora Drake (D-Milwaukee) questioned carving out an exemption to the state’s John Doe law. “This bill does not apply to any other crime in Wisconsin,” she said.

Lawmakers, Drake added, should do more to address “the environment and the situations” that have led to officer-involved deaths. 

Sen. LaTonya Johnson (D-Milwaukee), said testimony at the bill’s public hearing discussed only two attempts to invoke the John Doe proceeding after a prosecutor declined to file charges in an officer-involved death — and one of them involved former Wauwatosa police officer Joseph Mensah, who killed three people in five years.

Allowing for a John Doe investigation in an officer-involved death “protects the public,” Johnson said. “What it does is put a second eye on those cases that deserve a second look.”

The Senate passed the bill 19-13. Two Democrats, Sens. Kristin Dassler-Alfheim (D-Appleton) and Sarah Keyeski (D-Lodi), voted in favor along with 17 Republicans. Sen. Eric Wimberger (R-Oconto), who also opposed the bill in committee, joined the remaining Democrats who voted against the measure.

Reversing DPI testing standards: On a vote of 18-14 along party lines, the Senate concurred in an Assembly bill that would reverse a change that the Department of Public Instruction (DPI) made last year to testing standards.

AB 1 would revert the state’s testing standards to what they were in 2019 and link standards to the National Assessment of Educational Progress (NAEP).

Republicans voting for the bill said that the DPI change “lowered” standards — a claim DPI and Democrats rejected.

Direct primary care passes — but Democrats object: The Senate also voted 18-14 on party lines to pass SB 4, legislation that would clear the way for health care providers who participate in direct primary care arrangements. Under direct primary care, doctors treat patients who subscribe to their services for a monthly fee as an alternative to health insurance for primary care.

An amendment Democrats offered would have added a list of enumerated civil rights protections for direct primary care patients. That list was in a direct primary care bill in the 2023-24 legislative session that passed the Assembly but stalled in the Senate when two organizations protested language protecting “gender identity.”

After the amendment was rejected, also on a party-line vote, Democrats voted against the final bill.

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Tribal members chant and drum in a ceremony in the Wisconsin Capitol rotunda Tuesday before the State of the Tribes address in the Wisconsin Assembly chamber. (Photo by Erik Gunn/Wisconsin Examiner)

Pride of heritage, “uneasiness surrounding the recent changes at the federal government level,” praise for Gov. Tony Evers and an appeal to adopt provisions in his budget directed toward Wisconsin’s 11 tribal nations were among the themes  of the State of the Tribes address in the Capitol Tuesday.

“Our government-to-government relationship is forever transforming the work we do together. It contributes to shape our communities for everyone’s benefit,” said Thomas Fowler, chair of the St. Croix Chippewa Indians of Wisconsin, this year’s speaker for the annual event.

Fowler’s 50-minute speech celebrated the treaties going back nearly 200 years that, he said, established Wisconsin’s “reservations and territories in exchange for thousands of miles of our historical homelands and began the trust relationship between the federal government and tribes today.”

He highlighted the tribal nations’ initiatives and independence, but also their distinctive relationship with the United States.

“Tribal nations each have their own governments, languages, stories, traditions, values, beliefs and ceremonies,” Fowler said. “We operate our own health care facilities, law enforcement agencies, educational systems, social services and more. Our tribal people are both citizens of the United States and members of their own sovereign nations, and we are very proud of this.”

But he also spoke to historic injustices, the work needed to right past wrongs and the continuing education required to understand indigenous identity.

Fowler praised Wisconsin’s Department of Administration — the executive branch agency that most directly deals with Wisconsin’s tribal nations — for its description of that identity. “Tribal members are not racial minorities. We are citizens of our own tribal nations,” he said.

“Gov. Evers has repeatedly acknowledged the importance of respecting tribal nation sovereignty and has committed to empowering tribes to manage their own affairs and resources,” Fowler said.

Fowler called on lawmakers to enact a series of bills, including legislation granting tribes a larger role in licensing teachers and legislation requiring school districts to report the number and ages of children enrolled who have tribal affiliations — the latter of which passed the Assembly later Tuesday.

He also urged them to advocate for passage of a federal act calling for a truth and healing commission on boarding schools where Indian children, taken from their families, endured abuse for decades, their cultural heritage denied, and where many died.

The act, which passed the U.S. Senate at the end of last year but “continues to sit” in the U.S. House of Representatives, “seeks to uncover the U.S. government’s role in Indian boarding school systems,” Fowler said. “The tragedy of boarding schools requires remembrance, so that the spirits of our ancestors are not lost or forgotten.”

That history has contributed many ills, he said, including  family separations, drugs and violence within communities, disruption of Native American parenting and damage to the health of families.

Tribal communities such as the Ojibwe are also looking to revitalize their cultural connections, he said, including recovering their native languages.

“I encourage all of us in this room to push further in our communities, to move into a place of normalized use of our language amongst community members,” Fowler said.

He also made a direct pitch for Wisconsin to legalize medical cannabis — a plant cultivated by indigenous peoples as an herbal medicine, treating pain, inflammation and “addressing spiritual maladies.” Medical cannabis also holds the promise of “moving people off highly addictive drugs, drugs which are killing our people,” he added.

Fowler spoke as well of missing and murdered indigenous women, a phenomenon  “too common for our people” but still inadequately acknowledged.

“We need more state and federal resources,” he said. “We need adequate funding allocated to serve our understaffed police departments, more cohesive law enforcement training, strengthened alert systems, increased funding for tribal programs that provide shelter and increased mental health resources.”

Fowler urged lawmakers to do more to address water quality in the state, stiffening regulations on agricultural chemical runoff as well as threats from pollution, climate change and habitat loss. He called the December spill of 69,000 gallons of oil from Enbridge Line 6 “disheartening,” endangering the land, waterways, food, medicine and cultural practices.

“Our partnership with the state and the protection of our and stewardship of our lands has never been more important,” Fowler said. “The challenges are too vast to tackle alone. We must unify to secure the highest level of environmental protection possible.”

Fowler saved his last words for the scores of tribal members who watched from the back of the Assembly chamber and the galleries above it.

“We are not broken,” he told them. “We are strong and we will continue to rise.”

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Spending by candidates and outside groups combined will break records again in this year's Wisconsin Supreme Court race. (Getty Images)

Spending in the 2025 Wisconsin Supreme Court race could be two times as high as the record-breaking $51 million spent in the last election for a seat on the state’s highest court, and outside spending is dwarfing what the candidates themselves have raised so far this year.

The race, between Dane County Judge Susan Crawford and Waukesha County Judge Brad Schimel, will determine whether the Court maintains a 4-3 liberal majority that flipped two years ago or reverts to a conservative majority that was in place for more than a decade previously.

“We’re watching money just flood from out of state into Wisconsin,” said Nick Ramos, executive director of the Wisconsin Democracy Campaign, in a briefing Monday about campaign finance trends with two weeks to go before Election Day April 1. “It would not be crazy to say that this race could be double what the last Supreme Court race was, especially with the trends and especially with the track that we’re on.”

Crawford is ahead in fundraising by the campaigns themselves, raising $7.36 million. Among her donors, 35 have given the maximum Wisconsin allows an individual to donate to a single candidate, $20,000.

Schimel’s campaign has raised $4.93 million. There are 47 donors who have given him the maximum allowed under Wisconsin law.

The Court race is officially nonpartisan, but over the last couple of decades candidates have divided along partisan as well as ideological lines. Crawford’s campaign has received $3 million from the Democratic Party of Wisconsin’s Political Action Committee (PAC), and the Wisconsin Republican Party PAC has given $1.68 million to Schimel’s campaign.

Independent expenditures, however, have so far favored Schimel over Crawford by roughly 3 to 1. Independent expenditures, which explicitly favor or oppose a candidate, are spent by groups outside the campaigns.

Independent groups supporting Crawford have spent $7.79 million on pro-Crawford or anti-Schimel advertising — as much as her campaign has raised so far. But independent groups’ spending on Schimel’s behalf is almost three times that: $21.45 million.

With 15 days until Election Day, the independent expenditure total in the 2025 race is more than twice what it was at the same point in the 2023 state Supreme Court contest: $29.24 million compared with $14.4 million.

“Credit” for the trend goes to the U.S. Supreme Court ruling in the Citizens United case that unleashed corporate and union spending on campaigns and to a 2015 rewrite of state law that brought on “this wild west of campaign spending here in Wisconsin,” Ramos said.

The data also shows the outsized influence of billionaires on state politics, he said. Among the biggest spenders in the race are groups funded by Elon Musk and Richard Uihlein, Wisconsin Democracy Campaign reports. 

The top two biggest-spending independent groups favoring Schimel are linked to billionaire Musk: America PAC, spending $6.53 million so far, and Building America’s Future, spending $4.54 million, according to the Democracy Campaign.

Three other pro-Schimel organizations have been funded by Uihlein, owner of the office supplies company Uline: Fair Courts America, Americas PAC IEO, and American Principles Project PAC. Another Uihlein organization, Restoration PAC has also contributed to the American Principles Project PAC, according to the Democracy Campaign.

Launched 30 years ago, the Wisconsin Democracy Campaign tracks political spending in the state. The nonpartisan organization also promotes campaign finance reform as well as voting rights and access, along with other pro-democracy policies.

Ramos said voters shouldn’t let the immense sums that a few are plowing into the race discourage them from going to the polls or to believe their vote won’t matter. “At the end of the day, money does not vote, people do, and your power and your voice is that vote,” he said. 

Early voting starts Tuesday in Wisconsin, and the Democracy Campaign is taking part in campaigns to encourage people to vote early and “for folks to just continue to be civically engaged,” Ramos added. 

The Democracy Campaign also tracks spending on issue ads — advertising that does not include direct messages to vote for or against a candidate, but highlights information that paints candidates in a favorable or unfavorable light.

Issue ad spending is more difficult to track, and donors behind issue ad spending aren’t required to be disclosed under Wisconsin law. Total issue ad spending data will probably not be available until the summer, said Molly Carmichael, the Democracy Campaign’s communications director.

“Phony issue ads flood our airwaves with disinformation and, somehow, have even less reporting requirements than other forms of spending,” said Ramos. “It’s another part of our unregulated, unruly money in politics problems we’re going to need to clean up.”

One set of issue ads in the Court race has come under scrutiny for masquerading as a pro-Crawford campaign while it’s funded by a conservative group with ties to Musk.

The Facebook and Instagram ads as well as related text messages “are labeled as coming from a group called Progress 2028 and are made to look like authentic messages of support” for Crawford, the Associated Press reported March 5. But records for the ads showed they were underwritten by a conservative PAC for which Musk is a major contributor, according to the Wall Street Journal.

The ads describe Crawford as a “progressive champion,” the AP reported, while they focus “on hot-button issues” and use language “that potentially diminishes her standing with moderate or conservative voters.”

High court spending dwarfs superintendent race

Spending in the hotly contested race for the office of state superintendent is just a fraction of the money being spent on the state Supreme Court race. That election will choose the person to head the Wisconsin Department of Public Instruction (DPI).

Incumbent Jill Underly has raised $139,495 as of Monday, according to the Wisconsin Democracy Campaign. Kinser, a former charter school leader and school choice lobbyist, has raised more than double that, $316,316.

As with the high court race, the DPI contest is officially nonpartisan, but each candidate has been favored by one particular political party. The Democratic Party of Wisconsin has given Underly $56,118 from its PAC. The Republican Party has given Kinser $2,500.

Kinser has also benefited more from independent expenditures, with $40,518 spent to promote her or oppose Underly. Independent spending in favor of Underly or opposing Kinser has been about half as much, $23,177.

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In a stairwell in Van Hise Hall at the University of Wisconsin-Madison, Jon Shelton displays messages from UW system employees urging UW's Board of Regents to authorize campuses to hold discussions with employees and their unions about salaries and working conditions. AFT's Autumn Pickett records Shelton as he discusses the campaign. (Photo by Erik Gunn/Wisconsin Examiner)

Universities of Wisconsin employees affiliated with the American Federation of Teachers are calling on the UW Board of Regents to formally authorize chancellors in the system to meet with employees and the union to discuss pay and working conditions.

On Friday, about two dozen AFT members and supporters gathered outside Van Hise hall on the UW-Madison campus, where they attempted to deliver a letter to Board of Regents President Amy Bogost. The letter urges Bogust to put on an upcoming regents meeting agenda employees’ request for a formal discussion process with university chancellors to address wages and working conditions.

The group was unable to get access to the floors where the Board of Regents offices are located in order to deliver the letter in person. They left copies of their letters with campus police officers, WORT radio reported. 

The UW system’s communications director did not respond Friday to a request for comment. 

UW employees lost all union rights under Act 10, the 2011 law that stripped most collective bargaining rights for public employees except for some law enforcement officers and firefighters. 

Most public employee groups retained the right to formal union representation with an annual certification process. But except for graduate student teaching assistants, for UW employees even the right to certify a union representative was wiped out, said Jon Shelton, incoming president of AFT-Wisconsin and a UW-Green Bay faculty member. 

“We have no avenue to talk about salaries and working conditions,” Shelton said.

AFT members are not seeking a formal collective bargaining relationship — something outlawed under Act 10 — but in its place, a formal structure of meetings where employees can air their concerns about their jobs, Shelton said. The AFT’s request includes a detailed proposal on what that structure would look like. 

For other public employee groups, the 2011 law limits collective bargaining to the subject of wages, and limits wage increases to the rate of inflation. To cover a wider range of workplace issues, some Wisconsin public employers and  unions have engaged in “meet and confer” relationships through which they discuss pay and working conditions more broadly. 

Act 10 permits meet and confer relationships so long as they are not collective bargaining, Shelton said. “Many tech college unions have it,” he said. “Many K-12 [school] unions have it.” 

Where meet and confer relationships are in place, “it improves everything,” Shelton said. “It improves outcomes for students. It improves the feelings of morale for workers, it improves workplace conditions and improves retention.” While not the same as collective bargaining it’s “like a conduit … for people, faculty and staff, to channel their voices.”

Shelton said chancellors at nine UW campuses have either ignored or rejected AFT groups’ requests to discuss meet and confer arrangements. 

The campaign to bring meet and confer relationships to some campuses has its roots in reductions in academic staff at UW Oshkosh and on other campuses a couple of years ago. 

“No one in our union is saying that nothing can ever be cut. We understand the reality of the situation,” Shelton said. “But chancellors are just sort of unilaterally making these decisions.” 

Without “a seat at the decision-making table, then our [campus] administrations are going to make decisions that are going to disadvantage our students,” he added.

“There’s really a feeling across the UW system that faculty, academic staff and university staff are all overworked, under-compensated and really need to have a voice,” Shelton said.

“Positions are not being filled very intentionally,” said Neil Kraus, a UW-River Falls professor and president of the AFT union on that campus, “and the UW system is basically implementing the Republicans’ higher ed agenda, which is to narrow the curricular offerings …  massively increase online education and buy as much tech as possible. Those things are contrary to the interests of our students and our communities.”

The return to the White House of President Donald Trump after the November 2024 election has also posed “pretty existential threats to public higher education,” Shelton said — such cuts to longstanding research grants that could slash university resources.

“If that happens, we all need to be working together to make sure that we’re preserving student learning outcomes and preserving our publicly important research,” Shelton said. “At a time like this, it’s never been more important that administration and faculty and staff, representing their unions, are on the same page and defending the public education system and making sure things are good for every worker.”

Nearly 200 AFT members from UW campuses across the state have written to individual regents, asking them to address their call for a meet-and-confer relationship, according to the union.

“The regents, up to this point, some of them haven’t been as willing to have conversations about this as we would like,” Shelton said.

The refusal by chancellors to engage the proposal has led him to believe there may be a broader policy directive “telling chancellors not to do this,” Shelton aid. Regents are ultimately responsible for running the UW system, he added, “and so we can most definitely ask them to pass a policy to basically obligate our chancellors to do it.” 

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Juli and Katie McGuire pack apples at Blue Roof Orchard in Belmont, Wisconsin. Blue Roof is among the producers that took part in the Local Food Purchase Assistance Program, now canceled by the Trump administration. (Photo by Sharon Vanorny/Courtesy of Wisconsin Farmers Union)

The U.S. Department of Agriculture has abruptly stopped a program that has helped more than 280 Wisconsin farmers move their products to local food banks around the state, to the consternation of participating farmers.

On Tuesday, Gov. Tony Evers in a press release berated the administration of President Donald Trump for “trying to walk back promises to Wisconsin’s farmers and producers” and urged the administration to restore the 2025 Local Food Purchase Assistance program.

Funding for the program was approved and signed into law “years ago,” Evers said.

Over the past two years, 289 Wisconsin farmers took part in the program, distributing $4 million worth of food products across the state, said Julie Keown-Bomar, executive director of the Wisconsin Farmers Union, and participants were looking forward to continuing for a third season.

“It’s very disturbing that the federal government would renege on a federal contract that was already approved by Congress,” Keown-Bomar said in an interview.

“It was an enormous benefit to the farmers who counted on those purchases,” Keown-Bomar said. The program helped farmers have some certainty about their income, she added, and some hired new employees to handle the added production and distribution of goods.

“It really helped strengthen the food distribution system and create local food networks that were not there before,” she said.

Along with the Local Food Purchase Assistance program, the USDA told school nutritionists on Friday it would end a companion program that connects farmers with local schools. Politico reported Monday on the cancellation of both programs.

Politico quoted a USDA spokesperson who said funding announced in October “is no longer available and those agreements will be terminated following 60-day notification.” The unnamed spokesperson said the programs “no longer effectuate the goals of the agency.”

Evers’ office said the loss of the two programs would cut off farmers nationwide from more than $1 billion in support and would cut “Wisconsin’s promised funding by nearly $6 million.”

“The Trump Administration must stop turning their backs on America’s Dairyland and betraying our farmers, producers, and agricultural industries by trying to gut funding Wisconsin’s farmers and producers were promised,” Evers said.

He also took the administration to task for  tariffs on goods from Canada and Mexico, now on hold until early April.

“With President Trump’s 25 percent tariff taxes that are going to cause prices to go up on everything from gas to groceries and his escalating trade wars that could affect our farmers’ and producers’ bottom lines, these reckless cuts to critical federal programs couldn’t come at a worse time,” Evers said.

The local food programs marked the second time in less than a month that Wisconsin politicians have pushed back on Trump administration agriculture policies.

On Feb. 26, U.S. Democratic Sen. Tammy Baldwin wrote to USDA Secretary Brooke Rollins demanding that the department restart suspended grants for dairy farmers under the Dairy Business Innovation initiative. The program, begun in the 2018 Farm Bill, provides aid to dairy farmers to diversify and market products as well as expand their businesses.

“The uncertainty surrounding DBI funding is incredibly alarming because it threatens the future of many dairy businesses that were promised this support to grow and remain competitive,” Baldwin wrote in her letter to Rollins. She added that the “unnecessary and ill-advised disruption could have widespread economic consequences, particularly, for small dairy operations in Wisconsin that drive our rural economies.”

The suspension put 88 Midwestern dairy businesses on hold for $6.5 million in funds that had been appropriated in 2023, Baldwin said, including 30 in Wisconsin.

On Friday, Baldwin announced that USDA had restarted the program.

Evers noted Tuesday that complaints from his office, Baldwin and dairy industry leaders had successfully reversed the suspension, and called on the Trump administration to also reverse its decisions on the food bank and school food programs.

The governor’s office also criticized Trump for having “threatened to cut thousands of jobs from USDA,” including firing about 6,000 federal employees who were subsequently reinstated.

Evers’ 2025-27 budget proposal has been relying on the local food program funding, and includes a request for $770,000 over two years in conjunction with that money. His office said Tuesday that the loss of the program heightens the importance of a $30 million initiative in his budget proposal to help Wisconsin farmers and producers distribute their products across the state, and called on the state Legislature to approve that, among other items. 

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An ally of Michael M. Bell, the Kenosha father who has been campaigning for a decade for a new look at the police killing of his son 20 years ago, is suing the Wisconsin Department of Administration for records in a dispute with the state Department of Justice and the Wisconsin Crime Victims Rights Board (CVRB).

Russell Beckman filed the open records lawsuit Tuesday in Dane County circuit court in response to the administration department’s denial of billing records from a private law firm that had a contract with the victims rights board.

In the lawsuit, which he filed without a lawyer, Beckman states that he “believes the Department of Administration is attempting to conceal these records because they may contain information that constitute evidence of misconduct and unlawful collusion between high ranking Wisconsin State officials and citizen members of the CVRB.”

Michael M. Bell’s son, Michael E. Bell, was killed in November 2004 by a Kenosha Police Department officer after an altercation in the driveway of the home where the younger Bell lived. A department internal investigation found no wrongdoing on the part of the officers on the scene.

Michael M. Bell subsequently campaigned for a Wisconsin law, enacted in 2014, that requires fatalities at the hands of police to be investigated by another department

Since settling a civil lawsuit with the city of Kenosha arising from the killing, the elder Bell has sought to reopen the investigation into the death of his son. The younger Bell was being physically restrained by police when an officer shot and killed him, eyewitnesses and police reports agree. The police account reported that officer fired the shot after another officer at the scene, who was standing near the 21-year-old, shouted that Bell had grabbed his holstered service handgun.

Citing discrepancies between the official police account of the incident and eyewitness testimony as well as physical evidence at the scene, Michael M. Bell has maintained that his son probably never touched the second officer’s weapon, none of the officers were in danger of being shot by the younger Bell, and that the killing was unnecessary.

The elder Bell has said the second officer may have been sincere in his assumption that his gun had been grabbed. Based on eyewitness accounts, however, he thinks  the second officer was not where his son could have grabbed the gun. Bell believes the officer who fired the fatal shot was in a position to know that the second officer was mistaken and did not need to take his son’s life.

Bell’s repeated attempts to persuade authorities to reinvestigate the events of that night have been unsuccessful, including multiple appeals to Attorney General Josh Kaul.

In December 2022, Beckman, a retired Kenosha police detective who has been assisting the elder Bell for more than a decade, filed a complaint with the Wisconsin Crime Victims’ Rights Board on Bell’s behalf.

The complaint charged Kenosha police and city officials had concealed information about Michael E. Bell’s death, and in the process committed “alleged crimes [that] included the felonies of perjury, destruction of public records, misconduct in public office and conspiracy to commit these crimes.”

The complaint also charged that Kaul “and high ranking subordinates” at the state Department of Justice repeatedly ignored attempts by Beckman and Bell to bring their concerns to the attorney general’s attention.

In June 2023, Madison attorney Hal Harlow emailed parties in the case — Beckman, Bell and a DOJ lawyer — that he had been “retained to act as legal counsel to the Wisconsin Crime Victims Rights Board” in the matter.

In November 2023, the CRVB decided it lacked probable cause for the complaint, holding Michael M. Bell didn’t have “victim status” in connection with the complaint’s allegations. “The alleged conduct is against the government and its administration, not against individual persons,” the decision stated.

After that ruling, according to the lawsuit, Beckman “filed a number of public records requests with the CVRB, seeking records that may have evidence supporting his belief that Attorney General Josh Kaul and/or his staff may have colluded with the CVRB to influence their decision to dismiss the complaint.”

The board supplied records that have become part of the appeal that Beckman has filed on Bell’s behalf. The appeal is now before the Wisconsin Appeals Court District IV in Madison after being dismissed in circuit court.

Meanwhile, Beckman filed an open records request with the Department of Administration seeking attorney billing records for the Crime Victims Rights Board in connection with the Bell complaint.

The department issued a blanket denial of Beckman’s request. DOA cited the ongoing litigation over the lawsuit against the board and asserted that “those records and that information would reveal strategy and efforts that would affect the ongoing litigation.” The department also denied a request to reconsider its denial, and a request for a copy of the contract for the outside law firm.

The lawsuit filed Tuesday argues that the denials violate Wisconsin’s open records law. The attorney billing records, the contract and its addendums are not “attorney work product” and are not privileged attorney-client communications, Beckman argues.

Beckman said in an interview Tuesday he wants the billing records and contract because they might shed light on interactions between the DOJ and the Crime Victims Rights Board, which are supposed to operate independently of each other. He said he’s learned other unexpected information in his work with Bell over the years that turned up by perusing attorney billing records. 

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As Congress considers cuts to Medicaid, advocates warn that proposals will hike state costs or reduce services for people with no other resources. (Getty Images)

Of the laundry list of proposed Medicaid cuts circulating on Capitol Hill, policy watchers say some stand out as the most likely to be implemented because they’ve either been tried before, frequently embraced, or both.

Advocates argue that none of the ideas will actually help the program do a better job of its central mission: make it possible for poor and low-income people to get either primary or long-term health care. Instead, they contend, the outcome would be to transfer the costs to states unwilling to cut services or kick people off the rolls who have no other health care resources.

Broad outlines of the proposed Medicaid wish list for Congressional Republicans were outlined in a U.S. House memo that Politico published in mid-January, along with 50 pages of details. The memo is the basis for a summary of those proposed cuts from policy analysts and advocates at the Georgetown University Center for Children and Families.

Among the proposals that have garnered the most attention and concern are:

• Instituting work requirements for Medicaid recipients.
• Capping the current federal contribution to a state’s Medicaid budget, also known as turning Medicaid funds into a state block grant.
• Lowering the federal government’s minimum share of the cost of Medicaid, currently 50%.
• Ending the increased federal government match for states that have adopted Medicaid expansion under the Affordable Care Act (ACA)

Additional proposals would make other changes to how the federal matching rate is calculated or applied and reverse several Biden administration rules that made Medicaid enrollment easier and broadened access to benefits, according to the Georgetown summary.

Medicaid is funded by a combination of federal and state money. Proposals that lower the federal share would require states to pick up a larger share of the cost to avoid reducing coverage.

“The scale of the cuts Congress is contemplating is so large it really will cause fiscal peril for the state,” says Tamara Jackson of the Wisconsin Board for People with Developmental Disabilities.

Medicaid work requirements

The congressional proposals include imposing work requirements for “able-bodied” people as a condition of receiving Medicaid.

The congressional memo specifies that work requirements would not include “pregnant women, primary caregivers of dependents, individuals with disabilities or health-related barriers to employment, and full-time students.” It pegs the savings from a work requirement at $100 billion over 10 years.

According to KFF, a nonpartisan, nonprofit health policy research organization, however, more than two-thirds of Medicaid recipients are working, and those who aren’t would largely fall into the groups the memo says would be exempt.

The first Trump administration approved state Medicaid program waivers that included work requirements, while the Biden administration withdrew its approval. Among them was a requirement in Wisconsin dating from the administration of former Gov. Scott Walker.

The GOP majority in the Wisconsin Legislature passed a bill in 2022 that included a Medicaid work-requirement variation, but it was vetoed by Gov. Tony Evers.

According to KFF, a Congressional Budget Office analysis of a 2023 U.S. House proposal to institute Medicaid work requirements found that while it would save the federal government $109 billion, it would also increase the number of uninsured people by 600,000 without increasing employment. An Arkansas work requirement instituted in 2018 but later found unlawful by a federal court led 18,000 people to lose coverage.

“What we know is, even though people are working or would be technically subject to exemptions, there are very significant administrative burdens on enrollees to prove that or be found ineligible,” says Richelle Andrae, associate director of government relations for the Wisconsin Primary Health Care Association. The organization represents federally qualified health centers that serve low-income patients, including those on BadgerCare Plus and those who are uninsured.

“More time-sensitive paperwork and steps that are hard for people to understand or do and lots of people trying to complete administrative tasks at the same time are a recipe for mistakes, by individuals and government agencies that must do the work,” says Jackson. “That is how policies like work requirements and more frequent eligibility checks save money. Eligible people lose coverage or struggle to get in.”

Block grants

Currently Medicaid pays states at least 50% of all Medicaid costs, with states paying the balance.

In President Donald Trump’s first term, his administration attempted to replace that long-standing guarantee with a block grant — a fixed amount of money per Medicaid beneficiary in the state, regardless of the actual cost.

That per-patient cap on federal funds “would instead radically restructure Medicaid financing,” according to the Georgetown summary.

The cost would be felt across the board, from long-term care in nursing homes or in the community home care to primary health care through BadgerCare Plus, health care providers say, to the detriment of patients.

“Whatever the proposals are that are at the federal level — changing the formula, [per-patient] caps, at the end of the day they they’re all aimed at reducing funding for the Medicaid program, and it really is a vital lifeline for long-term care services and support,” says Lisa Davison, executive director of LeadingAge Wisconsin. The organization represents nursing homes and assisted living providers in the nonprofit, publicly owned and for profit sectors.

Reducing support would send some patients who now have Medicaid coverage back into the pool of uninsured people, says Patricia Sarvela, chief development officer for Partnership Community Health Center, a federally qualified health center in the Fox Valley that serves uninsured people as well as BadgerCare recipients.

Lacking health insurance, people are likely to put off addressing symptoms until their condition worsens enough for them to go to the emergency room, Sarvela says.

Directly or indirectly, taxpayers will likely wind up having to cover the cost of that care, however. “There might be short-term federal savings but ultimately at the end of the day it’s going to cost the taxpayers a lot more because patients will then not have health insurance,” Sarvela says.

Changes to federal match

Several proposed changes relate to the amount of the federal Medicaid match or how it’s calculated.

A proposal published by the Paragon Institute in July 2024 calls for reducing the federal match below 50% of the costs. The Paragon Institute has close ties to the Heritage Foundation, which produced Project 2025, the 900-page document that, although disavowed by Trump last year, has been echoed in numerous actions since he took office.

In 10 states the federal match is at the minimum and would likely be lowered, the Georgetown summary says, adding: “These states would likely have to make deep cuts to their Medicaid programs in response.”

The states are California, Colorado, Connecticut, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Washington and Wyoming.

Other states receive a higher federal match; Wisconsin gets 60% of its costs covered. It’s not clear whether those states’ matches would also be reduced under the proposal or other Medicaid reduction proposals.

Medicaid expansion

Another likely cut would be to reduce the additional federal match for Medicaid recipients whose incomes are between 100% and 138% of the federal poverty line.

The additional match was included in the Affordable Care Act, enacted in 2010. Originally Medicaid expansion was mandatory under the act, but a subsequent U.S. Supreme Court ruling that upheld the ACA made Medicaid expansion voluntary.

States that have accepted the expansion got a 90% federal match for the added beneficiaries. The Congressional memo proposes ending the higher match, and some states that have expanded are already considering ending expansion if that happens.

Wisconsin never accepted Medicaid expansion, however, so that change would not directly affect the state. Although Evers first ran in 2018 on a vow to accept Medicaid expansion after Walker rejected it, he’s been blocked from doing so by the GOP majority in the Legislature.

As he has with every budget he’s proposed since taking office, Evers has included accepting Medicaid expansion in his 2025-27 budget proposal.

In an interview with the Wisconsin Examiner last month after a visit with constituents in Port Washington to promote his budget, Evers said he didn’t consider leaving out Medicaid expansion, despite predictions that it would be pulled back by Republicans.

“First of all, we don’t know if it’s going to go away,” Evers said. Under the current 90% match, he said, Wisconsin would get about $2 billion in additional federal money every two years and the additional people covered in the state “would get better health insurance, so it’s a win-win-win.”

Evers acknowledged that in the current Congress, there’s a risk for sharp reductions in Medicaid.

If that happens, “it would be disastrous,” Evers said. “We have lots of people on Medicaid in the state of Wisconsin.”

Among states, Wisconsin’s Medicaid profile is “pretty average,” he added.

“There are places in the country where Medicaid is a huge, huge player, and if they would get rid of Medicaid, our health care system would implode. There’s just no question about that. That’s the thing that concerns me.”

This story is Part Three in a series.

Read Part One: Wisconsin patients, families are wary as Congress prepares for Medicaid surgery

Read Part Two: How Medicaid fuels an economic engine for caregivers, family members and patients

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Personal care worker Nate Walker demonstrates how he uses a hand-powered hydraulic lieft and a sling to help Mike Jones into and out of his bed. Walker is one of thousands of personal care workers in Wisconsin whose jobs are made possible by Medicaid coverage of home care for people who are eledrly and frail or who have disabilities. (Photo by Erik Gunn/Wisconsin Examiner)

At the age of 54, Mike Jones has spent a lifetime having to depend on others for meals and personal care.

Nate Walker is one of them. Walker visits Jones and other clients several times a week, helping with tasks that may include showering, getting people out of bed and meal preparation. He offers companionship as well.

Jones has cerebral palsy, an accident of birth, he says, when his oxygen was momentarily cut off. He requires a motorized chair to get around. Walker and other personal care aides who assist Jones use a hydraulic lift in his bedroom, along with a special sling, to help Jones in and out of his bed.

A Medicaid long-term care program allows Jones to live on his own in an apartment. “I am incredibly lucky,” Jones says, because unlike some of his fellow CP patients, his intellectual and cognitive skills were not impaired.  

He’s also lucky because he can feed himself, he says. Jones has met other patients who must use a feeding tube. Nevertheless, his food has to be prepared for him. Among his favorite dishes: pasta with parmesan cheese, capers and a white wine sauce that Walker makes. 

“I rely on Nate for everything you take for granted,” Jones tells a visitor. “Without the help, I’d be stuck in bed, and I’d be in the care of my elderly parents. It would be a very, very bad situation.”

For Walker, the wage is modest — about $15 an hour — but he finds the work rewarding. “I feel lucky to be able to help people for a living,” Walker says. “Helping people makes me feel better.”

Walker works for Community Living Alliance (CLA), a nonprofit that serves 11 counties in South Central Wisconsin. CLA provides care services at home for about 400 clients, most of them in Dane County, says Patti Becker, CLA’s director of program operations.

Walker is one of more than 320 employees at CLA, and CLA is just one of some 30,000 businesses in Wisconsin providing home care for the elderly and people with disabilities, Becker says. Some of those businesses might have just one or two self-employed people, while others have a sizable workforce.

An economic engine

Congress is preparing to follow through on a budget resolution enacted late last month that calls for $880 billion in cuts over 10 years from programs overseen by the House Energy and Commerce Committee. Medicaid is the single largest of that committee’s programs, and the size of potential cuts has patients, providers and health care policy analysts all wary about the outcome.

Much of their concert surrounds people who get health care — from a doctor’s visit to long-term care in a nursing home or at home — from the Medicaid program. Advocates also point out that by addressing people’s health Medicaid bolsters the broader economy as well.

Medicaid pays for nursing home care for more than half of all residents living in them. LeadingAge Wisconsin is a trade association for Wisconsin nursing homes, including those run by county governments and nonprofit organizations; its members also include assisted living homes, some of which have residents who get long-term care covered by Medicaid under Wisconsin’s home- and community-based Family Care program.

“Medicaid is the only program that pays for long-term care support,” says Lisa Davidson, LeadingAge Wisconsin’s executive director.

“Regardless of their location, their size and their services, Medicaid is a significant source of revenue to all of our members,” she adds. “And anything that would change the support that Medicaid provides would be extremely, extremely concerning — not only for the people that are receiving care now, but those that will need it in the future.”

Medicaid also pays for home care workers and supports clinics that serve low-income people, including those without insurance. By supporting people with disabilities, it can enable some of them to hold jobs themselves, or enable their family members to work outside the home.

Roughly 90,000 Wisconsinites work in the home care sector. “About $15 million a year of Medicaid dollars goes out in services and wages for the people who provide those services,” Becker says. “If you remove that wage amount from the economy, you’ll have a ripple effect there very similar to losing any other wage source.”

Forging stable health care relationships

Medicaid is a principal source of revenue for federally supported community health centers. And by covering their routine health costs, it enables patients to develop an ongoing relationship with a health care provider who can help them address illness more quickly, those providers say.

“When you don’t have health insurance, what do you do? You forgo necessary treatment. You put things on hold. You don’t access your preventive care,” says Patricia Sarvela, chief development officer at Partnership Community Health Center in Wisconsin’s Fox Valley.

Instead, patients may end up going to a hospital emergency room, “or having a preventable hospitalization and ultimately ending up with poor health outcomes,” she adds. “And when people are sick and not well, they don’t thrive in school, in their job, in life.”

Partnership Community Health has clinics in Winnebago, Outagamie and Waupaca counties. In addition to primary care, including pediatric care, the organization offers dental care and treatment for mental health and substance abuse.

It’s one of 19 community health center organizations in Wisconsin, operating in 60 locations across the state. The centers provide health care free or on a sliding scale for people without insurance with incomes up to 200% of the federal poverty guideline. The centers also have patients enrolled in BadgerCare Plus, Wisconsin’s Medicaid program for primary health care.

“Unlike some other types of health care organizations, community health centers are required to provide care regardless of insurance status,” says Richelle Andrae, associate director of government relations for the Wisconsin Primary Health Care Association, which represents the centers.

According to Andrae, 55% of the Wisconsin centers’ patients are enrolled in Medicaid, but Medicaid accounts for 73% of their revenue. The centers “would not be able to maintain the same level of care or expand the way they have without that revenue stream,” Andrae says.

A link to the work world

Julie Strenn is the president and CEO of Opportunity Development Centers Inc., based in Wisconsin Rapids. The business employs workers who provide personal care such as cooking or cleaning for people with developmental or intellectual disabilities who are living at home or in the community in long-term care.

ODC also has a staff of job developers — coaches and counselors who work with some of the same clients, enabling them to take jobs in the community. When a person is hired, Strenn says, the job developer may continue the relationship, so an employee can navigate difficulties that come up at work — a change in supervisor, for instance.

ODC’s current clients include about 400 people who are looking for jobs and 250 who are employed — “working for all kinds of businesses in the community,” Strenn says. “They’re employees that are needed in the community, sharing their gifts and talents.”

Job search assistance is funded through the state’s Division of Vocational Rehabilitation. Clients who have a job and receive ongoing support include people who are enrolled in Family Care or IRIS — Medicaid programs that cover long-term care services for people living at home or in the community.

More than 80 clients who are working have had their jobs for six years or longer, Strenn says, and another 100 have been working from two to five years.

“The work we do is proof that Medicaid dollars are supporting individuals with disabilities to be taxpayers, working and living in their local communities,” Strenn says. It also enables family members who would be responsible as caregivers full time to hold jobs themselves.

More fulfillment at lower cost

Providing skilled care at home costs on average about $4,250 a month, Becker says — less than half the $10,000-a-month cost of living in a nursing home.

And it’s a fraction of the $45,000 a month that the state spends for every resident living in a center for people with developmental disabilities, she says. The figures are included in a recent publication by the Survival Coalition, a group of organizations that serve the interests of people with disabilities.

Yet the role that this sort of support plays is often invisible. “When we do community services well, which is what Wisconsin tries to do, you don’t notice them,” Becker says.

Danielle Tolzmann is the executive director of Family Voices of Wisconsin, an advocacy group for families of children with disabilities. Medicaid support for those families ripples through the economy, she says.

“Some of those Medicaid-rooted supports allow families to have two parents working,” Tolzmann says — typically one full time and one part time. “If the supports that allow the parent to work part time were to disappear, the work environments would lose that employee. They would have to shift gears and become 110% caregiver.”

Phillip Redman is 32 years old and lives with his parents, Harriet and Rich, in Appleton. Diagnosed with cerebral palsy as an infant, Phillip has rare abnormalities in his genetic makeup and his brain.

Although doctors assumed he would never walk, his family says, Phillip learned to walk at the age of 10. His care was supported by Medicaid through the Katie Beckett waiver, which enables children who need intensive long-term care to receive that care at home instead of in an institution. At age 18, he was enrolled in one of Wisconsin’s Medicaid-funded long-term care programs for adults with disabilities, IRIS.

Had those programs not been available for Phillip, “the ultimate result would have probably been a nursing home or some type of institution,” Harriet Redman says. “That’s not physically or financially beneficial to people with disabilities or their families.”

It was in high school that a teacher saw Phillip was fascinated by the noise of a paper shredder, his parents recall.

“He loves the sound of the garbage disposal,” Rich Redman says. “It becomes an incentive for him to do things.”

With the support of the care professionals that worked with Phillip as he grew up, his family hit upon a way that Phillip “could be involved in the community,” Harriet says: Offering his services as a freelance operator of a shredding service.

The result was a small business that the family named “ShhRedman and Co.” With a caregiver, Phillip goes around to a half-dozen offices on his client list and shreds documents that are to be disposed of. The name is a pun both on the nature of the business and on Phillip’s ability to keep confidential the contents of the papers he shreds, since he neither reads nor speaks, his parents explain.

His enrollment in the IRIS home care program keeps him healthier, they say.

“When he’s inactive and more isolated he doesn’t feel as well,” Harriet says. “He gets stiff and more disabled.” The result is better care at less expense than if he were to be in a nursing home — but also greater freedom for the whole family, she says.

Without Medicaid-funded caregivers, “families, us included, would be even more dependent on support from the government,” she says. “It’s part of a sensible economy if you can keep people working and keep people active.”

This story is Part Two in a series. Read Part One: Wisconsin patients, families are wary as Congress prepares for Medicaid surgery

On Tuesday, Part Three reports on how Congress might try to target Medicaid cuts, and the likely impacts those would have.

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Max Glass-Hui uses an electronic communication device, picking words that the device then speaks to his mother, Tiffany Glass. (Photo by Erik Gunn/Wisconsin Examiner)

Max Glass-Hui is an energetic 14-year-old who romps through the modest home on Madison’s West Side where he lives with his mother.

Born with Down syndrome and diagnosed as autistic, Max can read words and understand what’s spoken to him, but he doesn’t talk. Instead, he communicates with an electronic device about the size of an iPad, pressing words that the machine then speaks on his behalf. “Good-bye,” he tells his mother through the machine one recent morning, as she sits with him in his bedroom.

Tiffany Glass smiles affably, acknowledges her son’s assertion of independence, and steps out of the room.

Their interaction isn’t so different from those any number of parents and children have every day. For this parent and this child, however, it might have seemed unimaginable a generation ago.

Not so long ago, a child like Max was likely to spend his life inside the walls of an institution. Changes in social attitudes, medical ethics, and state and federal policy have made it possible for him to grow up and thrive at home.

One of those policies, says Tiffany Glass, is Medicaid — and without it, she believes Max’s life would have been much worse.

“His medical problems would not have been treated as effectively,” she says. “His quality of life would have been absolutely terrible. He would have been much more excluded from our community than he is now.”

Medicaid is the state-federal health insurance plan launched in the 1960s to provide health care for people living in poverty. In Wisconsin, it’s  best known as BadgerCare Plus, which covers primary health care and hospital care for people living below the federal poverty guideline. But Medicaid touches hundreds of thousands of other Wisconsin residents as well.

More than half of Wisconsin’s nursing home residents are covered by Medicaid after spending down most of their other personal savings and assets. Other Medicaid programs provide long-term skilled care to people living in their own homes or in the community — people who are frail and elderly, but also people living with disabilities.

“I’m not sure people are aware of the lifeline Medicaid is to so many people,” says Kim Marheine, state ombudsman for the Wisconsin Board on Aging and Long Term Care. “Without Medicaid some of these people have no place to go for services.”

Congress is currently rewriting the federal budget in ways that patients, families, health care providers and advocates fear will upend the program dramatically, ending coverage for millions who have few or no alternatives.

Washington budget battle

The Republican majority in the U.S. House wants to find $4.5 trillion in federal funds to pay for renewing tax cuts enacted in 2017 during President Donald Trump’s first term. On Feb. 25, the House, voting along party lines, cleared the way for a budget resolution that carves $880 billion over 10 years from programs under the purview of the House Energy and Commerce Committee.

The text of the bill doesn’t doesn’t specify where those cuts come from — a point Republicans have emphasized to rebut claims that the vote was an attack on people’s health care. Nevertheless, Medicaid “is expected to bear much of the cuts,” according to KFF, a nonpartisan, nonprofit health news and research organization.

“What is in the jurisdiction of that committee? Well, the largest dollar amount is Medicaid,” said U.S. Rep. Mark Pocan (D-Black Earth) at a press conference in Madison Feb. 19. Advocates dismiss Republican denials, treating Medicaid cuts as a foregone conclusion and holding GOP lawmakers responsible.

“The draconian cuts to Medicaid that every single Wisconsin Republican voted for are an absolute wrecking ball,” says Joe Zepecki of Protect Our Care, a national advocacy group for the Affordable Care Act, Medicare and Medicaid. In that wrecking ball’s path, he says, are the state budget, tens of thousands of Wisconsin businesses that bill Medicaid, and more than a million state residents whose health care Medicaid covers.

Medicaid is funded jointly by federal and state governments. Federal law guarantees that the U.S. will pay at least half of the program’s cost, with the state paying for the rest. Wisconsin has a 60% federal contribution; the remaining 40% comes out of the state budget.

For fiscal year 2023, Wisconsin’s Medicaid expenditures totaled $12.5 billion, according to the Medicaid and CHIP Payment and Access Commission, a Congressional agency. The federal government paid just under $8.2 billion of that; Wisconsin paid the remainder, about $4.4 billion.

A Medicaid reduction on the scale that the budget resolution requires “will leave enormous shortfalls for the state heading into the next two years, all so Trump and his MAGA majorities can deliver another tax cut to huge corporations and CEOs like Elon Musk,” Zepecki says. “The federal money disappearing doesn’t mean the needs disappear, which is likely to force everyone else to pay even higher costs for their own health care.”

1 in 5 Wisconsin residents

According to the January 2025 enrollment numbers from the Wisconsin Department of Health Services (DHS), about 1.3 million Wisconsin residents rely on Medicaid for day-to-day health care, long-term care or both — more than 1 out of 5 state residents.

They include more than 900,000 Wisconsinites who are enrolled in BadgerCare Plus. The health insurance plan for people up to age 65 covers doctor’s office visits, preventive care, surgery, hospital stays including childbirth, and other day-to-day health care needs for families living below the federal poverty guidelines. Children are covered in families with incomes up to 300% of the federal guideline; BadgerCare covers one-third of Wisconsin’s children.

Medicaid also covers alcoholism treatment, substance abuse treatment and other forms of care for mental health. “Medicaid is one of the largest payers of mental health care in the state,” says Tamara Jackson, policy analyst for the Wisconsin Board for People with Developmental Disabilities. It is the major funder of county mental health services, whether provided directly by a county agency or in partnership with a community agency, according to the Wiscons Counties Association.

Covering mental health is more than simply covering the cost of medications that may be prescribed. “Depression and anxiety medications are most effective in combination with the use of counseling services,” says Sheng Lee Yang, an Appleton clinical social worker. But if patients prescribed a medication aren’t able to get counseling as well, “their symptoms are only being treated at a 50% rate. That’s not real effective.”

Medicaid is part of health care all across Wisconsin. A study from Georgetown University’s Center for Children and Families released in January found that residents of rural counties in the U.S. are more likely to rely on Medicaid for their health coverage than urban residents. In 27 northern and central Wisconsin rural counties, the share of children on Medicaid is higher than the state average, the study found.

Medicaid’s reach doesn’t stop there, however. Through nearly 20 different programs, Medicaid covers the health care of more than 260,000 additional Wisconsin residents.

For about 10,800 frail, elderly people who could not otherwise afford nursing home care, Medicaid pays the cost — about 60% of the state’s nursing home population.

Medicaid has also expanded beyond primary health care or nursing home care. Programs launched over the last several decades now allow eligible people who need long-term care to get the same services through Medicaid at home or in the community that they would receive in a nursing home.

To join those programs states apply to the federal government with proposals that would waive standard Medicaid rules. The idea is that if someone who needs long-term care can remain at home or in another homelike setting, the overall cost of care will be far lower than in a nursing home, stretching the Medicaid dollar farther.

More than 43,000 frail elderly or disabled adults in Wisconsin receive long-term care at home or in the community — in assisted living, for instance — under Medicaid waivers. Family Care began piloting in individual Wisconsin counties about 25 years ago as a nursing home alternative. It has since gone statewide, joined by allied programs that allow people to customize their care plans.

For elderly relatives who needed the intensive level of care offered by a nursing home, Family Care “gave them a tremendous alternative to skilled nursing care,” says Janet Zander, the advocacy and public policy coordinator for the Greater Wisconsin Agency on Aging Resources.

“A lot of work Wisconsin has been doing, and other states as well, has been shifting how we provide care to people’s homes,” says Jackson.

Care at home instead of an institution

Beth Barton’s daughter, Maggie, was born 25 years ago with cerebral palsy. She doesn’t talk and is not able to move about on her own, and for her whole life she’s needed complex medical care, Barton says.

One of Medicaid’s earliest waiver programs is named for Katie Beckett, a child from Iowa whose story led the Reagan administration in the 1980s to authorize long-term health care at home for children with disabilities instead of only in a hospital or nursing home. In Wisconsin, there are about 13,500 children enrolled in the state’s Katie Beckett waiver program.

When Maggie was a child, the Katie Beckett waiver enabled the Barton family to care for her at home. The family’s health care comes through the company plan where Beth Barton’s husband works. Medicaid served as a secondary insurer for Maggie, covering insurance copayments and for her care that the family insurance didn’t pay for.

Growing up, Maggie was able to attend Lakeland School, a public Walworth County school for children with disabilities. School “was difficult” her mother says, but it also provided rewarding interaction for her daughter. The school’s therapeutic pool became part of Maggie’s daily routine, where “she could be free,” Barton says, able to enjoy sensory experiences outside her wheelchair.

After Maggie turned 18, she was enrolled in IRIS — a Medicaid-funded long-term care program. While Family Care works though contracts with managed care providers, IRIS, a more recent variation, allows people to make their own arrangements for services, including home health care and personal care.

IRIS Medicaid funding helps pay for a social worker who visits four times a year and respite care when Barton can’t be at home. It also covers home modifications, such as an accessibility ramp.

Without the support Medicaid has provided throughout Maggie’s life, Barton believes her daughter might well have ended up in an institution. She’s not optimistic about that option.

“Her unique needs are best met one-one,” Barton says. “If we didn’t have private duty nursing, if we didn’t have Medicaid to meet those needs, I honestly don’t think she’d be with us.”

Children’s long-term support

Another Medicaid waiver covers certain purchases children with disabilities need as they grow up.

Danielle Bauer’s 3-year-old son, Henry, was born with Down syndrome and has also been diagnosed with autism. The family lives in Wausau, and Wisconsin’s Children’s Long-term Support waiver helped cover the cost of a sensory chair that offers Henry “a quiet retreat to prevent meltdowns,” Bauer says. The family also got coverage for a specialized high chair that will grow with him as he gets older.

“It has made a huge difference in his quality of life,” Bauer says of her son. “He is capable of so much more, but without these supports, families don’t have resources to help kids like him.”

Until Jessica Seawright’s son was born nine years ago, she and her husband had no inkling their child would have a disability, let alone a serious one. Because of a chromosome abnormality, he has cerebral palsy and uses a wheelchair.

“We didn’t have anything show up in terms of prenatal testing,” Seawright says. “This came out of the blue.”

The Children’s Long-term Support waiver helped the family purchase a wheel-chair van to transport their son. It also helped cover the cost of widening a doorway in their home on the South Side of Milwaukee so he can get into the bathroom using his chair.

Seawright is a social worker and therapist. Her employer provides the family’s primary insurance, with the couple paying about $300 a month toward the premium as well as covering their own medical and dental copayments.

The Katie Beckett waiver has made it possible for Medicaid, through BadgerCare, to pick up her son’s medical costs, Seawright says. He often has to go to the emergency room and has other complex medical needs. He has recurring seizures, and he has trouble swallowing and needs a gastric tube. He’s been prescribed various medications and formula supplements as well.

Without that support, she says it’s likely that the family would burn through the $5,000 annual cap on their out-of-pocket health care costs.

“We would be making really tough choices — what can we afford out of pocket each year? It would be a question of how often we pay for foot braces when he outgrows them,” Seaward says — along with the medications, supplements and formula he needs.

“It’s not that we don’t want to pay for our fair share, but with the cost of his care it’s not possible to keep up with,” she says.

Moving past ‘a dark part of our history’

Tiffany Glass is a University of Wisconsin research scientist, studying why children with Down syndrome often have trouble eating, drinking and swallowing. She was in the process of deciding what direction she wanted her research career to take when her son Max was born; his diagnosis pointed the way.

“Up until the mid-1980s in the United states, a lot of children with Down syndrome and other disabilities were institutionalized, because their communities didn’t have the resources to accommodate them,” Glass says.  

UW medical ethicist Dr. Norman Fost wrote in a 2020 journal article that as recently as the late 1970s it wasn’t unheard of for parents to allow newborns with Down syndrome to die without medical intervention.  

“It’s a really dark part of our history,” Glass says.

Medicaid changed that for Max — supporting him for his medical care, communication (it has paid in the past for an electronic tablet that speaks for him), and activities of daily living.

“He needs help with all of those things,” Glass says. “It adds up to needing skilled care 24 hours a day, seven days a week. For his whole life he’s required that type of care, and he probably always will.”

In addition to providing resources for Max’s care at home, Medicaid has also enabled Glass to pursue her scientific calling. Without it, her research career might have stopped before it started, she says.

Regular child care centers are unlikely to take someone whose disabilities are as severe as his, she has found, but the children’s long-term support waiver has covered the cost of respite care.

“That has allowed me to work outside the home for a decade as a research scientist,” says Glass. “If Medicaid hadn’t been there, I probably would not have been able to develop my research career. I would have had to stay home — to the detriment of scientific research.”

Now, however, she and countless others who have come to rely on the program — adults and children, people with disabilities and caregivers for elderly relatives — have grown anxious about whether they will still be able to count on the care that Medicaid has made possible.  

“Those arrangements are still very fragile,” Glass says. “We’re all very worried that if funding for Medicaid is reduced or eliminated, that could have really terrible implications for our families.”

This story is Part One in a series. 

This report was updated to correct the spelling of Max’s last name. 

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