“Frankly, Robin Vos’ move to prevent us from circulating this petition and his refusal to bring this bill to the floor is pathetic," Assembly Minority Greta Neubauer (D-Racine). (Photo by Baylor Spears/Wisconsin Examiner)

The Wisconsin Assembly met for its final floor session of 2025 Wednesday, where Democratic lawmakers sought to pass a bill that would extend Medicaid coverage for new mothers for one year after the birth of a child, though Republicans blocked it. Bills to encourage school district consolidation and make changes to elections laws passed.

Republicans block Democratic efforts to get a vote on postpartum Medicaid bill 

Wisconsin is one of two states in the U.S. that have not taken the federal government’s postpartum Medicaid expansion, and Democratic lawmakers hoped to begin the process of changing that during the floor session. 

The bill, which passed the Senate in April on a 32-1 vote, would allow eligible mothers to keep their Medicaid coverage for a year postpartum. Currently in Wisconsin, mothers only get 60 days of coverage if they don’t otherwise qualify for Medicaid.

Assembly Democrats planned to employ a rarely used Assembly rule to pull the bill out of committee and bring it up for a vote. Under the rule, if 50 lawmakers sign a petition, a bill can be brought to the floor. Democratic lawmakers hoped to have the chance to convince some of the Republican cosponsors of the bill to sign on.

Before that could come to fruition, however, the Assembly clerk notified Assembly Speaker Robin Vos (R-Rochester) of the plan, Assembly Minority Leader Greta Neubauer (D-Racine) told reporters. 

Republicans moved the bill from the Assembly Rules Committee, where it had sat since May, to the Assembly Organization Committee — triggering a rule that says a  withdrawal petition on the bill cannot be circulated for 21 days. 

“This is a great effort by the Speaker to prevent this important bill from getting a vote on the floor,” Neubauer said. 

Neubauer said she didn’t know why the clerk notified the Assembly Republican leaders.

“There had been some conversation with staff about the timeline for [the petition], but I’m not really sure why it happened the way it did,” Neubauer told reporters. She said that Rick Champagne, director of the Wisconsin Legislative Reference Bureau, told the lawmakers that notification should have happened when they turned the petition in with the 50 signatures, not prior to the petition circulating.

All 45 Democratic lawmakers are cosponsors of the bill as are over 20 Republicans, but the bill has been hung up in the Assembly due to opposition from Vos, who has said in the past that he doesn’t support expanding “welfare.” The bill only needs a simple majority of 50 votes to pass the Assembly.

Neubauer read out the names of the Republican cosponsors during the press conference. 

“These are legislators who believe that this bill should become law, so they say, but they have been bullied by their speaker into not pushing for a vote on this bill on the floor,” Neubauer said. “Frankly, Robin Vos’ move to prevent us from circulating this petition and his refusal to bring this bill to the floor is pathetic, and when moms in Wisconsin and their babies are put at risk, their health and well-being is put at risk, because they do not have adequate health care in the year after they have given birth, it will be Robin Vos’ fault.” 

The Republican lawmakers on the bill include Reps. Patrick Snyder (R-Weston), Jessie Rodriguez (R-Oak Creek), Scott Allen (R-Waukesha), Elijah Behnke (R-Town of Chase), Barbara Dittrich (R-Oconomowoc), Bob Donovan (R-Greenfield), Cindi Duchow (R-Delafield), Benjamin Franklin (R-De Pere), Rick Gundrum (R-Slinger), Nate Gustafson (R-Omro), Dean Kaufert (R-Neenah), Joel Kitchens (R-Sturgeon Bay), Rob Kreibich (R-New Richmond), Scott Krug (R-Rome), Tony Kurtz (R-Wonewoc), Dave Maxey (R-New Berlin), Paul Melotik (R-Grafton), Jeff Mursau (R-Crivitz), Adam Neylon (R-Pewaukee), Todd Novak (R-Dodgeville), Kevin Petersen (R-Waupaca), David Steffen (R-Howard), Rob Tusler (R-Harrison), Chuck Wichgers (Muskego), Rob Wittke (R-Caledonia), Rob Summerfield (R-Bloomer), Calvin T. Callahan (R-Tomahawk), Clint Moses (R-Menomonie) and Joy Goeben (R-Hobart). 

Democratic lawmakers also tried to introduce amendments to a bill on the floor that would have extended postpartum Medicaid coverage, but those were also blocked by Republicans.

“It shouldn’t be this hard to get Republicans to do the right thing. Wisconsin women deserve access to quality, affordable health care and that includes postpartum care,” Vining said before she was cut off by Speaker Pro Tempore Kevin Petersen who said she wasn’t on topic.

“This is a disgrace,” Vining yelled out.

School district consolidation 

Democratic and Republican lawmakers split over a package of bills that would encourage school districts to consolidate. Republican lawmakers argue the bills are necessary due to falling enrollment, which they say is the reason for school districts’ financial struggles. 

Rep. Amanda Nedweski (R-Pleasant Prairie) said at a press conference that the bills would address declining enrollment and the cycle of repeatedly going to referendum to raise money from local taxpayers that school districts are in. Schools in Wisconsin have seen a drop of about 53,000 students over a decade, from the 2013-14 to 2022-23 school years.

Of Wisconsin’s 421 school districts, about two-thirds are struggling with declining enrollment with preliminary numbers from the Department of Public Instruction showing that enrollment for public school districts in the 2025-26 school year fell by about 13,600 students. Total enrollment across Wisconsin school districts is about 759,800 this year. 

“Districts with declining enrollment receive less in state aid and to make up for that revenue loss. We’ve seen a growing cycle of constant referendums with varying degrees of success,” Nedweski said. “Wisconsin taxpayers are frustrated with our public school system… They are frustrated with districts continuously asking them to raise their own taxes, frustrated that their generous investments have not produced matching results.”

Democrats blamed Republicans for school districts having to go to referendum, noting that state aid has not kept pace with inflation in nearly two decades. They also said Wisconsinites have not been asking to close schools. Neubauer said Republicans were “proving how disconnected they are from our constituents.”

“Wisconsinites do not want to close school buildings, break up their communities, force their kids to ride on the bus for hours a day, or lose their local sports teams. Wisconsinites want us to fund our public schools,” Neubauer said. “Republicans’ push to close schools misses the mark completely, and Wisconsinites deserve better… Don’t close schools, fund them.”

According to the Department of Public Instruction, Wisconsin is spending the least, proportionally, in state revenue that it has ever spent on schools under the current funding formula. About 32.1% of state general purpose revenue goes to state general aid to schools, while that percentage used to be around 35%.

Rep. Angelina Cruz (R-Racine) noted during floor debate that many school districts lost state aid this year. Data from DPI for the 2025-26 school year shows that of 421 districts, 71% — or 301 districts — will receive less state aid this year compared to the prior year and 26% will receive more.

“For 15 years, Wisconsin has intentionally divested in our public schools while expanding privatization through voucher schemes,” Cruz said at a press conference, adding that Racine Unified School District has felt the loss of revenue acutely.

According to DPI data, about 15% of Racine’s revenue limit — or $43 million — goes to pay for voucher program participants.

“Since 2011, our community has gone to referendum three times —  in 2014, 2020 and 2025 — asking residents to raise their own property taxes to provide what the state has refused to fund,” Cruz said. “Even after those referendum paths, our district has been forced to close and consolidate schools including… the school where I grew up as a teacher. This is not about a lack of community commitment. It is about the state failing its constitutional obligation to provide free and as nearly uniform as practicable schools to children… Let me be clear, if there is money to close public schools, there is money to fund public schools.”

Rep. Joel Kitchens (R-Sturgeon Bay) rejected claims that the choice program is to blame.

“That’s a tiny little percentage of this,” Kitchens said. “It’s happening because of declining birth rates, of people choosing to have less kids, waiting long to have kids. I can’t imagine how anybody can look at our 421 school districts that we have right now and think that in 30 years, that’s going to be sustainable.”

Kitchens also emphasized that the bills are voluntary.

“Let’s trust our communities to work through these things and decide for what’s best for themselves,” Kitchens said. 

Republicans also rejected Democratic lawmakers’ insistence that the state needs to invest more money in its public schools. 

“[Democrats] want us to believe that if we simply spend more on K-12, people will flock to Wisconsin and increase enrollment,” Nedweski said. She compared Wisconsin to New York, which according to the New York Focus spends more per public school student than any other state. “Their outcomes are no better than ours, and they are losing students even faster than Wisconsin. As they elect more communist leaders like [New York City Mayor-elect] Zohran Mamdani, I suspect more New Yorkers will rapidly leave tax-and-spend Democratic Socialist policies. More spending is not a strategy, it’s denial.”

Nedweski said the bills are a “lifeline” for school districts that can use it and will encourage savings and “invest in increasing opportunities for students who may not otherwise have access to things like AP classes, world languages, advanced tech ed and specialized learning services.”

The six bills in the package:

• AB 644 would increase additional state aid to schools that consolidate in 2027, 2028 and 2029 to $2,000 per pupil in the first year. Under current law, school districts receive additional aid when they consolidate. For the first five years after consolidation, a consolidated school district gets $150 per pupil. In the sixth year, the aid drops to 50% of what the school district received in the fifth year and in the seventh year, the aid drops to 25% of the fifth year. It passed 53-44 with Rep. Shae Sortwell (R-Two Rivers) joining Democrats against the bill. 

• AB 645 would provide grants of up to $25,000 to groups of two or more school district boards for the costs of a feasibility study for school district consolidation or whole grade sharing agreements. It passed on a voice vote.
• AB 646 would launch a study of Wisconsin’s school districts, looking at current school district boundaries, potential school district consolidations, existing school district facilities, staffing levels and salary scales, the population of school-age children in each school district, and revenue limits and current overall spending. It passed 54-43 along party lines.

• AB 647 would create a four-year grant program for school districts that enter into a whole-grade sharing agreement, agreeing to educate students at one location. School districts would get up to $500 per pupil enrolled in a single grade. It passed 54-43 along party lines.

• AB 648 would help create new supplemental state aid for consolidated school districts to  address differences in school districts’ levies when they merge. The measure is meant to address concerns of higher property taxes for residents of low-levy districts when a consolidation takes place. It passed 54-43 along party lines.
•  AB 649 provides the funding for the bills, including $2.7 million for grants to schools that enter whole-grade sharing agreements, $3 million to provide state aid to offset levy limit differences and $250,000 for feasibility studies. It passed 54-43 along party lines.

Vote on online sports betting bill delayed

After being fast tracked through the public hearing process, a vote on a bipartisan bill that would legalize online sports betting in Wisconsin was postponed. 

The Wisconsin Constitution requires that gambling in the state must be managed by the state’s federally recognized Native American tribes. Following that requirement, sports betting has been allowed in Wisconsin since 2021, but bets have had to be made in person at tribal casinos. 

AB 601 would expand this to allow for online sports betting anywhere in the state by placing servers running the betting websites and apps to be housed on tribal land; this is known as a “hub and spoke” model. It was introduced in October and received hearings in the Assembly and Senate earlier this month. 

Assembly Majority Leader Tyler August (R-Walworth) said that he still would have had the votes on the bill if it had come up for a vote, but he had conversations with members of his caucus over the weekend that brought new issues to his attention. He would not provide details on what the concerns were, though he said they didn’t deal with issues of constitutionality.

“I’m not going to get into the details of the conversations that I’ve had with members,” August said. “We’re just working through some of that right now, and I’m confident that there’s no rush on this. It’s the right thing for the state, and I’m confident that we’ll get there.”

Neubauer said she planned to support the bill. 

“We know that our tribes in Wisconsin have the right to control gaming in our state, and right now, that’s not happening with online sports betting,” Neubauer said. “I do hope that we pass a bill that puts control of that industry back in their hands.”

The Assembly passed and concurred in a total of over 50 bills. Others include:  

• AB 596 and AB 597, which passed unanimously, would direct $1.9 million to be used for a state grant match program for veterans’ housing. A nonprofit group would need to be participating in the federal program, which currently provides about $82 per day per veteran housed to groups that offer wraparound supportive services to homeless veterans, to be eligible for a state matching funds of $25 per day per veteran. While no one voted against the bills, Democratic lawmakers expressed concerns that the bill would not fill the gaps that currently exist due to the closure of two Veterans Housing and Recovery Program sites earlier this year. 
• AB 602, which would instruct Evers to opt into a federal school choice program, passed 54-44 along party lines. 
• A pair of bills meant to help address students who are disruptive in class passed in 54-43 votes. AB 613 would require principals to provide written notification to parents every time a student is removed from a class and “the quality or quantity of instructional time provided to the pupils in the class is diminished.” AB 614 would add language into state law to say that teachers are allowed to maintain order in the teacher’s classroom, establish and enforce classroom rules, call 911 in an emergency, take immediate action if a pupil’s behavior is dangerous or disruptive and request assistance from school administrators during a disruptive or violent incident.
• AB 207, which would provide information about constitutional amendments to voters including their potential effects, passed on a voice vote.
• AB 312  passed on a voice vote. It would require absentee voting sites to be open for at least 20 hours during the period for voting absentee in-person.
• AB 385 passed in a 55-42 vote with Rep. Lori Palmeri (D-Oshkosh) joining Republicans in favor. The bill would prohibit a political committee, political party or conduit from accepting contributions that are made with a credit card online unless the contributor provides their credit card verification value (CVV) or code and the billing address associated with the card is located in the United States. Republican state lawmakers introduced the bill following efforts by Republicans and the Trump administration to target ActBlue — a Massachusetts-based platform that processes donations to Democratic campaigns.
• AB 617 passed 53-44. Rep. Paul Tittl joined Democrats voting against the bill. It would make a number of changes to elections law, including requiring that alternate absentee ballot sites must be in a building or facility constituting a fixed location and requiring absentee ballots with faulty or missing certifications be returned to voters if they are received seven days before the election. It is similar to a bill introduced last session, but it does not include a provision that would have allowed for Monday processing of absentee ballots. Rep. Scott Krug (R-Rome) said that he is speaking with the Assembly Elections Committee chair about potentially having an informational hearing on Monday processing.

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The U.S. Capitol building in Washington, D.C., amid fog on Tuesday, Dec. 10, 2024. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — U.S. senators began debating how to reduce health care costs for Americans during a hearing Wednesday, where experts’ varied recommendations and comments from lawmakers previewed the rocky and potentially long path ahead. 

Republicans on the Finance Committee argued the Affordable Care Act, or Obamacare, has led to a spike in health insurance costs for individuals  that shouldn’t be offset by tax credits any longer. 

Democrats urged their colleagues to extend the enhanced subsidies for at least another year to give Congress more time to address larger, more complex issues within the country’s health insurance and health care systems. 

Committee Chairman Mike Crapo, R-Idaho, said the hearing marked “the first step in building the foundation for” health care reform.

“We need both short-term and long-term solutions,” Crapo said. “In the short term, we cannot simply throw good money after bad policy. If we keep advancing a system that drives up premiums, we will make this problem even harder to solve.”

“Instead, we should set the groundwork for giving Americans more control over their health care choices,” Crapo added. “Rather than accepting the current system of giving billions of taxpayer dollars to insurers, we should consider providing financial assistance directly to consumers through health savings accounts, which are now available on the Obamacare exchanges through a provision in the One Big Beautiful Bill.”

Such tax-advantaged accounts are used to save money to pay for medical expenses and generally are used in conjunction with a high-deductible insurance plan, but an HSA “is a trust/custodial account and is not health insurance,” according to the Congressional Research Service.

The ACA, signed into law by President Barack Obama in 2010, overhauled the U.S. health care system with the intent of reducing high rates of uninsured people and ending insurance industry practices such as exclusions based on pre-existing conditions and the sale of policies with high costs and skimpy coverage. The law also expanded Medicaid and, for individual coverage, introduced the health insurance exchanges, or marketplaces, that now are at issue.

According to the health organization KFF, the number of uninsured Americans fell from about 14% to 16% in the years preceding passage of the law to a record low of 7.7% in 2023.

Pessimism about health care action

Oregon Sen. Ron Wyden, the top Democrat on the panel, rebuked Republicans for focusing on other policy areas throughout the year instead of making improvements to health care.

“Sitting on your hands has consequences,” he said. 

Wyden doesn’t see a way for Congress to extend the enhanced tax credits set to expire at the end of the year for people who get their health insurance from the ACA marketplace, despite Democrats pressing for that during the 43-day government shutdown that ended in mid-November. 

Wyden expressed support for working with Republican senators to address health insurance companies’ structure, though he said he is “skeptical” his GOP colleagues will actually approve legislation on that particular issue in the months ahead. 

“Now if they are serious about taking on the crooks that dominate big insurance, like UnitedHealthcare, I’m all in,” Wyden said. “In my view that starts with a laser focus on lower costs for consumers, going after fraud where it truly exists, and cracking down on middlemen.”

‘Very little that this Congress can do’

Douglas Holtz-Eakin, president at the center-right American Action Forum and former chief economist at the Council for Economic Advisers during the President George W. Bush administration, told the committee the structure of the Affordable Care Act poses problems. 

“As a piece of health policy, economic policy and budget policy, the ACA has always been a troubling construct,” Holtz-Eakin said, later adding there is “very little that this Congress can do to change the outlook” for 2026. 

Holtz-Eakin testified that Congress is long “overdue for a real rethinking of health care policy at the federal level” that he believes should focus on two primary areas. 

The first is to “rationalize the insurance subsidies” and the second is to address what he referred to as “high-value care,” which he said should include Medicare, the health program that covers 69 million Americans over 65 and some people with disabilities. 

“Medicare is a great budgetary threat, and so I encourage the committee and the Congress as a whole to take a hard look at that and make some progress toward better health care outcomes and better budgetary outcomes,” Holtz-Eakin said.  

Jason Levitis, senior fellow of the Health Policy Division at the left-leaning Urban Institute and a Treasury employee who led the ACA implementation at the department during the Obama administration, urged lawmakers to address the “too complicated and segmented” health insurance marketplace. 

Levitis said the best short-term option for Congress would be to extend the enhanced tax credits for ACA enrollees during 2026, despite the time crunch. 

“At this point the only feasible option is a clean extension of the existing enhancements,” Levitis said. “The marketplaces have already built that option and have been preparing for months for the possibility of an extension.” 

Former Trump adviser says ACA ‘failed’

Brian Blase, president of the Paragon Health Institute and a former special assistant to President Donald Trump at the White House National Economic Council, said bluntly that the Affordable Care Act has “failed.”

“The law entrenched an inefficient insurance-dominated health sector with massive subsidies flowing straight from the Treasury to health companies,” Blase said. 

The subsidies for ACA marketplace plans, he said, were “ill-designed and inflationary,” urging lawmakers not to extend them for another year.  

“The enrollee share of the premium is capped regardless of the total premium. When enrollees pay only a small slice of the premium or no premium at all, insurers face almost no price discipline,” Blase said. “Insurers can raise premiums knowing the taxpayers will absorb almost all of the increase.”

Blase said he believes the ACA’s regulations on health insurance companies are one of the reasons costs have spiked. 

“For example, under the medical loss ratio, insurers must spend a minimum share of premium revenue on medical claims. In other words, to increase profits, insurers must increase premiums,” Blase said. “The ACA’s essential health benefits require plans to cover the same set of services regardless of what people want or need. These rules increase premiums and wasteful spending.”

The medical loss ratio was included in the ACA in response to insurers who spent “a substantial portion” of premiums on administrative costs and profits, including executive salaries, overhead and marketing, according to the Centers for Medicare and Medicaid Services.

‘We all believe we need to reform’

Senate Majority Leader John Thune, R-S.D., told reporters separately from the hearing the debate over how to restructure health insurance to bring down costs has highlighted the “differences of opinion” among GOP lawmakers. 

“We’ve got a lot of people who have strong views, but the one thing that unites us is we all believe we need to reform, and we’ve got to do something to drive health care costs down,” Thune said. 

GOP leaders, he added, are “looking for solutions that will lower health care premiums, not increase them. And what we see today is just constant inflationary impacts from some of these policies of the past.”

Trump, who would need to support any health care overhaul bill for it to move through Congress, wrote in a social media post Tuesday that he wants lawmakers to send money straight to Americans, without detail on how that would work. 

“THE ONLY HEALTHCARE I WILL SUPPORT OR APPROVE IS SENDING THE MONEY DIRECTLY BACK TO THE PEOPLE, WITH NOTHING GOING TO THE BIG, FAT, RICH INSURANCE COMPANIES, WHO HAVE MADE $TRILLIONS, AND RIPPED OFF AMERICA LONG ENOUGH,” Trump wrote. “THE PEOPLE WILL BE ALLOWED TO NEGOTIATE AND BUY THEIR OWN, MUCH BETTER, INSURANCE. POWER TO THE PEOPLE! Congress, do not waste your time and energy on anything else. This is the only way to have great Healthcare in America!!! GET IT DONE, NOW. President DJT”

Reading Time: 7 minutes

This story was originally published by ProPublica.

The most powerful Republican in Wisconsin stepped up to a lectern that was affixed with a sign reading, “Pro-Women Pro-Babies Pro-Life Rally.”

“One of the reasons that I ran for office was to protect the lives of unborn children,” Assembly Speaker Robin Vos told the cheering crowd gathered in the ornate rotunda of the state Capitol. They were there on a June day in 2019 to watch him sign four anti-abortion bills and to demand that the state’s Democratic governor sign them. (The governor did not.)

“Legislative Republicans are committed to protecting the preborn because we know life is the most basic human right,” Vos promised. “We will continue to do everything we can to protect the unborn, to protect innocent lives.”

Now, however, Vos has parted with some in the national anti-abortion movement in its push for a particular measure to protect life: the life of new mothers.

Many anti-abortion Republicans have supported new state laws and policies to extend Medicaid coverage to women for a year after giving birth, up from 60 days. The promise of free health care for a longer span can help convince women in financial crises to proceed with their pregnancies, rather than choose abortion, proponents say. And many health experts have identified the year after childbirth as a precarious time for mothers who can suffer from a host of complications, both physical and mental.

Legislation to extend government-provided health care coverage for up to one year for low-income new moms has been passed in 48 other states — red, blue and purple. Not in Arkansas, where enough officials have balked. And not in Wisconsin, where the limit remains two months. And that’s only because of Vos.

The Wisconsin Senate passed legislation earlier this year that would increase Medicaid postpartum coverage to 12 months. In the state Assembly, 30 Republicans have co-sponsored the legislation, and there is more than enough bipartisan support to pass the bill in that chamber.

But Vos, who has been speaker for nearly 13 years and whose campaign funding decisions are considered key to victory in elections, controls the Assembly. And, according to insiders at the state Capitol, he hasn’t allowed a vote on the Senate bill or the Assembly version, burying it deep in a committee that barely meets: Regulatory Licensing Reform.

Vos’ resistance has put him and some of his anti-abortion colleagues in the odd position of having to reconcile their support for growing families with the failure of the Assembly to pass a bill aimed at helping new moms stay healthy.

“If we can’t get something like this done, then I don’t know what I’m doing in the Legislature,” Republican Rep. Patrick Snyder, the bill’s author and an ardent abortion foe, said in February in a Senate hearing.

Reached by phone, Vos declined to discuss the issue with ProPublica and referred questions to his spokesperson, who then did not respond to calls or emails. Explaining his opposition, Vos once said, “We already have enough welfare in Wisconsin.” And in vowing to never expand Medicaid, he has said the state should reserve the program only for “those who truly need it.”

His stance on extending benefits for new mothers has troubled health care professionals, social workers and some of his constituents. They have argued and pleaded with him and, in some cases, cast doubt on his principles. ProPublica requested public comments to his office from January 2024 to June 2025 and found that the overwhelming majority of the roughly 200 messages objected to his stance.

“I know this is supported by many of your Republican colleagues. As the ‘party of the family’ your opposition is abhorrent. Get with it,” one Wisconsin resident told the speaker via a contact form on Vos’ website.

Another person who reached out to Vos chastised him for providing “lame excuses,” writing: “The women of Wisconsin deserve better from a party that CLAIMS to be ‘pro-life’ but in practice, could care less about women and children. We deserve better than you.”

 ‘A commonsense bill’

Donna Rozar is among the Wisconsin Republicans who staunchly oppose abortion but also support Medicaid for new mothers.

While serving as a state representative in 2023, she sponsored legislation to extend the coverage up to one year. Her effort mirrored what was happening in other states following the end of Roe v. Wade and the constitutional right to an abortion. Activists on both sides of the abortion issue recognized that there could be a rise in high-risk births and sought to protect mothers.

“I saw this as a pro-life bill to help mothers have coverage for up to a year, in order to let them know that they would have the help they needed if there were any postpartum complications with their pregnancy,” said Rozar, a retired registered nurse. “I thought it was a commonsense bill.”

Vos, she said, would not allow the bill to proceed to a vote even though it had 66 co-sponsors in the 99-person chamber. “The speaker of the state Assembly in Wisconsin is a very powerful individual and sets the agenda,” she said.

Rozar recalled having numerous “frustrating” conversations with Vos as she tried to persuade him to advance the legislation. “He was just so opposed to entitlement programs and any additional expenditures of Medicaid dollars that he just stuck to that principle. Vehemently.”

Vos has argued as well that through other options, including the Affordable Care Act, Wisconsinites have been able to find coverage. While some new mothers qualify for no-cost premiums under certain ACA plans, not all do. Even with no-cost premiums, ACA plans typically require a deductible or co-payments. And next year, when enhanced premium tax credits are due to expire, few people will be eligible for $0 net premiums unless Congress acts to change that.

Rozar lost her race for reelection in August 2024 after redistricting but returned to the state Capitol in February for a Senate hearing to continue advocating for the extension. She was joined by a variety of medical experts who explained the extreme and life-threatening risks women can face in the first year after giving birth.

They warned that without extended Medicaid coverage, women who need treatment and medication for postpartum depression, drug addiction, hypertension, diabetes, blood clots, heart conditions or other ailments may be unable to get them.

One legislative analysis found that on average each month, 700 women fell off the Medicaid rolls in Wisconsin two months after giving birth or experiencing a miscarriage because they no longer met the income eligibility rules.

Justine Brown-Schabel, a community health worker in Dane County, told senators of a new mother diagnosed with gestational diabetes who lost Medicaid coverage.

“She was no longer able to afford her diabetes medication,’’ Brown-Schabel said. “Not only did this affect her health but the health of her infant, as she was unable to properly feed her child due to a diminishing milk supply.”

She described another new mother, one who had severe postpartum depression, poor appetite, significant weight loss, insomnia and mental exhaustion. Sixty days of Medicaid coverage, Brown-Schabel said, “are simply not enough” in a situation like that.

Currently, new moms with household incomes up to 306% of the poverty line (or $64,719 a year for a single mom and baby) can stay on Medicaid for 60 days after birth. But the mother must be below the poverty line ($21,150 for that mom and baby) to continue with coverage beyond that. The new legislation would extend the current protections to a year.

Bipartisan unity on the legislation is so great that Pro-Life Wisconsin and the lobbying arm of the abortion provider Planned Parenthood, which offers some postpartum services, both registered in support of it before the Senate.

“It’s something that we can do and something that’s achievable given the bipartisan support for it,” Matt Sande, a lobbyist for Pro-Life Wisconsin, said in an interview. “It’s not going to break the bank.”

Once fully implemented, the extended coverage would cost the state $9.4 million a year, according to the state Legislative Fiscal Bureau. The state ended fiscal year 2025 with a budget surplus of $4.6 billion.

With the Assembly bill buried by Vos, Democratic Rep. Robyn Vining tried in July to force the issue with a bit of a legislative end run. She rose during floor debate on the state budget and proposed adding the Medicaid extension to the mammoth spending bill.

All of the Republicans who had signed on to the Medicaid bill, except one absent member, voted to table the proposal, sinking the amendment. They included Snyder, the bill’s sponsor, who in an email to ProPublica labeled the Democrats’ move to raise the issue during floor debate “a stunt.”

“Democrats were simply more concerned with playing political games to garner talking points of who voted against what, than they were in supporting the budget negotiated by their Governor,” he said.

Said Vining of the Republicans who tabled the amendment: “They’re taking marching orders from the speaker instead of representing their constituents.”

Well-funded opposition

Vos’ opposition echoes that of influential conservative groups, including the Foundation for Government Accountability, a Florida think tank that promotes “work over welfare.” Its affiliated lobbying arm openly opposed the Medicaid extension for new moms when it first surfaced in Wisconsin in 2021, though it has not registered opposition since then. Reached recently, a spokesperson for the foundation declined to comment.

Over the past decade, the foundation has received more than $11 million from a charitable fund run by billionaire Richard Uihlein, founder of the Wisconsin-based shipping supplies company Uline. In recent years, Uihlein and his wife, Liz, also have been prolific political donors nationally and in the Midwest, with Vos among the beneficiaries.

Since 2020, Liz Uihlein has given over $6 million to Wisconsin’s Republican Assembly Campaign Committee, which is considered a key instrument of Vos’ power. And in February 2024, she donated $500,000 to Vos’ personal political campaign at a time when he was immersed in a tough intraparty skirmish.

One concern cited by extension opponents such as the Foundation for Government Accountability is that Medicaid coverage for new moms could be used for health issues not directly related to giving birth. Questions over how expansive the coverage would be spilled into debate in Arkansas in a Senate committee in April of this year.

“Can you explain what that coverage is? Is it just like full Medicaid for any problem that they have, or is it somehow specific to the pregnancy and complications?” asked GOP Sen. John Payton.

A state health official told him new mothers could receive a full range of benefits.

“Like, if they needed a knee replacement, I mean, it’d cover it?” Payton said.

“Yes,” came the reply.

The bill failed in a voice vote.

In Wisconsin, no lawmaker voiced any such concern during the February Senate hearing, which was marked by only positive feedback. In fact, one lawmaker and some medical experts in attendance openly snickered at the thought that Arkansas — a state that ranks low in public health measurements — might pass legislation before Wisconsin, leaving it the lone holdout.

Ultimately, the Wisconsin Senate approved the legislation 32-1 in April, sending it along to the Assembly to languish and leaving Wisconsin still in the company of Arkansas on the issue.

Despite the setbacks and Vos’ firm opposition, Sande of Pro-Life Wisconsin and other anti-abortion activists are not giving up. He thinks Vos can be persuaded and the bill could move out of its purgatory this winter.

“I’m telling you that we’re hopeful,” Sande said.

Rozar is, too, even though she is well aware of Vos’ unwavering stance. “He might have egg on his face if he let it go,” she said.

ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.

He vowed to ‘protect the unborn.’ Now he’s blocking a bill to expand Medicaid for Wisconsin’s new moms. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Maryland Democratic Gov. Wes Moore spent a few minutes sorting donated food before signing an executive order in late October declaring a state of emergency to allow for distribution of food aid. As the federal government reopens, questions remain about how states will be reimbursed for the costs they incurred. (Photo by Bryan P. Sears/Maryland Matters)

Though Congress ended the record-setting federal government shutdown, many questions remain for states that were already wading through seismic federal changes.

One major uncertainty: whether and how states will be reimbursed for the costs they incurred, as they have been in previous shutdowns. And for the longer term, the shutdown offered a glimpse into the funding challenges facing states. They’ll have to rely more on their own money and staff to keep federal programs going even at a time when many face their own budget problems.

That’s a top concern for the federal food stamp program, known as the Supplemental Nutrition Assistance Program, or SNAP. Amid conflicting federal guidance during the shutdown, states reacted in different ways: Some issued partial benefit payments, others sent aid to food banks to keep people from going hungry.

But even after the government reopening restores SNAP aid, other challenges loom. The major tax and spending law enacted this summer tied SNAP funding to state error rates, which measure the accuracy of benefit payments. Advocates fear the shutdown will increase error rates because of conflicting federal guidance.

Air travel, SNAP benefits, back pay at issue as federal government slowly reopens

“States are really worried,” said Crystal FitzSimons, president of the Food Research & Action Center, a nonprofit working to address poverty-related hunger.

And states have been rushing to inform rural residents, veterans and older adults that they will soon be forced to meet work requirements or lose SNAP benefits. It’s just the first in a wave of cutbacks to the nation’s largest food assistance program required under the One Big Beautiful Bill Act that President Donald Trump signed in July.

FitzSimons said the shutdown highlighted the importance of SNAP and how “untenable” many of the upcoming changes will prove for states. For now, states are working to get benefits to people immediately, and then will focus more on questions of reimbursement and ongoing changes to SNAP.

“The hope is that states will be able to move quickly and then turn their attention to all the changes,” she said.

While public attention has centered on the shutdown chaos in recent weeks, more fundamental changes are occurring outside the spotlight, said Eric Schnurer, founder and president of Public Works, a consulting firm specializing in government performance and efficiency.

“The ground is shifting under their [states’] feet even as this goes on,” he said. “Even if the Trump administration and his policies were to pass on in another three years, there are serious structural changes in the relationship between state and federal government.”

Since taking office, the Trump administration has stripped states and cities of billions of dollars that Congress approved for education, infrastructure and energy projects. And the president’s One Big Beautiful Bill Act mandates deep cuts to social service programs, including Medicaid and food stamps.

Under the law, states will be required to pay a greater share of administering SNAP in the coming years. That requirement, along with eligibility changes, could result in millions of Americans losing benefits.

“I think the public in general got a taste of what that might look like over the past month,” Schnurer said, referencing the shutdown’s first-ever disruption to SNAP benefits.

State-federal strain

The legislation to reopen the government approved by Congress and signed by the president this week says that states shall be reimbursed for expenses “that would have been paid” by the federal government during the shutdown.

“So that sounds promising for states,” said Marcia Howard, executive director of Federal Funds Information for States, which analyzes how federal policymaking impacts states.

But it’s unclear how that language will be interpreted. For example, states that sent money to food banks for emergency food assistance are less likely to be made whole compared with states that sent funds through existing federal programs like SNAP, she said.

California dedicated $80 million in state funds and deployed the National Guard to food banks across the state. But Virginia launched a temporary state-level version of the federal food stamp program.

Previous administrations have been more flexible with federal funds, making it easier for states to receive funding or reimbursement, Howard said.

“This administration is really more holding states’ feet to the fire perhaps than other administrations have. So I think they’ll be less permissive in who and how they reimburse,” she said.

It could take weeks or months before states know the full fallout from the shutdown, especially with food assistance.

“[States] did such different things, and I think there’s going to be a fair bit of back-and-forth: should this be covered? Should this not be covered?” Howard said.

The shutdown and its aftermath underscore the ongoing strain between state and federal governments, said Lisa Parshall, a professor of political science at Daemen University in New York.

Federal uncertainty can cause state leaders to be more cautious about their own budgets — similar to how an economic downturn can decrease consumer spending, she said.

“There’s a delay of services, there’s a diminishment of capacity and partnership, and those things might be harder to quantify when you’re talking about what is the cost of the shutdown,” she said. “But I think those are real costs.”

And the end of the shutdown does not extinguish those tensions.

“In some ways, even though the shutdown is over, things are not going to go back to ‘normal,’” she said.

More changes coming

Aside from spending cuts and new administrative costs, Trump’s July law made major tax code changes poised to cost many states, said William Glasgall, public finance adviser at the Volcker Alliance, a nonprofit that supports public sector workers.

Most states use the federal tax code as a basis for their own income tax structures, so changes at the federal level can trickle down to state tax systems or states can choose a different structure to avoid those changes.

Last month, a Massachusetts budget official said federal tax changes would cost the state $650 million in revenue this budget year.

So even with the government back open, states have to plan for some level of unpredictability, Glasgall said. And the future of entire agencies like the Department of Education remain up in the air, he noted.

“So there’s still a lot of uncertainty, even with this bill,” he said.

On Wednesday, state budget analysts briefed Maryland lawmakers on the $1.4 billion budget gap they could face as they head into the 2026 legislative session.

That figure does not include the fallout from the federal government shutdown, which may not be known for months, according to Maryland Matters.

In late October, Democratic Gov. Wes Moore declared an emergency and directed $10 million in state funds toward food banks and pantries. Earlier this month, he announced $62 million in state funds would be deployed directly to SNAP recipients.

Rhyan Lake, a Moore spokesperson, told Stateline that Maryland expects the federal government to reimburse the state for its SNAP expenditures during the shutdown.

But lawmakers are still gearing up for a hit from major federal changes.

In addition to cuts from Trump’s domestic tax and spending law, Maryland has lost about 15,000 federal jobs, budget officials said. But many federal workers who took buyouts were paid through September. And the shutdown caused a pause in federal employment data, potentially concealing the true impact.

State Sen. James Rosapepe, Democratic chair of the joint Spending Affordability Committee, said he’s worried the state has only seen the beginning of its federally induced fiscal challenges. He also noted that this week’s shutdown-ending legislation only assures the government remains open through January, meaning another shutdown could be just a couple months away.

“We’re less than a year into the administration, and the effects of things they’ve already done don’t seem to have flowed through yet to the data that we have, which leads me to believe that the worst is yet to come,” he said.

Stateline reporter Kevin Hardy can be reached at khardy@stateline.org.

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Planned Parenthood of Wisconsin resumed scheduling abortions on Monday after a nearly monthlong pause due to federal Medicaid funding cuts in President Donald Trump’s tax and spending bill that took effect at the beginning of October.

Planned Parenthood of Wisconsin said it was able to resume scheduling abortions as of noon on Monday because it no longer fits the definition of a “prohibited entity” under the new federal law that took effect this month and can receive Medicaid funds.

The organization said it dropped its designation as an “essential community provider” as defined under the Affordable Care Act. Dropping the designation will not result in changes to the cost for abortions or other services or affect the organization’s funding, Planned Parenthood of Wisconsin President and CEO Tanya Atkinson said.

“At this point, in all of our research and analysis, we really shouldn’t see much of an impact on patient access,” she said. “If relinquishing this does ultimately impact our bottom line, then we will have to understand what that path forward is.”

A national fight over abortion funding

Abortion funding has been under attack across the U.S., particularly for affiliates of Planned Parenthood, the biggest provider. The abortion landscape has shifted frequently since the U.S. Supreme Court ruling in 2022 that allowed states to ban abortion. Currently, 12 states do not allow it at any stage of pregnancy, with limited exceptions, and four more ban it after about six weeks’ gestation.

Planned Parenthood has warned that about half its clinics that provide abortion could be closed nationwide due to the ban in the new federal law on Medicaid funding for Planned Parenthood for services other than abortion.

Wisconsin, where abortion is legal but the Republican-controlled Legislature has passed numerous laws limiting access, was the only state where Planned Parenthood paused all abortions because of the new federal law, Atkinson said.

Because of the complexities and varieties of state abortion laws, Planned Parenthood affiliates are responding to the new federal law in a variety of ways, Atkinson said. In Arizona, for example, Planned Parenthood stopped accepting Medicaid but continued to provide abortions.

The move in Wisconsin is “clearly aimed at sidestepping” the federal law, Wisconsin Right to Life said.

“Planned Parenthood’s abortion-first business model underscores why taxpayer funding should never support organizations that make abortion a priority,” said Heather Weininger, executive director of Wisconsin Right to Life. “Women in difficult circumstances deserve compassionate, life-affirming care — the kind of support the pro-life movement is committed to offering.”

Impact on Wisconsin abortion clinics

In Wisconsin, pausing abortions for the past 26 days meant that women who would normally go to clinics in the southeastern corner of the state instead had to look for other options, including traveling to Chicago, which is within a three-hour drive of the Planned Parenthood facilities.

Affiliated Medical Services and Care for All also provide abortions at clinics in Milwaukee.

Atkinson said it was “really, really difficult to say” how many women were affected by the pause in services. She did not have numbers on how many women who wanted to have an abortion since the pause went into effect had to seek services elsewhere.

Planned Parenthood of Wisconsin serves about 50,000 people, and about 60% of them are covered by Medicaid, the organization said.

Given those numbers, the priority was on finding a way to continue receiving Medicaid funding and dropping the “essential community provider” status, Atkinson said.

Wisconsin is part of a multistate federal lawsuit challenging the provision in the law. A federal appeals court in September said the government could halt the payments while a court challenge to the provision moves ahead.

Ramifications for Medicaid

Planned Parenthood of Wisconsin cited a Sept. 29 court filing on behalf of U.S. Health and Human Services that said family planning organizations could continue billing Medicaid if they gave up either their tax-exempt status or the “essential community provider” designation.

By giving up that designation, it no longer fits the definition of “prohibited entity” under the federal law and can continue to receive federal Medicaid funds, the organization said. Planned Parenthood of Wisconsin is not giving up its tax-exempt status.

The “essential community provider” designation was originally given to organizations to help make it easier for them to be considered in-network for billing with private health insurers, Planned Parenthood said.

Atkinson called it a “nuanced provision” of the law and she does not anticipate that giving it up will affect Planned Parenthood’s ability to continue providing abortions and other services.

Planned Parenthood provides a wide range of services including cancer screenings and sexually transmitted infection testing and treatment. Federal Medicaid money was already not paying for abortion, but affiliates relied on Medicaid to stay afloat. Services other than abortion are expected to expand in light of the new law.

Planned Parenthood performed 3,727 abortions in Wisconsin between Oct. 1, 2023, and Sept. 30, 2024, the group said.

Wisconsin Watch is a nonprofit and nonpartisan newsroom. Subscribe to our newsletters to get our investigative stories and Friday news roundup. This story is published in partnership with The Associated Press.

Planned Parenthood of Wisconsin resumes offering abortions after a nearly monthlong pause is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Although President Donald Trump’s “One Big Beautiful Bill Act” offers new tax deductions and credits across different income levels, low-income households – the bottom 20% of income earners – are largely excluded from any significant tax benefits. 

“It’s particularly shocking because the law is so big,” said Elaine Maag, a senior fellow at The Urban-Brookings Tax Policy Center. “Typically, when trillions of dollars are spent, you see it really spread across the income distribution.”

The bill was signed into law over the summer.

Benefits that people with low incomes do receive may be outweighed when considered alongside other provisions in the bill, said Andrew Reschovsky, professor emeritus of public affairs and applied economics at the University of Wisconsin-Madison.

This is especially true of cuts to safety net programs such as Medicaid and the Supplemental Nutrition Assistance Program, or SNAP, Reschovsky said.

“This is the dilemma – if you count those things in with the tax side, the net will be that a lot of people are going to be worse off.”

Credits and deductions

A credit is an amount subtracted directly from the tax you owe while a deduction reduces the amount of income that can be taxed. Both can help keep more money in taxpayers’ pockets. 

The bill establishes new credits and deductions. 

The bill increases the: 

• Child Tax Credit from $2,000 per qualifying child to $2,200.  
• Child and Dependent Care Credit, which allows taxpayers to subtract certain costs associated with caring for children under 13 or dependents incapable of self-care. 

The bill introduces new deductions for:

• Workers in jobs where tips are common, allowing them to deduct up to $25,000 of tip income. 
• Individuals who work overtime, allowing them to deduct up to $12,500 of overtime pay. 
• People 65 and older, allowing them to deduct $6,000. 

Limitations

These changes may appear to help people who are financially struggling. But the bill affects federal taxes, so its new deductions and credits apply only to income taxable by the federal government. 

People with low income generally owe little or no federal income tax. 

Older low-income adults, for example, often rely primarily or entirely on Social Security benefits and are generally not subject to federal taxes. This means that a new $6,000 deduction would not benefit them, Rechovsky said.   

Rechovsky noted other reasons the new deductions are misleading or extremely narrow. 

“Yes, you’re a waiter and you benefit from not paying taxes on your tips,” he said. “But take someone in the same income range who works as a home health care worker – they don’t benefit at all.” 

Reschovsky also questions how those with low incomes would benefit from reducing the amount owed on overtime pay. 

“One of the reasons some people are low-income is that they’re lucky to get a 40-hour workweek,” he said. 

The same limitation applies to the new credits. 

An analysis by Maag estimates that in 2025 about 17 million children under 17 – or one in four – will receive less than the full value of the Child Tax Credit because their parents earn too little.

The bill also changes which families qualify based on citizenship status.  

The Child Tax Credit will be limited to children who are U.S. citizens and have at least one parent with a valid Social Security number. 

About 2 million U.S. citizen children will lose their Child Tax Credit because of this new requirement, Maag wrote, citing an analysis from the Joint Committee on Taxation. 

Safety nets

One benefit to people with low incomes from the bill is that it makes permanent many provisions from the 2017 Tax Cuts and Jobs Act, including lower income tax rates and larger standard deductions. 

“It’s true across the board that if taxes go down, your income after taxes goes up,” Reschovsky said. 

But for those with low incomes, the increase is minimal and will likely be outweighed by changes to Medicaid, premium subsidies provided by the Affordable Care Act and changes to SNAP. 

For example, the lowest 10% of earners may see a $1,600 reduction in annual income and benefits, mainly due to cuts in Medicaid and SNAP, according to the nonpartisan Congressional Budget Office. 

“It’s just that classic view … that, ‘Well, these people are just sucking on the teat of the federal government, so we’re going to just make it as hard as possible for them to do that, because they’re just freeloaders,’” said Anthony Myers, program director of the Riverworks Financial Clinic.

Where to get help

For people with incomes under $67,000, free tax assistance is available through programs such as the IRS’ Volunteer Income Tax Assistance, or VITA. 

VITA sites can be found using the IRS Free Tax Prep Help website. 

Maag and Myers recommend making appointments as soon as possible. 

In addition to serving as a VITA site, Riverworks Financial Clinic operates year-round as the City of Milwaukee Financial Empowerment Center. 

Residents of the city who are 18 years and older can get free one-on-one financial counseling there. 

“Anyone that’s struggling with any of these (One Big Beautiful Bill Act) provisions, we can assist them with navigating through this,” Myers said. 

Here’s how Trump’s new tax law affects people with low incomes is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Jess Deis, a nurse practitioner and nurse midwife in Kentucky and Indiana, learned she had cervical cancer after she qualified for Medicaid insurance in 2014. (Sarah Ladd/Kentucky Lantern)

Third in a five-part series.

It had been a decade since Jess Deis’ last women’s wellness exam when Kentucky expanded Medicaid and she finally qualified for the state insurance program.

Physicians recommend a cervical cancer screening — also referred to as a Pap smear, which is a swab of the cervix — as part of a wellness exam once every three to five years for women between the ages of 21 and 65. Deis, 43, was in her last semester of nursing school in 2014 when the test came back with abnormal results. Her doctor ordered additional testing.

“Then I got a call on a Sunday evening from a physician letting me know I had cervical cancer and I needed to see a specialist,” Deis said.

Cervical cancer is one of few cancers that has a known path of prevention after the approval of the first HPV vaccine in 2006. But that also means it falls at the intersection of three cultural issues that are facing strong political opposition — broad access to low-cost or free reproductive health care, access to vaccines for children, and sex education.

Kentucky had the highest cervical cancer incidence rate in the country between 2015 and 2019, according to medical research, and a mortality rate twice as high as the rest of the country. The state tied with West Virginia for the second-highest rate of 9.7 cases per 100,000 residents between 2017 and 2021. Oklahoma topped the list for that five-year period with 10.2 cases per 100,000, according to the National Cancer Institute.

Deis delayed the surgery to remove her uterus until after graduation, and later became a certified nurse practitioner. Now she provides Pap smears to patients multiple times a day at Planned Parenthood clinics in Kentucky and Indiana and other care via telehealth. She recently helped a patient who hadn’t been seen for a screening in 15 years discover she had advanced cervical cancer.

She is troubled by what could happen in the wake of the new Medicaid rule passed by Congress and signed by President Donald Trump in July that barred nearly all Planned Parenthood affiliates from receiving Medicaid reimbursements because some clinics in the nonprofit network provide abortions. Kentucky and Indiana both have abortion bans, but still have Planned Parenthood clinics to provide other reproductive health care.

“I don’t just worry; I know that there’s going to be more folks with stories like mine, but without the happy ending,” Deis said.

‘What we’re really talking about is our daughters getting cervical cancer’

The American Cancer Society recently reported the number of early cervical cancer cases has declined sharply among young people since the vaccine’s introduction nearly 20 years ago. But vaccine adoption rates for children are low in the states where rates are highest — about one-third of boys and girls between the ages of 13 and 17 were vaccinated in Mississippi as of 2020.

The vaccine is most effective when given before engaging in any kind of sexual activity for the first time, because it can prevent the sexually transmitted strains of HPV that present the highest risk of cervical cancer. More than 98% of cervical cancer cases are caused by HPV, and a 2024 study from the Journal of the National Cancer Institute found zero cases of cervical cancer in Scottish women born between 1988 and 1996 who were fully vaccinated against HPV between the ages of 12 and 13.

“We could make (cervical cancer) an eradicated disease,” said Dr. Emily Boevers, an Iowa OB-GYN. “But everything is falling apart at the same time.”

Boevers said limitations on Medicaid coverage and the loss of Title X family planning funding will make screenings and vaccines less accessible for the populations that need them the most, even if clinics don’t close as a result. But it will take years to see the consequences of these changes, she said, because it takes about 15 years on average for HPV to become cancer. 

“So what we’re really talking about is our daughters getting cervical cancer,” she said. 

Kentucky’s legislature acknowledged the importance of HPV vaccines as recently as 2019, when representatives passed bipartisan House Resolution 80, which encouraged females and males between the ages of 9 and 26 to get the HPV vaccine and everyone to “become more knowledgeable of the benefits of the vaccine.” Only four legislators voted against it.

But today, the U.S. Department of Health and Human Services is led by Secretary Robert F. Kennedy Jr., who has made false statements about the HPV vaccine’s safety and effectiveness and played a leading role in organizing a mass lawsuit against one of the vaccine’s manufacturers, Merck. The Associated Press reported the judge dismissed more than 120 claims of injuries from Gardasil, the name of one HPV vaccine, because of a lack of evidence. 

“Secretary Kennedy supports renewing the focus on the doctor-patient relationship and encourages individuals to discuss any personal medical decisions, including vaccines, with their healthcare provider,” a Health and Human Services spokesperson wrote to States Newsroom in September. “The American people voted for transparency, accountability, and the restoration of their decision-making power, and that is exactly what HHS is delivering.”

The response did not clarify whether Kennedy still thinks the vaccine is unsafe and what basis there is for that claim. 

Dr. Linda Eckert, a University of Washington School of Medicine professor and practicing OB-GYN, has an extensive background in immunizations and cervical cancer prevention. She served as a liaison for the American College of Obstetricians and Gynecologists to the CDC’s Advisory Committee on Immunization Practices until 2024. Members of the committee were recently dismissed by Kennedy’s agency and replaced by new members, several of whom have reportedly expressed anti-vaccine views. Eckert said the group had plans in motion to present to the ACIP in June a case for administering the HPV vaccine at the earliest age of 9 before it was disbanded. 

Although Black and Hispanic women are affected by cervical cancer at disproportionate rates because of systemic inequities, Eckert said the fastest rising group experiencing late-stage cancer is white women in the Southeast. But she added that Alabama was the first state in the country that launched a targeted campaign to eliminate cervical cancer. 

Treatment for the cancer once it develops can also be difficult to obtain, Eckert said. It can be expensive and require many follow-up visits, and usually leads to infertility either through hysterectomy or invasive radiation treatments. 

“It is a really devastating disease to treat,” Eckert said. “Even if you live, you are permanently changed.”

Recent study showed zero cases of cervical cancer after HPV vaccine 

Dr. Aisha Mays, founder and CEO of a Dream Youth Clinic in Oakland, California, said the services her clinic offers to young people for free includes most of the same services that Planned Parenthood clinics provide, including the HPV vaccine.

“That’s the work of Planned Parenthood and clinics like mine that are encouraging and doing regular Pap smear screenings and vaccines, and having really clear conversations with young people around the importance of these procedures,” Mays said.

The recent turn against vaccines by some segments of the public and members of President Donald Trump’s cabinet who doubt their effectiveness and baselessly claim that they cause injury and developmental issues like autism has made the promotion of HPV vaccines more difficult for Mays. Overwhelming evidence, including from the Centers for Disease Control and Prevention, shows that they are safe and effective.  

The vaccine can also protect against genital warts, anal cancer and oropharyngeal cancer, Mays said. There are about 40 strains of HPV in total that are known to infect the genitals, and more that can attach to certain patches of skin. Most people who have sex will come in contact with one or more of the strains by the time they reach their mid-20s or early 30s.

Mays’ clinic is largely funded by state and local grants, but it received more than $100,000 in federal funding for a sexual health education program through the U.S. Department of Health and Human Services’ Office of Population Affairs. It was a nationally distributed podcast hosted by adolescents, Mays said, and they chose topics to talk about related to sexual health, including HPV.

The program’s grant was one of many that have been cancelled under the Trump administration. An objective laid out in Project 2025, the blueprint document for the next Republican presidency written by conservative advocacy group the Heritage Foundation, was to ensure no subgrantees of sex education programs were promoting abortion or “high-risk sexual behavior” among adolescents. It also stated that any programming should not be used to “promote sex.”

HHS also terminated funding for one of California’s sexual health programs in August over the state’s refusal to remove references in the programming related to gender, including the idea that biological sex and gender identity are distinct concepts. Another directive of Project 2025 was to make sure biological sex is never conflated with gender identity or sexual orientation.

States with high rates of cervical cancer have low density of physicians

States with the lowest incidences of cervical cancer, including Massachusetts, New Hampshire, Connecticut and Minnesota, also have the highest density of physicians per capita. According to the Association of American Medical Colleges’ state physician workforce data, Massachusetts has the highest number of physicians per 100,000 people, and Oklahoma ranks in the bottom three.

Kentucky is in the bottom 15, and so is Indiana, where Marissa Brown works as a Planned Parenthood health center manager in Bloomington. Brown described her clinic as “an oasis in a desert” because there are few options for gynecological care in the area, and even fewer for obstetrics. Brown said they routinely see patients from rural areas two or more hours away, and many of them are coming for wellness exams that include cancer screenings.

Indiana used to have 38 Planned Parenthood clinics, but through 15 years of funding cuts and targeted anti-abortion legislation, the organization closed 21 of them between 2002 and 2017. In the years since then, another seven shut down to consolidate services. Many of them did not provide abortions.

“We hear a lot about patients coming in who can’t get into their gynecologist for four to 12 weeks,” Brown said. “We can do that in a few days to two weeks, and we have walk-in appointments too.”

Health Imperatives, a nonprofit network of seven community health clinics in southern Massachusetts, can no longer bill for Medicaid because they provide medication abortions and received about $800,000 in reimbursements for other services in 2023, like Planned Parenthood. One of Health Imperatives’ clinics is in Martha’s Vineyard, whose working-class residents have to work three to four jobs just to afford to live on the affluent island, said Julia Kehoe, the organization’s president and CEO.

More than a decade ago, she said she noticed a pattern: Their patients would come in for an annual gynecological exam, receive an abnormal cervical cancer screening, but not follow up, because the closest available specialist would require expensive travel off the island. Kehoe said that once their Martha’s Vineyard clinic purchased a colposcopy machine, from privately raised funds, in 2012, they started diagnosing some of their regular patients with now-advanced cancer.

“In the first year that we did colposcopies, we found four individuals who had stage three or four cancer, who we luckily were then able to connect up to Boston for critical care,” she said. “But if we had had that capacity earlier … we would have caught it earlier.”

States Newsroom reproductive rights reporter Sofia Resnick contributed to this report.

Coming Thursday: Telemedicine could help narrow the care gap in rural communities.

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Planned Parenthood of Wisconsin will stop scheduling patients for abortions starting next week as it works to find a way to provide the service in the face of Medicaid funding cuts in President Donald Trump’s tax and spending bill, the nonprofit said Thursday.

Abortion funding across the U.S. has been under siege, particularly Planned Parenthood affiliates, which are the biggest provider. Wisconsin appears to be the first state where Planned Parenthood is pausing abortions because of the new law.

The organization warned earlier this year that about half its clinics that provide abortion could be closed as a result of a ban on Medicaid funding for Planned Parenthood for services other than abortion.

The measure was part of the tax and spending law President Donald Trump signed in July. Initially, a judge said reimbursements must continue, but a federal appeals court this month said the government could halt the payments while a court challenge to the provision moves ahead.

Planned Parenthood services include cancer screenings and sexually transmitted infection testing and treatment. Federal Medicaid money was already not paying for abortion, but affiliates relied on Medicaid to stay afloat.

The remaining Planned Parenthood clinics in Louisiana – where abortion is banned – are scheduled to shut down at the end of this month.

Planned Parenthood of Wisconsin said in a statement that it is trying to see as many patients as possible between now and Tuesday. The federal law takes effect Wednesday. It is not scheduling patients beyond that date, and the organization believes the move will allow it to continue seeing other Medicaid patients. The organization said it was working with providers across the state to make sure patients are referred quickly and receive timely care.

It is also considering taking legal action, the group said.

“Planned Parenthood of Wisconsin will continue to provide the full spectrum of reproductive health care, including abortion, as soon and as we are able to,” Planned Parenthood of Wisconsin President and CEO Tanya Atkinson said in the statement. “In the meantime, we are pursuing every available option through the courts, through operations, and civic engagement.”

The abortion landscape has been shifting frequently since the U.S. Supreme Court ruling in 2022 that allowed states to ban abortion. Currently, 12 states do not allow it at any stage of pregnancy, with limited exceptions, and four more ban it after about six weeks’ gestation.

The bans have resulted in more women traveling for abortion and an increased reliance on abortion pills. Prescribers in states where they’re allowed have been shipping the pills to places where abortion is banned, a practice that is facing some legal challenges and is expected to attract more.

The Wisconsin Supreme Court in July struck down the state’s 1849 near-total ban on abortion, saying it was superseded by newer state laws regulating the procedure. The same day it ruled in that case, the court dismissed a lawsuit filed by Planned Parenthood of Wisconsin asking it to find the law unconstitutional.

Wisconsin’s abortion ban was in effect until 1973, when the U.S. Supreme Court’s landmark Roe v. Wade decision legalizing abortion nationwide nullified it. Legislators never officially repealed it, however, and conservatives argued that the U.S. Supreme Court’s ruling that overturned Roe reactivated it.

Planned Parenthood of Wisconsin stopped providing abortions after that ruling for 15 months before resuming them as the lawsuit over the state law played out. It has been providing abortions at three clinics in Wisconsin for the past two years.

Planned Parenthood of Wisconsin serves about 50,000 people across the state. About 60% of them are covered by Medicaid, the organization said.

The federal Hyde Amendment already restricts government funding for most abortions, and less than 5% of the services Planned Parenthood provides are abortions, according to the organization’s 2023 annual report.

Planned Parenthood provides a wide range of services besides abortion. Its most recent annual report shows that contraceptive services and testing and treatment for sexually transmitted infections make up the vast majority of its medical care. It performs more cancer screening and prevention procedures than abortions, according to the report.

Mulvihill reported from Cherry Hill, New Jersey. Associated Press reporter Christine Fernando in Chicago contributed.

Wisconsin Watch is a nonprofit and nonpartisan newsroom. Subscribe to our newsletters to get our investigative stories and Friday news roundup. This story is published in partnership with The Associated Press.

Planned Parenthood of Wisconsin to pause abortions amid federal Medicaid funding cut is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Americans who earn less than $18,000 are estimated to see a slight federal tax cut under President Donald Trump’s big bill, but the net effect of the bill is likely to lead to a loss in household resources.

The average federal tax change from current levels for the bottom 20% of American earners is a reduction of $150 by 2026 and a reduction of $160 by 2030, according to estimates from the nonpartisan Tax Policy Center. In contrast, the average income earner will receive a $2,860 cut while the top 1% of earners will see a $75,410 cut on average. 

Lower income earners already pay little in taxes. Reductions in Medicaid and SNAP benefits are likely to affect lower income earners disproportionately, resulting in a projected net decline of 2.9% in their household resources.

This fact brief is responsive to conversations such as this one.

Sources

• Tax Policy Center: T25-0231 – Reconciliation Bill, One Big Beautiful Bill Act (OBBBA), As Passed by the House and Senate, Distribution by ECI Percentile, 2026
• The Budget Lab at Yale: Tax Provisions in the Reconciliation Bill: Combined Distributional Impacts
• Penn Wharton Budget Model: President Trump-Signed Reconciliation Bill: Budget, Economic, and Distributional Effects
• The Budget Lab at Yale: Distributional Effects of Selected Provisions of the House and Senate Reconciliation Bills

Will the bottom 20% of American income earners pay more in taxes under Trump’s big bill? is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

The Transporting Students with Disabilities and Special Needs (TSD) Conference in Frisco, Texas this fall looks to address the unique challenges and considerations of transporting this at-risk population.

Providing the best care for the students, empowering the transportation staff, and building an operational culture of communication and clear policies will be discussed by industry veterans, transportation consultants, and school district and bus company staff members.

In the driver training category, session topics include how to model behavior interventions in transportation settings, training for empathy of children’s needs, providing training for the service of medically fragile riders, and other proactive training educational discussions.

For upholding legal requirements and federal standards, speakers will plan to address topics such as impact of the updated National School Bus Specifications and Procedures on operations, alternative transportation, Medicaid reimbursement funding, and developing policies for proper and safe usage of student restraint and seclusion practices.

To address collaborating with contractors or other resources to aid student transportation, examples of topics include how to avoid one-size-fits-all solutions, how to create successful partnerships between school districts and contractors, and the OT/PT Transporter Forum on multidisciplinary policy development.

In addition to the hands-on training classes that cover wheelchair securement, school bus evacuations and use of child safety restraint systems on school buses, instructors from the Texas School for the Deaf will provide training for student transporters on using American Sign Language to communicate.

For a full list of 2025 TSD conference topics, visit tsdconference.com.

Save $100 on regular conference registration with Early Bird registration by Oct. 3. The TSD Conference will be held November 6-11 in Frisco, Texas at the Embassy Suites Dallas-Frisco Hotel and Convention Center. Find more information on daily agenda, unique experiences, hotel and registration at tsdconference.com

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Related: TSD Conference Registration is Open for Event in November
Related: TSD Evacuation Class Emphasizes Importance of Training
Related: (STN Podcast E236) TSD 2024 Recap: Supporting Students with Special Needs as Unique People

The post TSD Conference Topics Plan to Cover Unique Aspects of Transporting Students appeared first on School Transportation News.

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For over a decade, Wisconsin has heard the same message from Republicans regarding full Medicaid expansion: Accepting 90% federal reimbursement to cover more low-income people will only set Wisconsin up for failure if the federal government abandons its part of the deal. 

At first glance, President Donald Trump’s recently signed big bill appears to validate that argument. The 40 states that have fully expanded are now expected to lose billions of dollars in federal aid while getting tagged with additional administrative costs to create work requirements and eligibility assessments required in the bill. 

But it turns out Wisconsin is still going to be subject to the new federal mandates without the higher federal reimbursement rate that expansion states will continue to receive. In other words, at a time when the Republican-controlled federal government is supposedly pulling out the rug from expansion states, Wisconsin is still left holding the bag.

A look back

Back in 2014, then-Gov. Scott Walker and Wisconsin Republicans made the controversial decision not to accept full Medicaid expansion.

At the time, Walker explained his goal “is to get more people out into the workplace, more people covered when it comes to health care and fewer people dependent on the government, not because we’ve kicked them out, but we’ve empowered them to take control of their own destiny.”

But he also argued that the federal government would eventually pull back on its commitment to fund Medicaid at 90%.

“That commitment is not going to be there and taxpayers all across America will be on the hook,” Walker said. “They are not going to be on the hook in Wisconsin.”

At the time, Wisconsin was one of 25 states not accepting expansion. Now, the state is one of the 10 remaining holdouts, with most of the others in the deep red South. Even reliably red states, like Arkansas and Louisiana, have accepted full expansion. 

Instead of accepting full expansion, Wisconsin chose to cover individuals through BadgerCare, the state’s Medicaid-supported health insurance program for low-income residents set up by former Gov. Tommy Thompson, a Republican. 

Walker and Republicans lowered Medicaid coverage to 100% of the federal poverty line from the previous 200% and eliminated the waiting list for childless adults. Those above the poverty line without employer-sponsored insurance could purchase it through the Affordable Care Act marketplace using federal subsidies, according to the Wisconsin Policy Forum.  

But Wisconsin taxpayers are paying more to cover individuals below the poverty line: 39.3% of costs rather than 10% under full Medicaid expansion. In 2023, Medicaid accounted for 15.7% of state taxpayer spending, according to the policy forum.

Under its approach, Wisconsin doesn’t have an eligibility gap like some states, something Republicans highlight as a reason the state doesn’t need to expand.

But that has come with a loss of federal funds. Over the past decade, Wisconsin’s Department of Health Services estimates, the state has spent about $2.6 billion more to cover the costs of a partial expansion compared with the projected cost under a federal expansion.

Under an expansion, more individuals would be able to access Medicaid. But the Wisconsin Policy Forum found it would have a somewhat modest impact on coverage levels — the percentage change in Medicaid enrollees would be 7.2%, compared with nearly 30% or more in other non-expansion states. 

Work requirements still in effect under Trump bill

With the recent federal bill, Walker and other Republicans still argue Wisconsin was right not to accept federal expansion. The state is going to experience the impacts to a lesser extent than fully expanded states. 

But because Wisconsin receives federal waivers for its Medicaid program, the state is still subject to some provisions under the new law, including the work requirements, eligibility determinations and provider taxes.

Under the new work requirements, individuals covered by Medicaid are required to prove they are working 80 hours per month — parents with dependent children or people who are medically frail are exempted.

As a result, some 230,000 Wisconsin residents could lose coverage while the state incurs administrative costs to account for the new requirements, according to an estimate from U.S. Senate Democrats based on data from the Congressional Budget Office.

The work requirements don’t stop at individuals covered by Medicaid alone; it also extends to coverage through marketplace subsidies, affecting over 200,000 Wisconsin residents. 

Work requirements used to be required for Wisconsin residents to access coverage through federal waivers, but in 2021 then-President Joe Biden removed the work requirement. 

The labor force participation rate has dipped from about 68% in 2017 to a little over 65% as of May 2025 but has remained higher than the national average, which is about 62%. Some reports suggest that decline is due to the aging workforce in the state.

Work requirements have also been found to increase the uninsured rate.  

The Wisconsin Policy Forum reports that one of the main reasons work requirements may lead to higher uninsured rates is that they are confusing and time-consuming. Some people may choose to get rid of coverage altogether to avoid unnecessary paperwork. 

What could happen with the federal bill?

The Kaiser Family Foundation also found that implementing work requirements will be costly for states, costing anywhere from $10 million to over $270 million, depending on the size of the state. DHS estimates the state will pay $6 million annually to implement work requirements, while receiving a lower federal match rate than fully expanded states to reimburse for administrative costs.

With a lower federal match rate, Wisconsin has increased Medicaid funding through hospital taxes, which the new state budget just increased from 1.8% to the federal maximum of 6% for the 2025-27 biennium budget.

Republican lawmakers in the state were quick to approve the hospital tax increase, despite their previous opposition to Medicaid expansion as a means for drawing down additional federal funding. If they hadn’t, the state’s 1.8% tax would have been frozen under Trump’s big bill. The increase will raise some $1 billion more annually in federal matching funds that the state can use to pay hospitals for care they provide Medicaid patients.

States that expanded will not lose the 90% federal match rate, but those like Wisconsin that didn’t will now miss out on an additional incentive to expand created during the Biden administration.

The incentive would have raised the federal match rate to 95% for two years, but was eliminated by Trump’s big bill. Instead Wisconsin will remain at about 60% reimbursement, while still facing the same bureaucratic requirements as expansion states.

Wisconsin still losing out from not expanding Medicaid — even under Trump’s big bill is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Wisconsin will receive an estimated $1 billion more annually in federal funds for Medicaid because the state budget includes a change that pre-empts a provision in President Donald Trump’s big bill.

Trump’s bill would have prevented Wisconsin from raising its hospital tax.

But days before Trump signed it, the Republican-led Legislature and Democratic Gov. Tony Evers approved a 2025-27 state budget that raises Wisconsin’s hospital tax from 1.8% to 6%.

The increase will raise some $1 billion more annually in federal matching funds that the state can use to pay hospitals for care they provide Medicaid patients.

Wisconsin’s largest Medicaid program is BadgerCare Plus, which provides health insurance to about 1 million low-income people age 64 and under.

Republican U.S. Rep. Derrick Van Orden, who represents western Wisconsin, claimed that Trump’s bill “secured” the $1 billion.

The bill cuts roughly $1 trillion over 10 years from Medicaid, which costs nearly $900 billion annually.

This fact brief is responsive to conversations such as this one.

Sources

• Wisconsin Hospital Association: WI State Budget Bill Includes Historic Medicaid Rate Increase for Hospitals
• Milwaukee Journal Sentinel: Derrick Van Orden claims credit for Wisconsin's extra Medicaid dollars after voting to cut the program
• Milwaukee Journal Sentinel: Ron Johnson laments Wisconsin's reach for Medicaid funds, spurred by the Trump bill he voted for
• Wisconsin Department of Administration: Wisconsin Health Services Department budget
• Wisconsin Legislature: Health Services budget
• Wisconsin Department of Health Services: BadgerCare Plus
• Wisconsin Department of Health Services: BadgerCare Plus
• X: Derrick Van Orden post
• Axios: Trump's spending bill cuts Medicaid: Here's what it's called in your state
• Kiplinger: What to Know About New Medicaid Cuts: Is Your Local Hospital Closing Soon?
• Wisconsin Watch: Have millions of nondisabled, working-age adults been added to Medicaid?

Does Donald Trump’s big bill provide an additional $1 billion annually for Wisconsin’s Medicaid program? is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.