The Madison Social Security Administration field office. (Wisconsin Examiner photo)

Wisconsinites are holding rallies  across the state Wednesday to call on Congress and the Trump administration to increase funding for operations at the Social Security Administration.

Staff reductions and office closures in the last year have created bottlenecks in service for members of the public who need help from the agency, according to Jessica LaPointe, the Wisconsin-based president of American Federation of Government Employees (AFGE) Council 220. The union represents field operations employees for the Social Security Administration across the country.

“We’re struggling to meet the needs of the public,” LaPointe said, with more than 10,000 people a day becoming eligible for the federal retirement program.

Along with AFGE, the Wisconsin Alliance for Retired Americans will be rallying outside Social Security offices in eight Wisconsin communities Wednesday.

“When they start closing offices, that hinders our senior citizens,” said Ross Winklbauer, president of WARA. “They call into Social Security if they have a question or to file a claim, and they’re sitting on the phone for hours because of short staffing and not getting their questions answered.”

WARA will take part in a rally starting at 12 noon outside the Social Security offices in the Milwaukee suburb of Greenfield along with AFGE. Rallies are also planned in Eau Claire, Madison, Racine, Rhinelander, Stevens Point, Wausau and Wisconsin Rapids. Winklbauer said WARA has about 100,000 members in the state, mostly union retirees, and about 1,000 active participants.

The rallies are part of a national day of action in anticipation of the possibility that the government will shut down at the end of January if Congress can’t agree on a budget for the rest of the year, LaPointe said.

Talks are underway between congressional Republicans and Democrats to enact the rest of the government’s spending plan for the current year by the upcoming deadline.

Nevertheless, LaPointe said the most recent shutdown that started Oct. 1 and ran for a record 43 days brought home to many field office workers in the Social Service Admin. the limits of their compensation, especially if they are furloughed.

In a report released Wednesday, the Strategic Organizing Center said its review of 36,000 Social Security workers’ pay rates showed that 54% — just over half — were paid less than what the MIT Living Wage Calculator has set as a living wage for the regions of the U.S. where they live. The developers of the calculator at the MIT Living Wage Institute define a living wage as “the rate that a full-time worker requires to cover the costs of their family’s basic needs where they live.”

“We don’t get paid enough to save for a rainy day,” LaPointe said. “We’re understaffed, we’re underpaid and we’re struggling to meet the needs of the public who are coming to us for their earned benefits.”

In January 2025, when President Donald Trump took office, the agency’s staff was at its lowest in 50 years, LaPointe said, and “the public was waiting too long for benefits and services.”

Since then, the agency instituted a buyout program, offering workers up to $25,000 to quit, and the staff dropped from 58,000 a year ago to about 50,000 now — “the largest single staffing cut in Social Security history,” LaPointe said. 

About 2,000 field staff were lost in the last year — 10% of the field operations, she said, with the number of employees at some offices falling to single digits. 

LaPointe said the agency has moved to “digital first” operations that favor online or telephone contacts instead of in-person visits. In addition, the agency has shifted to processing inquiries from the public nationally rather than at the local office she said — “where a customer out in California would be served by someone in Wisconsin, or a customer in Madison might be served by someone in New Jersey.”

In an email message, a Social Security Administration spokesperson depicted the digital shift as part of a modernization program so that “more Americans are choosing to resolve their needs online or over the phone.” The statement cited a recent audit by the Social Security Administration inspector general that found average hold times for callers had dropped to seven minutes by September 2025 from a high of 30 minutes in January.

Social Security Commissioner Frank Bisignano “has pledged to have the right level of staffing to operate at peak efficiency and deliver best-in-class customer service to the American people,” the spokesperson said.

The Social Security Administration “is taking action to improve workplace satisfaction, support professional development, and enhance communication across all levels of the organization,” the spokesperson added.

LaPointe, however, said there’s been “a breakdown in community based service” with the new system, and Social Security staffers are no longer the face of government in the local community.

“You now have to have an appointment to do anything with Social Security,” LaPointe said. “It’s created a bottleneck of service to where people cannot get access to apply for benefits in a timely fashion.”

Frontline workers are concerned that a move toward using artificial intelligence technology to review benefit applications will increase errors — either benefit approvals that are mistaken or unwarranted denials, she said.

“It still takes a human being to adjudicate claims — every claim, whether on the phone, online or in person,” LaPointe said.

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This article first appeared on KFF Health News.

As Congress debates whether to extend the temporary federal subsidies that have helped millions of Americans buy health coverage, a crucial underlying reality is sometimes overlooked: Those subsidies are merely a band-aid covering the often unaffordable cost of health care.

California, Massachusetts, Connecticut and five other states have set caps on health care spending in a bid to rein in the intense financial pressure felt by many families, individuals and employers who every year face increases in premiums, deductibles and other health-related expenses.

Hospitals and other health care providers are citing Republicans’ One Big Beautiful Bill Act, signed by President Donald Trump in July, as one more reason to challenge those limits.

The law is expected to reduce federal Medicaid spending by more than $900 billion over a decade, which mathematically should help the overall health care system meet the caps. But the law is also expected to increase the number of uninsured Americans, mostly Medicaid beneficiaries, by an estimated 10 million people. Health care analysts predict hospitals and other providers will raise prices to cover the double whammy of lost Medicaid revenue and the cost of caring for an influx of newly uninsured patients.

Whether regulators in some states will allow providers to justify higher prices and exceed the spending caps is unclear. Only California and Oregon can penalize providers financially if they fail to meet targets.

“Are we going to say, ‘That’s OK’? Or are we going to say, ‘Well, you exceeded the target. We’re still going to penalize you for that’?” said Richard Pan, a former state lawmaker and a member of the California Office of Health Care Affordability’s board. “That has not yet been decided.”

The California Hospital Association, the industry’s main state lobbying group, filed a lawsuit in October asking a state court to strike down the spending caps, which it argued fail to account for all the cost pressures hospitals face. Those pressures, it said, include an aging, sicker population; the rising cost of labor; expensive advances in medical technology; large capital outlays on required seismic retrofitting; and changes in federal policy, including the One Big Beautiful Bill Act. The hospital group’s lawsuit also asserted that the state affordability office, by hastily imposing ill-considered cost-cutting targets, was undermining its other key mission of improving health care access, quality and equity.

California’s affordability office last year set a five-year target to cap statewide spending growth, starting at 3.5% in 2025 and declining to 3% by 2029. The annual caps apply to a wide range of health care entities, including hospitals, medical groups, insurers and other payers.

Earlier this year, it imposed much lower spending growth caps — starting at 1.8% in 2026 and declining to 1.6% by 2029 — for seven “high-cost” hospitals.

“The spending caps set by politically appointed bureaucrats could force cuts that result in many Californians traveling farther for care, facing longer emergency room wait times, experiencing more overcrowding and losing access to critical services,” Carmela Coyle, the hospital association’s president and CEO, said in an October press release.

The California attorney general’s office, which will represent the affordability agency, has not yet filed a response to the hospital group’s complaint and did not respond to a request for comment.

Hospitals’ pushback

California is not the only state taking a close look at hospital prices, which are widely considered a primary driver of health care costs.

“States, armed with information that points to payments to hospitals as a driver of what is way beyond affordable commercial premiums, have begun to take increasingly targeted actions focused on commercial hospital prices,” said Michael Bailit, founder of the Needham, Massachusetts-based consultancy Bailit Health, which has advised multiple states, including California, on ways to tame health care spending. “It is not surprising that the hospital industry is going to oppose such state actions.”

In its lawsuit, the California Hospital Association said the affordability office’s own report showed that pharmaceutical and insurance companies are largely responsible for high costs.

Hospitals in some states with cost growth limits, including Connecticut and Massachusetts, have expressed objections similar to the ones raised in the California lawsuit. They could follow their counterparts in California if their lawsuit succeeds, said Peter Lee, who led California’s Affordable Care Act marketplace, Covered California, for over a decade and is now a senior scholar at Stanford Medicine’s Clinical Excellence Research Center.

Lee said the work of California’s affordability office and similar agencies in other states is just about the only systemwide effort being made to cut health care costs. They are basically saying, “‘Look, health care is taking money away from education, it is taking money away from the environment, it is taking money away from everything in the public sector, and in the private sector it is taking money away from wages,’” he said. “‘We don’t know how you, the health system, are going to do it, but it is your job not just to provide quality but to lower costs. Here’s the target.’”

To be sure, achieving the cost savings that California and those other states are seeking is no easy lift. It will ultimately require persuading large, financially powerful players that compete fiercely for health care dollars to adopt a different mindset and begin cooperating to reduce costs instead. And that, in many cases, will mean lower revenue.

But the status quo, as many people know all too well, means continued financial pain for millions.

In early 2020, Estevan Rodriguez, a bartender at California’s Monterey Beach Hotel, had surgery for a staph infection in his leg. The bill came to nearly $168,000. His insurance paid most of it, but he still owed $5,665, which took him two years to pay, more than $200 every month. “It may not be a lot to some people, but it was a lot to me,” Rodriguez said.

He said he dropped his Hulu subscription, switched to a lower-cost cellphone, and got cheaper car insurance. He started going to food banks rather than the grocery store, he said, and had a lot less time with his kids, because he was constantly working to pay off the hospital bill.

Community Hospital of the Monterey Peninsula, where Rodriguez had his surgery, is one of the seven hospitals identified by California’s affordability office as high-cost. A study by the office attributed high hospital prices in Monterey County to a lack of market competition “rather than higher operating costs or superior quality of care.”

The Monterey hospital referred a request for comment about its “high-cost” designation to the California Hospital Association. CHA spokesperson Jan Emerson-Shea declined to comment beyond the language of the lawsuit and Coyle’s press release statement.

Reduced competition

Health care analysts worry the One Big Beautiful Bill Act will reduce market competition even further by stressing already weak hospitals, leading some to shut services, merge with larger health systems, or close. One study estimates 338 rural hospitals are at risk of closing nationwide.

Less competition, in addition to fewer Medicaid dollars and an increase in uninsured patients, will only strengthen the incentive of health systems with the requisite market clout to raise their commercial prices, increasing premiums for employers and individuals.

“We think commercial prices will continue to increase as health care providers, and hospitals in particular, will seek to preserve or increase their revenue,” said Rachel Block, a program officer at the Milbank Memorial Fund, a foundation that focuses on health equity.

That in turn could pose a challenge to state affordability regulators tasked with overseeing compliance with growth targets for health care spending.

California’s affordability office is required to consider mitigating factors, including changes in federal and state laws. But some of its board members have expressed skepticism about letting hospitals offset Medicaid losses with higher commercial prices.

“There’s a lot of talk about using HR 1 and other federal policies as an excuse to raise prices on commercial payers,” Ian Lewis, an affordability office board member and policy director for UNITE HERE Local 2, a hospitality workers union in the Bay Area, said at the agency’s July board meeting, referring to the One Big Beautiful Bill. “There’s no more blood to be squeezed from this stone.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling and journalism. Learn more about KFF.

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The state of Wisconsin generally cannot consider U.S. citizenship or national origin in hiring for state jobs.

Republican U.S. Rep. Tom Tiffany of northern Wisconsin, who is running for governor in 2026, said Nov. 17 he would ensure state jobs “go to Americans.”

His congressional and campaign offices did not respond to requests for comment. 

The U.S. Supreme Court has held that states cannot restrict public employment to citizens.

Both public and private employers are generally barred by federal law from treating people differently based on national origin or ethnicity.

Wisconsin laws prohibit discrimination by public or private employers based on national origin or ancestry.

The state’s hiring handbook says the state can hire only people legally in the U.S., but “shall not refuse to hire aliens based on their foreign appearance, accent, language, name, national origin, citizenship, or intended U.S. citizenship.”

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

Sources

• FindLaw: Sugarman v. Dougall 413 U.S. 634 (1973)
• Cornell University Legal Information Institute: Amdt14.S1.5.3.2 Alienage Classification
• Wisconsin Statutes: State Employment Relations
• U.S. Equal Employment Opportunity Commission: National Origin Discrimination
• Wisconsin Department of Workforce Development: Discrimination because of Race, Color, National Origin, and Ancestry
• Wisconsin Personnel Management Division: Wisconsin Human Resources Handbook

Can Wisconsin require state jobs go only to Americans? 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.