A Wisconsin plant that President Donald Trump and Republicans championed during his first administration as the “8th Wonder of the World” is set to venture into building data centers with a new $569 million investment.
But members of Congress said the state should first address serious concerns from constituents about manufacturers’ energy and water use, which could strain existing infrastructure and leave consumers footing the bill.
“The average Wisconsinite should not have to subsidize the power or water for a commercial entity,” Republican Rep. Derrick Van Orden said.
Foxconn, a Taiwanese company and one of the world’s largest electronics manufacturers, says it will create nearly 1,400 jobs in Racine County over the next four years, in exchange for up to $96 million in total performance-based tax credits. It’s the second amendment to the company’s contract with the Wisconsin Economic Development Corp. after Foxconn dramatically rolled back its initial plan, proposed in 2017, to invest $10 billion and create as many as 13,000 jobs.
Foxconn had invested nearly $717 million by the end of last year, according to WEDC.
The company’s original multibillion-dollar deal with Wisconsin was heralded as an “America first” achievement, complete with a White House rollout attended by former Speaker Paul Ryan and former Republican Gov. Scott Walker.
“The construction of this facility represents the return of LCD electronics and electronics manufacturing to the United States,” Trump said at the announcement in 2017.
However, Foxconn’s new investment will take Wisconsin — where Meta and Microsoft in the last several months have announced deals to build data centers — further into the AI economy.
Five days before Foxconn pledged new investments in Wisconsin in November, OpenAI announced it would “share insight into emerging hardware needs across the AI industry to help inform Foxconn’s design and development efforts for hardware to be manufactured at Foxconn’s U.S. facilities.”
Democratic Rep. Mark Pocan, whose district includes 11 Madison-based data centers, said the state’s growing data sector should be a wake-up call to the Republican-led Congress.
“All the more reason Congress should get its act together because we need to do the proper regulation that’s good on all fronts related to AI, and I feel like we’re not even crawling at this point,” Pocan said.
The House reconciliation bill included a provision to halt AI regulation by states for 10 years, but the Senate cut the language.
The question of who will pay for the new data centers’ anticipated energy and water consumption is becoming a major concern for lawmakers and constituents alike.
“I think if you’re going to have this data center, you are either going to — business is not going to like this — you’re either going to help pay for those utility rates (that) are rising, or you’re going to self-power,” Van Orden said.
Some Wisconsin residents have spoken out against data centers’ environmental impacts, including at small protests in seven cities across the state in the first week of December.
Just two major data centers slated for development alone, including the Microsoft project, would require the energy of 4.3 million homes, according to Clean Wisconsin, an advocacy organization that has criticized rising resource demands from the state’s data centers.
“The issue is we only have 2.8 million homes in Wisconsin,” said Amy Barrilleaux, a spokesperson for the organization.
Sen. Ron Johnson, R-Wis., said that although the energy and water demands of data centers are ultimately a local permitting issue, constituents’ concerns are very real.
“I’d be concerned about that, as well,” Johnson said.
A petition to pause approvals of AI data centers until these issues are resolved got nearly 3,000 signatures since last week, Barrilleaux said, calling it a sign of the growing “frustration” from Wisconsinites over the state’s lack of transparency about how the centers will affect the energy system.
“If you’re in Wisconsin right now and probably a lot of states, you hear about a new AI data center development every couple of weeks. So it feels overwhelming,” Barrilleaux said. “It’s not just what’s happening on that Foxconn site.”
Sen. Tammy Baldwin, D-Wis., pointed to public input processes taking place in local government.
“I want my constituents to get their questions answered before these projects move ahead,” Baldwin told NOTUS.
Reps. Glenn Grothman and Tony Wied declined to comment on the Foxconn plant. A spokesperson for Rep. Bryan Steil, whose district includes Racine County, did not immediately return a request for comment Thursday.
This story was produced and originally published by Wisconsin Watch and NOTUS, a publication from the nonprofit, nonpartisan Allbritton Journalism Institute.
Foxconn, Trump’s ‘America first’ factory, is moving to AI. It’s giving lawmakers some 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.
SUPREME COSTS: This is the third in a series of articles about how Wisconsin chooses its judges.
Wisconsin is one of the only places on Earth that thrusts top judges into big-time politics.
Here Supreme Court candidates compete in officially nonpartisan statewide elections that have grown increasingly polarized and expensive, with campaigns now costing far more than those in any other state. This spring’s $144.5 million high court contest marked the first time that campaign spending approached that of recent races for governor and U.S. senator.
By contrast, the federal government and the majority of other states and countries appoint their judges. Some of those appointed judges eventually must face voters, but only in yes-or-no retention elections intended to avoid the political heat of head-to-head campaigns.
Not all of those other systems succeed in taking the politics out of choosing judges. The process of appointing federal judges is widely viewed as partisan, particularly for the U.S. Supreme Court. And even some retention elections have become multimillion-dollar contests, as activists try to change the ideological balance of state high courts.
However, 11 states have set up independent nonpartisan or bipartisan nominating commissions to ensure that Supreme Court justices are chosen by merit. Many other countries select judges through civil service systems. And 12 states use independent performance reviews of judges to help voters or appointing authorities decide whether judges should keep their jobs.
Although 57% of all Wisconsin Supreme Court justices were first appointed by governors to fill vacancies, past efforts to switch to appointing every justice faced strong political headwinds. No other state has dropped judicial elections in four decades.
Some Republicans are even pushing in the opposite direction, calling for Wisconsin to join the eight states that pick Supreme Court justices in fully partisan elections.
When Wisconsin became a state in 1848, electing judges was a new and controversial idea. Most judges had been appointed since their federal or state courts were created. In the Federalist Papers, Alexander Hamilton argued for lifetime appointments to preserve federal judges’ independence against political pressures.
But some states started to embrace judicial elections in the populist wave that followed President Andrew Jackson’s 1828 election. That was partly a reaction to judicial appointments that were seen as political rewards, Wisconsin Supreme Court Chief Justice Shirley Abrahamson said in 2009. Mississippi was the first to switch in 1832, followed by New York in 1846 — just before Wisconsin’s first constitutional convention.
Walworth County delegate Charles Baker argued during the convention that electing judges was consistent with democratic principles, according to the State Law Library. That view was met with thunderous opposition from Racine County delegate Edward Ryan, a future chief justice, who asked of the judiciary, “Must its judgments represent the will of the people? No sir! No sir! God forever forbid it! … It represents the eternal principles of truth and justice.”
As a compromise, the new constitution banned electing judges at the same time as other state officials, in an attempt to discourage political parties from nominating judicial candidates. After parties didn’t take the hint, the Legislature outlawed party labels on judicial ballots in 1891.
Meanwhile, every state admitted between the Civil War and the 1950s decided to elect at least some of its judges. Those races were initially partisan, until 1873, when Chicago-centered Cook County, Illinois, pioneered nonpartisan judicial elections, a concept that spread during the Progressive Era. Of the 22 states that now elect high court justices, 13 (including Wisconsin) have fully nonpartisan elections, eight have fully partisan elections, and Michigan nominates justices at party conventions but doesn’t list partisan affiliations on general election ballots.
Yet nonpartisan elections haven’t kept big money and ideological divisions out of state Supreme Court races. As documented by the Brennan Center for Justice at New York University, many states’ high court campaigns have ballooned past $1 million in spending over the past 25 years, driven by special interests trying to influence rulings on social, political and economic issues that include hot-button topics like abortion and same-sex marriage.
Since 2000, nine of the 13 states with fully nonpartisan elections — including Wisconsin — have seen at least one $1 million-plus high court race. But every state with fully partisan elections has had million-dollar court contests, along with partly partisan Michigan.
Political parties have helped push up the price tag for Wisconsin’s formally nonpartisan elections, aided by a state law allowing unlimited donations to candidates. The last three Supreme Court races drew $34.1 million in party cash, with Democrats outspending Republicans more than 2-to-1.
Voters seem to have mixed feelings about the partisan involvement. On one hand, 61% of Marquette University Law School Poll respondents in February said they believe party contributions cut into judicial independence, while only 38% said partisan support gives voters useful information about candidates.
Yet the partisan passions ratcheted up by big spending and polarizing issues have dramatically transformed how closely Supreme Court results reflect the most recent presidential vote.
In 1978, county-level results showed almost no relationship between the two, according to calculations by Marquette Poll Director Charles Franklin. But the correlation has trended sharply upward, particularly after the start of multimillion-dollar races in 2007, Franklin found. Last spring, his calculations showed a 98.5% correlation between support for liberal now-Justice Susan Crawford and 2024 Democratic presidential nominee Kamala Harris and between backing for conservative Brad Schimel and GOP President Donald Trump.
“It’s a stunning change, but not a new change,” considering how the partisanship evolved over time, Franklin said.
Judicial votes increasingly mirror political divide
Voting results by counties for Wisconsin Supreme Court elections and presidential elections, 1980 – 2024.
Presidential election
Supreme Court election
Democratic lead
Republican lead
Liberal lead
Conservative lead
0
+20
+10
+10
+20
0
+20
+10
+10
+20
1980
2007*
2025**
* Presidential election data from 2004.
** Presidential election data from 2024.
Source: Marquette University Law School
Graphic by Hongyu Liu/Wisconsin Watch
Judicial votes increasingly mirror political divide
Voting results by counties for Wisconsin Supreme Court elections and presidential elections, 1980 – 2024.
Supreme Court election
Presidential election
Democratic lead
Republican lead
Liberal lead
Conservative lead
0
0
+20
+10
+10
+20
+20
+10
+10
+20
1980
2007*
2025**
* Presidential election data from 2004.
** Presidential election data from 2024.
Source: Marquette University Law School
Graphic by Hongyu Liu/Wisconsin Watch
Nationwide, however, nonpartisan elections may still affect how voters react to candidates, said Douglas Keith, deputy director of the judiciary program at the Brennan Center. In nonpartisan races in Montana, Arkansas and Kentucky, “voters chose the candidate who ran the less overtly partisan campaign,” Keith said.
By contrast, Keith said, voters seem more likely to treat partisan high court campaigns like other partisan races — including in Ohio, where the Republican-controlled Legislature switched from a variation on the Michigan method to fully partisan elections, starting in 2022.
Franklin, Keith and other experts also believe that Wisconsin’s spring elections, originally designed to deter partisanship, could have had the opposite effect, by taking high court races out of competition with other major contests where candidates are seeking donations and attention. Most other states hold judicial elections in the fall, regardless of whether they’re partisan or nonpartisan, with only Georgia and West Virginia joining Wisconsin in the spring.
In October, the Marquette poll found 56% of state voters thought high court races have become so partisan that candidates should run with party labels. That idea was backed by nearly two-thirds of Republicans, with Democrats and independents almost evenly split.
However, politicians’ support for switching to partisan judicial elections seems to depend on whether they think it will help their own side. Ohio Republicans figured they would benefit from fully partisan high court elections, and they have won every race since the 2022 change, said Barry Burden, director of the Elections Research Center at the University of Wisconsin-Madison. Similarly, Louisiana Republicans are changing Supreme Court justice nominations to regular partisan primaries, starting in 2026, instead of the state’s unique all-party primaries.
In 2009, after the conservative candidate won a brutal, record-spending Wisconsin high court race the previous year, Sen. Tim Carpenter, D-Milwaukee, and other Democrats introduced a constitutional amendment to abolish nonpartisan spring elections and elect all public officials in the fall. The measure died in committee in a Democratic-controlled Legislature.
That was when conservatives were more likely to vote in low-turnout contests, said Franklin and UW-Milwaukee Professor Emeritus Mordecai Lee, a former Democratic lawmaker. Now liberals have the edge in those races, Franklin and Lee said, and support for partisan elections has flipped.
After liberals won four of the last five Supreme Court races, Wisconsin Republican U.S. Rep. Derrick Van Orden called for moving all spring elections to the fall of even-numbered years. GOP state Rep. Dave Maxey, chair of the Assembly Campaigns and Elections Committee, and Van Orden’s Republican House colleague Tom Tiffany, who is running for governor, are open to discussing that idea, their spokespeople said.
Such a major change would cause numerous complications for thousands of currently nonpartisan local officials and lower court judges, as well as presidential primaries, said Wood County Clerk Trent Miner, president of the Wisconsin County Clerks Association.
Washington County Executive Josh Schoemann, another GOP gubernatorial candidate, is calling for a more modest change: shifting only the statewide contests for Supreme Court and superintendent of public instruction to fall and moving primaries for fall races from August to April.
In an interview, Schoemann said he didn’t have a strong feeling about whether high court elections should remain nonpartisan, but he added, “Everybody acknowledges that they’re largely partisan races anyway. … Let’s be honest about what they are.”
Both Schoemann and a Tiffany spokesperson said maximizing voter participation would be the main reason to reschedule elections.
Because constitutional amendments must be approved in two consecutive legislative sessions and then in a statewide referendum, any change would be at least a few years away.
By the 1920s, some states were growing disillusioned with judges’ involvement in electoral politics. Nowhere was this concern greater than in Missouri, where Democratic Party boss Tom Pendergast’s Kansas City machine regularly defeated state Supreme Court justices who ruled against its wishes, according to a 2014 report by the Institute for the Advancement of the American Legal System (IAALS) at the University of Denver.
In 1940, Missouri voters approved a new method of appointing judges. Under that system, now called the Missouri Plan, a nominating commission screens judicial applicants based on merit. The governor then chooses a judge from a list of potential nominees presented by the commission. Newly appointed judges typically serve a relatively short first term before facing voters in a yes-or-no retention election to keep their jobs for a longer second term.
Kansas was next to adopt the Missouri Plan in 1958, after its governor resigned a few days before his term ended — and was promptly appointed to the state Supreme Court by the lieutenant governor who succeeded him. Some form of commission-based gubernatorial appointment is now in place in 22 states, including Iowa.
Merit selection is supposed to guard against the appearance of “cronyism, patronage and self-dealing” that can arise if a governor or president has no limits on nominating judges, according to a 2018 Brennan Center report.
“With merit selection, candidates move forward in the process based on their qualifications and
experience,” the 2014 IAALS report said. “In other systems, the amount of money spent in an election campaign, name recognition, and political or party connections can be the determinative factors.”
For example, Indiana law requires that state’s Judicial Nominating Commission to “consider each candidate’s legal education, legal writings, reputation in the practice of law, physical ability to do the job, financial interests (for conflict-of-interest purposes), public service activities, and any other pertinent information the commission feels is important to select the most qualified candidates.”
A 2021 paper in the Journal of Public Economics found that justices chosen in merit selection processes or nonpartisan elections produced better work — as measured by how often their rulings were favorably cited in other judges’ decisions — than justices chosen in partisan elections.
Missouri was the first state to create an independent commission and require the governor to choose from its list. In most of the 11 states with that approach, no single official or institution dominates commission appointments, and members may be appointed by various elected leaders, the state high court or the state bar association. Some states also call for geographic or demographic diversity among commissioners.
However, not all commissions are equally independent. In 11 of the 22 states where such commissions advise governors, the governor can either appoint a majority of commission members or choose a candidate who’s not on the commission’s list. In South Carolina, legislative leaders appoint a commission to screen candidates for election by lawmakers.
Four other states allow governors to nominate high court justices without consulting a commission, although some of those governors may create their own advisory panels and all of those appointees must be confirmed by lawmakers or other officials.
Confirmation is also required in seven states with governor-controlled commissions and three states with independent commissions.
Virginia’s legislature elects justices without nominations from either the governor or a commission.
In 1999, after Wisconsin’s first million-dollar Supreme Court race, then-state Rep. Mary Hubler, D-Rice Lake, introduced a constitutional amendment to let the governor appoint high court justices with Senate confirmation, but without a nominating commission. The measure drew bipartisan support but died in committee in a Republican-controlled Assembly. After three even more expensive races, then-state Rep. Mark Gottlieb, R-Port Washington, introduced a 2009 amendment calling for appointment with confirmation and retention elections. It died in committee in a Democratic-controlled Assembly.
Abrahamson, the state’s first female justice and the only one to win four contested elections, opposed a switch to appointment. “Elected judges are more apt to go and speak with the people about the judicial system and listen to their concerns,” the late justice said in 2009.
Former Justice Janine Geske said that she had long supported elections for the same reason: “It made justices more human and someone who people can identify with,” in contrast to more isolated federal judges. But Geske added, “I liked the elected judiciary until all this happened (with big-spending television-centered campaigns). People are so sick of these terrible ads that relate to issues that the court doesn’t decide,” mainly criminal cases in lower courts.
Now the moderate Geske said she leans toward appointment, but only if nominees are screened by a bipartisan commission and only if the governor must choose from the commission’s list.
Former Justice Dan Kelly, a conservative who lost back-to-back multimillion-dollar races in 2020 and 2023, said he also supports appointment, with Senate confirmation. Citing the Federalist Papers, Kelly said judges “must reject politics entirely” in their rulings, and appointment offers “much more protection against politics” than elections in which “campaigns have become explicitly political.”
However, Kelly — who was appointed by Republican Gov. Scott Walker to fill a vacancy — disagrees on one key point with Geske, an appointee of GOP Gov. Tommy Thompson. Kelly said the governor should be free to name someone outside a nominating commission’s list as a check on a panel that may have been “politically captured” by special interests.
Kelly’s comments echo a frequent conservative critique of the Missouri Plan — that nominating commissions may be controlled by liberal-leaning lawyers. Although some states specifically require non-lawyer representation on nominating panels, a 2019 study by the Brennan Center’s Keith found attorneys dominated most commissions, with corporate and plaintiff’s attorneys outnumbering prosecutors and public defenders.
In Kansas — the only state where the bar association names a majority of the commission — the Republican-controlled legislature has endorsed a constitutional amendment to abolish the merit selection process and return to electing justices. If voters approve the amendment in August, lawmakers would decide whether the elections should be partisan or nonpartisan.
Although 13 states switched from elections to merit selection in the 1960s and 1970s, Utah was the last state to do so in 1985, while Rhode Island was the last state to convert its appointment process to merit selection in 1994, according to IAALS. Voters rejected merit selection of high court justices in Ohio in 1987 and in Nevada in 1972, 1988 and 2010.
Geske and Burden said it would be challenging to convince Wisconsin legislators and voters to drop judicial elections for merit selection. February’s Marquette poll found 90% support for continuing to elect justices, with relatively minor differences by party. And in 2018, voters resoundingly defeated a GOP-backed constitutional amendment to end elections for state treasurer.
“On the other hand, Republicans are having their heads handed to them in Supreme Court races, so there may be some interest” among GOP lawmakers in appointment, Burden said. Liberals have won four of the last five high court races by double-digit margins and now hold a 4-3 majority on the seven-member court. Conservatives are defending seats in 2026 and 2027 and won’t have a shot at regaining control until 2028 — or later if liberals boost their majority in April.
Governors have appointed 46 of the 81 justices who have served since statehood. Conservative Justice Rebecca Bradley, who is not seeking re-election in 2026, is the only current member of the court who was originally appointed.
Wisconsin is one of 10 states that don’t require their governors to consult a nominating commission or seek confirmation for a high court appointee. By contrast, 29 states require governors to use nominating commissions in filling vacancies, and 17 states require confirmation of justices appointed to fill vacancies. Lawmakers fill vacancies in South Carolina and Virginia, and sitting justices fill vacancies in Illinois and Louisiana.
In 2000, a Wisconsin state task force on judicial diversity endorsed the governor’s use of an advisory committee to screen candidates, but opposed writing the practice into the state constitution. It didn’t recommend creating a more independent commission or requiring the governor to choose only applicants recommended by the committee.
Most states with independent commissions skip the confirmation process and wait for voters to decide the justices’ future in retention elections.
Altogether, 20 states use retention elections for at least some high court races. California, Maryland and Tennessee combine confirmation and retention elections. In Illinois and Pennsylvania, justices initially chosen in partisan head-to-head elections must run in retention elections for subsequent terms. And in Montana and New Mexico, regular elections become retention elections if nobody files to challenge an elected incumbent.
“Because judges do not face opponents in retention elections, they usually do not need to raise money and conduct campaigns,” IAALS says on its website. “At the same time, special interest groups are not as active in retention elections as they are in contested elections, because a good judge’s performance speaks for itself” and even if they try to oust an incumbent, “they cannot select a replacement who fits their particular agenda.”
Nonetheless, special interests have targeted some retention elections, driving them into the multimillion-dollar range. According to the Brennan Center, that trend was accelerated by a $1 million race in 2010, when conservatives waged a successful campaign to defeat three Iowa Supreme Court justices after the seven-member court unanimously overturned the state’s ban on same-sex marriage. Retention election spending peaked at $9.9 million in 2020, when conservatives ousted a Democratic justice from the Illinois Supreme Court.
As an alternative to incumbent justices facing voters in either head-to-head contests or retention elections, the Brennan Center advocates for a single term of 14 to 18 years, and the State Bar of Wisconsin has called for a single 16-year term, compared with Wisconsin’s current 10-year terms.
“Extensive evidence suggests that election pressures impact judicial decision-making in a wide array of cases, and that retiring justices rule differently than those seeking to keep their jobs,” the Brennan Center wrote in its 2018 report.
Among the 46 states where justices stay in office through elections or reappointment by elected officials, New York’s 14-year terms are the longest, followed by five states with 12-year terms.
Conversely, “15 years is a long time to go without any accountability to the public,” said Danielle Kalil, IAALS director of civil justice and the judiciary.
Although no state restricts justices to a single long term, the Brennan Center cited four states that found other ways to insulate them from political pressure:
Working with former U.S. Supreme Court Justice Sandra Day O’Connor, IAALS came up with a system for adding judicial performance reviews to the Missouri Plan, to help inform voters before retention elections. The institute now advocates for that modified plan, which it named after the late justice.
“Most Americans undergo job evaluations, and there is no reason why judges should not do the same,” IAALS says on its website. Such evaluations focus on “holding judges accountable to high quality job performance while maintaining judicial independence, by focusing on politically neutral qualities like impartiality, case administration, and clarity of communication rather than specific case outcomes.”
Alaska was the first state to use judicial performance reviews, starting in 1976. Now seven states release evaluations to voters before retention elections, five others use evaluations in reappointment decisions, and four share them only with judges. Hawaii and New Hampshire also release summaries that don’t identify specific judges. Republican-led legislatures ended evaluations in Kansas in 2011 and Tennessee in 2014.
IAALS recommends that evaluations be conducted by independent commissions, separate from nominating commissions. Kalil said evaluating commissions should survey attorneys and possibly others involved in the justice system and observe judges in courtrooms.
Even if states elect high court justices, multimillion-dollar campaigns aren’t inevitable. Brennan Center data show four states with head-to-head judicial elections have escaped the national trend of high-spending races: Minnesota, Oregon, Idaho and North Dakota.
In Minnesota, candidates and their supporters spent just $637,011 to elect 10 justices in five contested and five uncontested races from 2013 through 2022 — a period when Wisconsin candidates and their allies spent almost $33 million to elect seven justices in six contested campaigns and one uncontested election, according to the Brennan Center and the Wisconsin Democracy Campaign.
Both states share a history of nonpartisan elections, but unlike Wisconsin, Minnesota elects justices in the fall for six-year terms, with no restrictions on how many seats can be on the ballot in the same election, University of Minnesota-Twin Cities research fellow Eric Ostermeier said.
Minnesota’s elections also have been far less competitive than Wisconsin’s, said Ostermeier, the author of the Smart Politics blog. Since 2000, the average margin of victory in Minnesota has been 23 percentage points across 20 contested elections, almost twice the 11-point average in 14 contested Wisconsin elections. Only one Minnesota race was decided by a single-digit margin, compared with five in Wisconsin.
Perhaps most telling, Minnesota’s incumbent justices never lost an election and the state never had a wide-open race for any seat in that time, while Wisconsin voters ousted two appointed incumbents and six elections lacked incumbents.
Regardless of whether states elect or appoint justices, “no system is perfect,” Kalil said.
Yet public sentiment could be shifting toward change, said Nick Ramos, executive director of the election watchdog Wisconsin Democracy Campaign.
“People are becoming fed up and tired,” with the flood of attack ads, Ramos said. “People are becoming more receptive to doing something.”
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Sick of those state Supreme Court campaign ads, Wisconsin? Here’s how other states avoid them 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 State Capitol (Wisconsin Examiner photo)
Gov. Tony Evers vetoed nine bills Friday including a Republican bill that would have barred local and state funds from being used for immigrants without legal status.
Wisconsin already doesn’t allow immigrants without legal status to access BadgerCare, which Evers noted in his veto message. Republicans lawmakers acknowledged that fact as they advocated for AB 308, saying the bill was intended to block future use of health care benefits by immigrants. The bill would have prohibited state, county, village, long-term care district and federal funds from being used to subsidize, reimburse or provide compensation for any health care services for a person not lawfully in the U.S.
“As this bill’s Republican co-author in the Wisconsin State Assembly plainly stated in the public hearing on this proposal, ‘Wisconsin currently doesn’t allow undocumented immigrants to enroll in BadgerCare,’” Evers wrote in his veto message.
“I object to Republican lawmakers passing legislation they acknowledge is unnecessary to prevent problems they admit do not exist, all for the sake of trying to push polarizing political rhetoric,” Evers added.
Evers said the bill was “more about being inflammatory, stoking fear, and sowing division than it was about accomplishing any significant policy outcome or being prudent stewards of taxpayer dollars.”
U.S. Rep. Tom Tiffany, one of two Republican candidates for governor, criticized the veto in a statement, saying Evers was putting the interests of “illegal aliens” ahead of Wisconsin taxpayers and sought to tie Evers’ action to next year’s high-profile gubernatorial election. Evers is not running for reelection, and there is a crowded Democratic field that is still taking shape.
“If Democrats take the governor’s office in 2026, you can count on them to hand out driver’s licenses, in-state tuition and taxpayer-funded health care to illegal aliens. I will not let that happen,” Tiffany said.
Evers also vetoed a bill that would have allowed for more tobacco bars in Wisconsin.
Wisconsin first enacted its smoke-free air law in 2010 — prohibiting smoking cigars, cigarettes, pipes and other products in public spaces. The law included an exclusion for cigar bars that were in existence before June 4, 2009.
AB 211 would have allowed for more exemptions for tobacco bars if they came into existence on or after June 4, 2009 provided that they allowed only the smoking of cigars and pipes and were not part of a retail food establishment.
Evers, a former smoker and an esophageal cancer survivor, said he objected due to the harm that the bill could have on Wisconsinites public health.
“Secondhand smoke, a known carcinogen, causes serious health problems and is responsible for thousands of deaths on an annual basis,” Evers stated. He said the state’s smoke-free air law was “a critically important step forward for keeping kids, families, and communities healthier and safer, improving public health and, most importantly, saving thousands of lives… I cannot in good conscience reverse course on that important step for public health, safety, and well-being by restoring indoor smoking in certain public spaces.”
Evers also vetoed AB 165, which would have banned local governments from using tax money to create guaranteed income programs without a work or training requirement.
Evers wrote in his veto message that he objects to lawmakers’ “continued efforts to arbitrarily restrict and preempt local governments across our state.” He said they should instead focus on finding ways to support local communities and ensure they have the resources they need to “meet basic and unique needs alike.”
Evers vetoed AB 450, which would have put off the effective date of Wisconsin’s updated commercial building code until April 1, 2026, saying he objected to “further unnecessary delay in implementing new building standards that will benefit Wisconsin communities.”
The new building codes were originally blocked by lawmakers on the Joint Committee on the Review of Administrative Rules for years, but they were reinstated this year by the the Department of Safety and Professional Services (DSPS) after a state Supreme Court decision. Justices ruled in July that state laws allowing the Legislature to block executive branch administrative rules indefinitely were unconstitutional.
The current effective date for the building codes is Nov. 1, 2025.
Republican lawmakers claimed the delay to next year was needed to provide clarity to builders who had been planning projects under the previous code.
Evers wrote in his veto message that the bill would do the opposite.
“This bill would not only create confusion for developers with current building projects under review but would also further delay the implementation of new safety and energy efficiency standards that have been already widely adopted,” Evers said. “The department has and will continue to work with building professionals throughout the state to ensure proper understanding and compliance with the new building commercial code.”
A handful of Republican education-related bills were rejected by Evers.
Currently, teacher preparation programs are required to have a full semester of student teaching during the school year. SB 424 would have allowed for programs to use student teaching during a summer session as an alternative to a full school-year semester.
Lawmakers had said the bill would help with recruitment by allowing for more flexibility to students seeking to become teachers. However, Evers said that the bill would potentially reduce the rigor of the current training that students are required to have, especially given that summer sessions can be shorter than a typical school term and may not allow students to experience the same opportunities available during the school year such as parent-teacher conferences.
“Reducing training, qualifications, experience, and work ages are not real solutions for solving Wisconsin’s generational workforce shortages,” Evers said in his veto message. “Wisconsin’s challenges recruiting, training, and retaining exceptional educators will not be aided by making education professionals less trained, less qualified, and less experienced — nor will our kids.”
Evers also vetoed AB 166, which would have required UW system institutions, technical colleges and private nonprofit colleges to report cost and student outcome data and required the information be provided to high school juniors and seniors in academic and career planning services.
Evers said in his veto message that he didn’t want to burden the state’s higher education institutions with more administrative requirements, especially without “necessary resources.” He noted that the UW system says that the requirements in the bill “overlap substantially” with existing information that is already available.
The University of Wisconsin system keeps a public dashboard with some of the information that the bill would have required, including for financial aid, retention and graduation, and time and credits to degree.
Evers also vetoed SB 10, which would have mandated that Wisconsin public school districts provide military recruiters with access to common areas in high schools and access during the school day and during school-sanctioned events. He said that while he supports the troops, he doesn’t support lawmakers’ attempts to “usurp” local control of decisions on when and where military recruiters are given access to schools.
Voters currently can file a complaint to the Wisconsin Election Commission if they allege an election official serving the voter’s jurisdiction has failed to comply with certain election laws or has abused his or her discretion with respect to the administration of such election laws. A voter who doesn’t agree with a WEC decision can appeal to a court, though currently courts are only allowed to take up an appeal if voters have suffered an injury to a legally recognized interest as a result. That requirement was established in a 2025 state Supreme Court decision.
SB 270 would have eliminated that requirement, and Evers said he objected because it “would open the floodgates to frivolous lawsuits that not only burden our courts, but our election systems as well.”
AB 366, which would have allowed housing providers to require documentation for service animals and created penalties for misrepresentation of an animal. Evers said he objects to “the creation of unnecessary barriers for individuals with legitimate disability-related needs.”
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The U.S. Supreme Court on Oct. 9, 2024. (Photo by Jane Norman/States Newsroom)
The U.S. Supreme Court said Friday justices will hear a case to decide if President Donald Trump’s order to end birthright citizenship is constitutional.
The court agreed to hear a case, before it is decided in a lower court, that deals with the Constitution’s 14th Amendment, which grants citizenship to almost everyone born in the United States. The amendment’s birthright citizenship clause has been used to give citizenship to the children of immigrants in the country without legal authorization or on a temporary basis.
While a schedule for arguments has not yet been released by the court, it’s likely the case would be heard sometime in early 2026.
The Trump administration argued in its petition to the court that the amendment, which was adopted in 1868, was meant to apply to newly freed slaves. It was not meant to provide citizenship to the children of immigrants without legal status, Solicitor General D. John Sauer wrote.
“Long after the Clause’s adoption, the mistaken view that birth on U.S. territory confers citizenship on anyone subject to the regulatory reach of U.S. law became pervasive, with destructive consequences,” Sauer wrote in the September petition.
The petition also sought Supreme Court review of a related challenge to the order by the states of Washington, Arizona, Illinois and Oregon. Friday’s court order did not grant a hearing on that case.
Trump signed an executive order on Jan. 20 seeking to redefine the birthright citizenship clause to exclude the children of immigrants in the country without legal authority or only temporarily. Democratic-led states and advocacy groups swiftly sued.
Courts have largely blocked enforcement of the order, although the Supreme Court in June allowed it to go into effect in the states that had not sued to preserve the right.
In a Friday afternoon statement, the American Civil Liberties Union, a leading civil rights group, noted that several federal judges had blocked enforcement and predicted the Supreme Court would preserve birthright citizenship.
“No president can change the 14th Amendment’s fundamental promise of citizenship,” Cecillia Wang, ACLU’s national legal director, said. “For over 150 years, it has been the law and our national tradition that everyone born on U.S. soil is a citizen from birth. The federal courts have unanimously held that President Trump’s executive order is contrary to the Constitution, a Supreme Court decision from 1898, and a law enacted by Congress. We look forward to putting this issue to rest once and for all in the Supreme Court this term.”
Members of a key CDC advisory committee, known as the Advisory Committee on Immunization Practices, met in Atlanta on Dec. 4. Maya Homan/Georgia Recorder
ATLANTA — A Centers for Disease Control and Prevention committee voted to eliminate a recommendation that all newborn babies receive a vaccine against hepatitis B, ending a policy that has been in place since 1991 to protect Americans against an incurable liver disease that can lead to cirrhosis, cancer and liver failure.
The current three-dose series for hepatitis B includes one vaccine administered to infants within 24 hours of birth, and subsequent booster shots given one month and six months after the initial dose. The universal vaccination policy is credited with a 99% drop in serious infections among American children between 1990 and 2019.
In its updated guidelines, the agency will continue to recommend that babies born to mothers who test positive for hepatitis B receive a vaccine at birth. However, in all other cases, the decision will be left to “individual-based decision-making,” a change that experts say will lead to an increase in chronic hepatitis B infections. The new recommendation also suggests that parents delay the first dose of the vaccine until at least two months after birth.
Friday’s decision comes after an 8-3 vote from a key CDC advisory committee, known as the Advisory Committee on Immunization Practices, which is charged with setting national guidelines around which people should be vaccinated against a wide range of preventable diseases and when those vaccines should be administered. The recommendations play a key role in determining which vaccines insurance companies are willing to cover and how accessible those immunizations are to the public.
The two-day meeting included several presentations from prominent anti-vaccine activists, including Aaron Siri, a vaccine injury lawyer who has previously represented U.S. Health Secretary Robert F. Kennedy Jr. and reportedly helped him vet health officials for President Donald Trump’s administration. At least two of them — Cynthia Nevison, a climate researcher who has ties to anti-vaccine groups, and Mark Blaxill, a former consultant and author — were recently hired by the CDC.
Retsef Levi, an ACIP member and professor of operations management at the Massachusetts Institute of Technology, called the updated recommendation a “very positive change in policy,” arguing that blanket vaccine recommendations force newborns to serve as “a safety net for adults’ mistakes.”
But Dr. Cody Meissner, another member of the committee who also serves as a professor of pediatrics and medicine at Dartmouth College, argued that the vaccines play a crucial role in protecting infants from the disease, and said there was no valid scientific evidence to support the changes implemented by the panel.
“Thoughtful inquiry is always commendable,” he told the committee. “But that inquiry should not be confused with baseless skepticism, which is what I think we’re encountering here.”
Sandra Fryhofer, a doctor and liaison for the American Medical Association, also criticized the move, arguing that implementing guidelines based on the mother’s hepatitis status will leave babies vulnerable to developing the disease from other sources, such as infected relatives. According to CDC data, roughly half of people with hepatitis B do not know they are infected.
“Are we going to test every patient that has access to or touches that baby?” she asked the committee Thursday. “I mean, that’s not something that’s really doable.”
The updated recommendation for the hepatitis B vaccine mirrors COVID-19 vaccine guidelines passed by the same panel in September, which place new emphasis on the risks of immunizations, though the CDC’s own data shows that the vaccines are safe and effective for most people.
A second vote, which passed 6-4, encourages parents to discuss using serology testing, a type of blood test that measures antibodies to gauge how well a patient’s immune system has responded to a disease, before allowing their children to receive additional doses of the hepatitis B vaccine.
The changed recommendations will not prevent doctors from administering hepatitis B vaccines to newborns, but critics say they could create additional hurdles for families and healthcare providers.
“Adding excessive or ambiguous language around shared decision-making for routine vaccines muddies the waters, creates a false sense of scientific uncertainty and places unnecessary burden on clinicians and families,” said Dr. Natasha Bagdasarian, who was representing the Association of State and Territorial Health Officials.
Children enrolled in Medicaid or the Vaccines for Children program, which provides free immunizations to children who are uninsured or underinsured, will continue to be eligible for hepatitis B vaccines at birth under the new recommendations, according to program liaisons.
As with the new COVID-19 vaccine recommendations, the updated hepatitis B guidelines will not take effect until being officially signed off by the acting CDC Director, Jim O’Neill.
But amid shifting federal guidance on public health policies, a growing number of state and federal officials are developing their own policies rather than relying on the agency’s guidelines. In a Dec. 3 letter sent ahead of ACIP’s meeting, more than 30 members of Congress urged O’Neill to maintain the existing recommendations, regardless of what the advisory committee decided.
“There is no data to support delaying the first immunization to one-month, four years, or 12 years of age,” the letter states.
U.S. Sen. Bill Cassidy, a Louisiana Republican who heads the Senate Health, Education, Labor and Pensions Committee, also called for O’Neill to forgo signing the updated recommendations.
“As a liver doctor who has treated patients with hepatitis B for decades, this change to the vaccine schedule is a mistake,” he wrote in a social media post after the vote. “The hepatitis B vaccine is safe and effective. The birth dose is a recommendation, NOT a mandate.”
Cassidy, a doctor, cast the deciding vote to confirm Kennedy as health secretary on the condition that Kennedy “maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices without changes.” Kennedy later backtracked on that promise, firing all 17 previous members of the committee and replacing them with a slate of hand-picked appointees, many of whom are seen as vaccine skeptics.
In a Thursday social media post, Cassidy criticized the committee for its plans to hear testimony from Siri, the vaccine injury lawyer.
“The ACIP is totally discredited,” he added. “They are not protecting children.”
This story was originally produced by Georgia Recorder, which is part of States Newsroom, a nonprofit news network which includes Wisconsin Examiner, and is supported by grants and a coalition of donors as a 501c(3) public charity.
Neubauer said in an interview that Republicans have continued to “ignore” the core challenges facing Wisconsinites, which for the most part center on costs. (Photo by Baylor Spears/Wisconsin Examiner)
Assembly Minority Leader Greta Neubauer (D-Racine) told the Wisconsin Examiner in a year-end interview that Democrats have spent the past year preparing to lead and she is optimistic about the chances for flipping the Assembly. Neubauer reflected on the current session and previewed what’s ahead.
This session has been different from previous ones, said Neubauer, who was first elected to the state Assembly in 2018 and has led Assembly Democrats since 2022.
“Closer numbers in the state Assembly and state Senate have yielded some more bipartisan work,” Neubauer said. Republicans hold a 54 to 45 majority in the Assembly, and a 18 to 15 majority in the state Senate.
She felt the difference this year from her first seven years in the body, she said, when Democrats were “in a position where we really were on defense and having to spend a huge amount of time just trying to prevent the worst policy ideas from going through.”
That work across the aisle, she said, was evident in the state budget, when Senate Democrats had a seat at the negotiating table and were able to secure more money for public schools. She also sees a difference in some of the housing bills that recently passed the Legislature. Neubauer said that Assembly task forces focused on children’s social media use and elder care also allowed for discussion across the aisle and she is hopeful they will yield some bipartisan legislation.
Still, she said, the session hasn’t yielded everything she had hoped for.
“We have not seen the kind of movement that I would have hoped, especially given that we’re all up for election next year, and everyone’s going to have to go home and answer to their constituents for what was and was not accomplished.”
Neubauer said Republicans have continued to “ignore” the core challenges facing Wisconsinites, which for the most part center on costs.
“That’s what we hear over and over from the people that we represent,” Neubauer said, noting several issues where Democratic lawmakers have introduced proposals or advocated for action. “There’s been no interest from our Republican colleagues on addressing the cost of prescription drugs and health care, especially in light of the [Affordable Care Act] premiums going up in a significant way. We have had a bill out for the entire session on Healthy School Meals. This would save the average family with two kids $1,800 a year. People would really appreciate that money right now, especially going into the holiday season, but we’ve had no interest from our Republican colleagues in addressing that issue…. and we do need to see more movement on housing and on child care.”
Neubauer also noted that a bill to extend postpartum Medicaid remains stuck in the state Assembly due to opposition from Assembly Speaker Robin Vos (R-Rochester). Democratic lawmakers tried to force a vote on the issue during their last scheduled floor session this year, but failed.
Neubauer said she still hopes that measure could advance next year in the time remaining in the session.
“We know that people across the state believe that new moms should have access to health care. It’s essential for mom and baby… You do have to ask why [Rep.] Pat Snyder and [Rep.] Jessie Rodriguez, authors on that bill, are not able to get it done when they are governing,” Neubauer said. “They’re in the majority, and they have been for a long time.”
Despite the gridlock on certain issues, Neubauer said Democratic lawmakers have been able to think differently this year.
“We are able to think about what bills are we going to pass when we’re governing. How can we work across the aisle and use our numbers to get things done and put pressure on Republicans to make the bills better if they need our support,” Neubauer said. “I do think that we are preparing to govern in that way, and we’re really working over the next several months to get more input from our constituents on the things that are important to them to make sure that our agenda and our plan for the first hundred days is really tuned to the particular challenges that people are facing.”
Democratic lawmakers have spent the session introducing and advocating for bills on a number of issues including K-12 education, higher education, local government and elections. Most haven’t advanced or received a public hearing, but they are laying the groundwork for the future.
“The bills that we’ve rolled out this fall would be things we would absolutely do when we come into the majority,” Neubauer said. “We also know there are some pretty essential rights and freedoms that we would want, things like enshrining access to abortion in state law, in case there are further court cases that would put that at risk.”
Neubauer said Democratic lawmakers will have additional bills coming out in the next few weeks and in 2026, addressing public safety, housing and health care. She declined to provide details on what those proposals might do.
Neubauer said her caucus will continue to push for additional education funding in the fall, including general aid. This year the state budget included additional funding for special education, but Republican lawmakers refused to provide an increase in general aid — something that public school leaders and advocates have said will strain their budgets and put pressure on property taxpayers.
“We have failed to adequately fund our local public schools and what we see from Republicans is [a plan to] consolidate districts and close local schools. No one’s asking us for that,” Neubauer said. “They’re asking us to maintain that essential funding that will allow their kids to attend a grade school where they get a good reading and math education, they’re safe, and they’re prepared for their future career.”
Neubauer also commented on a handful of other issues that the Legislature is grappling with.
Neubauer, who confirmed she will be running for another term in the Assembly, said she is optimistic about Democrats’ chances of winning the Assembly majority next year. The 2026 elections will serve as Assembly Democrats’ second opportunity under new legislative maps adopted in 2024 to try to flip the chamber for the first time in 16 years.
In 2024, Democrats won 10 additional seats. For Democrats to win control in 2026, they’ll need to hold all of their current seats and win five more.
The seats that they’ll be competing for are very close, Neubauer said, including some that former Vice President Kamala Harris won in 2024, even as she lost the state as a whole.
“There are people who like the vision that we’re putting forward in these districts, so the path is there. We are recruiting great candidates who are very connected to their local community and who are ready to go out and speak directly to the voters of their district from now until election day,” Neubauer said. “That’s how we win. We win by talking about the failures of Republicans and pointing out that they have been in control here for coming up on 15 years, and they have really failed to provide the essential services that people deserve.”
Neubauer said it helps that Democrats have fewer seats that they need to flip in 2026, so they’ll be able to better focus on tough districts.
Neubauer said Democrats have candidates from a diverse array of backgrounds including teachers, coaches, small business owners, farmers, public safety employees and union members, who she said are representative of the state.
“We know that people want to see folks in office that remind them of themselves and of their neighbors and who understand the challenges that they’re going through. We’ve got folks running who get what it’s like to be looking at the budget and worried about how they’re going to make it to the next month or how they’re going to afford those Christmas gifts or special meals for the holidays,” she said.
She said to look out for more candidate announcements early next year.
Neubauer also said the election results from across the country bode well for Democrats in Wisconsin. She said the results in New Jersey and Virginia were a “really strong overperformance for Democrats.” She said it’s a sign that people are unhappy with Republican leadership and the direction of the country.
“[President] Donald Trump said that he was going to focus on the economy and making life a little easier for folks, and he has engaged in reckless trade wars, and taking other steps that have made it harder for people to get by — not easier,” Neubauer said. She also said it is “shocking” that Trump would “completely fail” to recognize how cutting SNAP funding would hurt people, and said his comments about running for a third term are “unsettling” and it is “incumbent on all of us who believe in democracy and who believe in fair elections” to push back.
“I think you’re seeing the effects of that on people across the country. Not only the federal Republicans, but their state level Republicans are just not following through on the promises that they made so I think people are looking for something different and that gives us an opportunity here.”
Wisconsinites will also make a choice next year in a high-profile open race for governor, and Neubauer said she’ll do everything she can to elect a Democratic governor.
“I am looking for someone who understands the necessity of winning in Wisconsin next year and is focused on communicating with the people of this state a vision for how life would be better with Democrats running the state Capitol,” Neubauer said. “It’s really important that we put out a vision, and that we connect directly with the people of Wisconsin and push through the frustration that folks have with politics right now by being really clear about what we’ll do and then winning and then getting those things done.”
Neubauer said she is happy with the field of Democrats running for governor, especially given how many have legislative experience, but won’t be making an endorsement. She noted that Democratic U.S. Sen. Tammy Baldwin, U.S. Rep. Mark Pocan and U.S. Rep. Gwen Moore all spent time serving in the Wisconsin Legislature.
Two current lawmakers, state Rep. Francesca Hong (D-Madison), and state Sen. Kelda Roys (D-Madison), are running along with former lawmakers Lt. Gov. Sara Rodriguez, Milwaukee Co. Executive David Crowley and former Lt. Gov. Mandela Barnes.
“We’re excited that so many folks understand what it’s like to be a legislator and who will work well, I think, with our caucus in a governing trifecta,” Neubauer said.
Former Wisconsin Economic Development Corporation CEO Missy Hughes, another Democratic gubernatorial hopeful, has no legislative experience.
In the event a Republican wins, Neubauer said Democrats in the Legislature will “work with them to the best of our ability to deliver.”
U.S. Rep. Tom Tiffany, who is considered the frontrunner in the primary race, and Washington County Executive Josh Schoemann, are the current Republican hopefuls.
“We show up every day remembering that our constituents sent us here to get things done and that has to be our first priority, so we will work with anybody who wants to work with us and that would include a Republican governor if that’s the situation that we’re in,” Neubauer said. “People are struggling, and it is our responsibility to respond to that and to do what we can to help.”
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Older men play cards in a park in New York City's Chinatown in 2024. Medicare, the public health insurance for older Americans, is piloting a new prior authorization program powered by artificial intelligence that some physicians fear will result in more denials and delays in medical care for patients. (Photo by Spencer Platt/Getty Images)
A Medicare pilot program will allow private companies to use artificial intelligence to review older Americans’ requests for certain medical care — and will reward the companies when they deny it.
In January, the federal Centers for Medicare & Medicaid Services will launch the Wasteful and Inappropriate Services Reduction (WISeR) Model to test AI-powered prior authorizations on certain health services for Medicare patients in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington. The program is scheduled to last through 2031.
The program effectively inserts one of private insurance’s most unpopular features — prior authorization — into traditional Medicare, the federal health insurance program for people 65 and older and those with certain disabilities. Prior authorization is the process by which patients and doctors must ask health insurers to approve medical procedures or drugs before proceeding.
Adults over 65 generally have two options for health insurance: traditional Medicare and Medicare Advantage. Both types of Medicare are funded with public dollars, but Medicare Advantage plans are contracted through private insurance companies. Medicare Advantage plans tend to cost less out of pocket, but patients enrolled in them often must seek prior authorization for care.
AI-powered prior authorization in Medicare Advantage and private insurance has attracted intense criticism, legislative action by state and federal lawmakers, federal investigations and class-action lawsuits. It’s been linked to bad health outcomes. Dozens of states have passed legislation in recent years to regulate the practice.
In June, the Trump administration even extracted a pledge from major health insurers to streamline and reduce prior authorization.
“Americans shouldn’t have to negotiate with their insurer to get the care they need,” U.S. Health and Human Services Secretary Robert F. Kennedy Jr. said in a June statement announcing the pledge. “Pitting patients and their doctors against massive companies was not good for anyone.”
Four days after the pledge was announced, the administration rolled out the new WISeR program, scheduled to take effect in January. It will require prior authorizations only for certain services and prescriptions that the Centers for Medicare & Medicaid Services has identified as “particularly vulnerable to fraud, waste, and abuse, or inappropriate use.” Those services include, among other things, knee arthroscopy for knee osteoarthritis, skin and tissue substitutes, certain nerve stimulation services and incontinence control devices.
The companies get paid based on how much money they save Medicare by denying approvals for “unnecessary or non-covered services,” CMS said in a statement unveiling the program.
The new program has alarmed many physicians and advocates in the affected states.
“In concept, it makes a lot of sense; you don’t want to pay for care that patients don’t need,” said Jeb Shepard, policy director for the Washington State Medical Association.
“But in practice, [prior authorization] has been hugely problematic because it essentially acts as a barrier. There are a lot of denials and lengthy appeals processes that pull physicians away from providing care to patients. They have to fight with insurance carriers to get their patients the care they believe is appropriate.”
CMS responded to Stateline’s questions by providing additional information about the program, but offered few details on what the agency would do to prevent delays or denials of care. It has said that final decisions on coverage denials will be made by “licensed clinicians, not machines.” In a bid to hold the companies accountable, CMS also incentivizes them for making determinations in a reasonable amount of time, and for making the right determinations according to Medicare rules, without needing appeals.
In the statement announcing the program, Abe Sutton, director of the CMS Innovation Center, said the “low-value services” targeted by WISeR “offer patients minimal benefit and, in some cases, can result in physical harm and psychological stress. They also increase patient costs while inflating health care spending.”
Dr. Bindu Nayak is an endocrinologist in Wenatchee, Washington, a city near the center of the state that bills itself as the “Apple Capital of the World.” She mainly treats patients with diabetes and estimates 30-40% of her patients have Medicare.
“Medicare recipients are a vulnerable group,” Nayak told Stateline. “The WISeR program puts more barriers up for them accessing care. And they may have to now deal with prior authorization when they never had to deal with it before.”
Nayak and other physicians worry the same problems with prior authorizations that they’ve seen with their Medicare Advantage patients will plague traditional Medicare patients. Nayak has employees on staff whose only role is to handle prior authorizations.
More than a quarter of physicians nationwide say prior authorization issues led to a serious problem for a patient in their care, including hospitalization or permanent damage, according to the most recent report from the American Medical Association.
And some patients are unfairly denied treatment. Private insurers have denied care for people with Medicare Advantage plans even though their prior authorization requests met Medicare’s requirements, according to an investigation from the U.S. Department of Health and Human Services published in 2022. Investigators found 13% of prior authorization denials were for requests that should have been granted.
But supporters of the new model say something must be done to reduce costs. Medicare is the largest single purchaser of health care in the nation, with spending expected to double in the next decade, according to the Medicare Payment Advisory Commission, an independent federal agency. Medicare spent as much as $5.8 billion in 2022 on services with little or no benefit to patients.
In November, congressional representatives from Ohio, Washington and other states introduced a bill to repeal the WISeR model. It’s currently in committee.
“The [Trump] administration has publicly admitted prior authorization is harmful, yet it is moving forward with this misguided effort that would make seniors navigate more red tape to get the care they’re entitled to,” U.S. Rep. Suzan DelBene, a Washington Democrat and a co-sponsor of the bill, said in a November statement.
Physician and hospital groups in many of the affected states have backed the bill, which would halt the program at least temporarily. Shepard, whose medical association supports the bill, said that would give CMS time to get more stakeholder input and give physicians more time to prepare for extra administrative requirements.
“Conventional wisdom would dictate a program of this magnitude that has elicited so much concern from so many corners would at least be delayed while we work through some things,” Shepard said, “but there’s no indication that they’re going to back off this.”
Adding more prior authorization requirements for a new subset of Medicare patients will tack on extra administrative burdens for physicians, especially those in orthopedics, urology and neurology, fields that have a higher share of services that fall under the new rules.
That increased administrative burden “will probably lead to a lot longer wait times for patients,” Nayak said. “It will be important for patients to realize that they may see more barriers in the form of denials, but they should continue to advocate for themselves.”
Dr. Jayesh Shah, president of the Texas Medical Association and a San Antonio-based wound care physician, said WISeR is a well-intentioned program, but that prior authorization hurts patients and physicians.
“Prior authorization delays care and sometimes also denies care to patients who need it, and it increases the hassle factor for all physicians,” he told Stateline.
Shah added that, on the flip side, he’s heard from a few physicians who welcome prior authorization. They’d rather get preapproval for a procedure than perform it and later have Medicare deny reimbursement if the procedure didn’t meet requirements, he said.
Prior authorization has been a bipartisan concern in Congress and statehouses around the country.
Last year, 10 states — Colorado, Illinois, Maine, Maryland, Minnesota, Mississippi, Oklahoma, Vermont, Virginia and Wyoming — passed laws regulating prior authorization, according to the American Medical Association. Legislatures in at least 18 states have addressed prior authorization so far this year, an analysis from health policy publication Health Affairs Forefront found. Bipartisan groups of lawmakers in more than a dozen states have passed laws regulating the use of AI in health care.
But the new effort in the U.S. House to repeal the WISeR program is sponsored by Democrats. Supporters worry it’s unlikely to gain much traction in the Republican-controlled Congress.
Prior authorization delays care and sometimes also denies care to patients who need it, and it increases the hassle factor for all physicians.
– Dr. Jayesh Shah, president of the Texas Medical Association
Shepard said his organization has talked with state and congressional representatives, met with the regional CMS office twice, and sent a letter to CMS Director Dr. Mehmet Oz.
“We’ve looked at all the levers and we’ve pulled most of them,” Shepard said. “We’re running out of levers to pull.”
CMS announced in November it has selected six private tech companies to pilot the AI programs.
Some of them are backed by venture capital funds that count larger insurance companies among their key investors.
For example, Oklahoma’s pilot will be run by Humata Health Inc., which is backed by investors that include Blue Venture Fund, the venture capital arm of Blue Cross Blue Shield companies, and Optum Ventures, a venture capital firm connected to UnitedHealth Group, the parent company of UnitedHealthcare. Innovaccer Inc., chosen to run Ohio’s program, counts health care giant Kaiser Permanente as an investor.
Nayak said she knows little about Virtix Health, the Arizona-based private company contracted by the feds to run Washington state’s pilot program.
“Virtix Health would have a financial incentive to deny claims,” Nayak said. “It begs the question, would there be any safeguards to prevent profit-driven denials of care?”
That financial incentive is a concern in Texas too.
“If, financially, the vendor is going to benefit by the denial, it could be a problem for our patients,” Shah said. He said that Oz, in a webinar presentation on the new program, assured physicians that their satisfaction and turnaround times would be metrics that Medicare would factor into the tech companies’ payments.
Editor’s note: This story has been updated to correct a reference to Medicare Advantage.
Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.
This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news network which includes Wisconsin Examiner, and is supported by grants and a coalition of donors as a 501c(3) public charity.
Christine Neumann Ortiz, executive director of Voces de la Frontera, speaks at a press conference on the Wisconsin Supreme Court case challenging the legality of Wisconsin law enforcement agencies' cooperation agreements with ICE | Photo via Voces de la Frontera Facebook video
In Wisconsin we have been watching in horror as President Donald Trump’s lawless immigration crackdown terrorizes communities in our neighboring states of Minnesota and Illinois.
Here at home, so far, things are mostly quiet. Farmers in western Wisconsin report no ICE raids on the dairies where 60% to 90% of workers are immigrants without legal status. There have been a few high-profile arrests and deportations in Milwaukee, Madison and Manitowoc, but nothing like the scenes of chaos in the streets of Chicago and Minneapolis, where masked federal agents are aiming guns at civilians, smashing out car windows and dragging parents from their children, hustling them off to detention centers to be fast-tracked out of the country without due process.
One of the most disturbing things about this campaign of terror is that it seems to be directed by the president’s whim. In a Thanksgiving post full of invective and schoolyard insults directed at Minnesota Gov. Tim Walz and U.S. Rep. Ilhan Omar, Trump denounced the Somali community he claimed was “completely taking over the great State of Minnesota.” One week later, CBS News confirmed that ICE operations were underway targeting Somali immigrants in the Twin Cities.
Since we can’t count on the federal government to stay inside the bounds of reason or the law, it is critical that local and state leaders stand up to the racist, unconstitutional and unAmerican assault on immigrants.
It was good news when, on Wednesday, the Wisconsin Supreme Court accepted a case filed by the state chapter of the ACLU on behalf of the immigrant rights group Voces de la Frontera, contending that Wisconsin law enforcement agencies do not have the authority to make arrests or keep people in jail on detainers based solely on ICE’s administrative warrants.
Tim Muth, the ACLU of Wisconsin’s senior staff attorney, said hundreds of people throughout the state are being illegally held for days.
“It is extremely important for the Wisconsin Supreme Court to determine whether any law enforcement in Wisconsin has the legal authority to put or keep people in jail when they have not committed a crime and when no judge has issued an arrest warrant,” Wisconsin immigration attorney Grant Sovern wrote in an email to the Examiner. “Anyone in Wisconsin would want dangerous people to be kept from the public. But ICE is currently making no determinations about dangerousness or the likelihood to show up for a hearing if a summons is issued. A summons is a perfectly rational and legal way to address a civil legal question like someone’s immigration status. Jailing people before any independent adjudicator determines someone to be dangerous is against the Constitution and not the Wisconsin way.”
At a press conference Wednesday, Christine Neumann-Ortiz, executive director of Voces, told the story of a landscaper in Green Bay who was picked up for driving without a license (immigrants without legal status are barred by a 2007 state law from obtaining driver’s licenses). He was sent to county jail and then handed over to ICE. “He was a grandfather, very active in his church,” Neumann-Ortiz said, describing him as “someone who does not represent any kind of threat to society at all” and who, on the contrary, is a pillar of his community and beloved by his family.
Voces helped fight the deportation in a case that is still working its way through the courts. “At least he’s out and together with his family,” Neumann-Ortiz said. “But that’s an example of how people can be impacted by this.”
As it scrambles to meet arbitrary deportation quotas, ICE sends detainers even for people who have never been convicted of a crime and have only minor charges pending in Wisconsin courts.
Voces has been fighting at the local level since the first Trump administration for local law enforcement to refuse to collaborate with ICE unless there is a judicial warrant for someone, meaning that person is being sought in connection with a serious crime. As a result of Voces’ efforts, that is now the standard in Milwaukee County. The state Supreme Court case is an effort to establish the same standard statewide.
Neumann-Ortiz said she’s grateful the Supreme Court justices recognized the urgency of the issue in agreeing to take the case on an expedited basis, “given the current level of abuse that we’re seeing happen, and which will only escalate.”
And, she added, “We certainly very much anticipate Milwaukee being one of the cities that will be targeted for militarized occupation with these aggressive sweeps.”
Whether or not Wisconsin communities can protect people from the kind of violence we’ve been seeing in other states depends on the courageous actions of state and local officials, advocates and informed community members. It begins with recognizing that the Trump administration’s actions are wrong and then standing up.
At the press conference, a reporter asked about ICE’s assertion that the agency doesn’t have room for everyone in its detention facilities and therefore needs space in county jails. Muth responded: “Detain fewer people.”
Neumann-Ortiz added some clarifying context. “They are profiling people, they are just grabbing people without any probable cause. So it’s a very racist program that is using violence against people and is trying to hijack, through bribery and through threats, local law enforcement to be part of this mass deportation machinery,” she said.
“We’re seeing, at the local level, community come together,” she added, “to reject these efforts to undermine local law enforcement — which is supposed to play a public safety role — into just this arm of deportation driven by xenophobia and racism. And which is making a lot of money for the for-profit prison industry.”
This year, communities across the state have pushed back on 287g partnership agreements between local law enforcement and ICE that turn sheriff’s departments into an arm of the federal immigration agency. Palmyra, Ozaukee and Kenosha counties rejected ICE’s offers of money to transform their sheriffs into agents of federal immigration enforcement.
The Kenosha sheriff’s office made its decision not to participate after the ACLU and Voces had already named it in the Supreme Court lawsuit, along with Walworth, Brown, Sauk and Marathon counties. Palmyra also reversed a decision to accept a large payment from ICE to participate, responding to public outrage.
“Resistance is happening, it’s successful, it’s building community,” Neumann-Ortiz said. “But we do need state protections to uphold our rights.”
GET THE MORNING HEADLINES.
U.S. Immigration and Customs Enforcement will move its Milwaukee processing operations from a downtown building owned by the Milwaukee School of Engineering to a site on the Northwest Side, an ICE spokesperson said in an email to NNS.
ICE has been using the university-owned building at 310 E. Knapp St. as a processing center, a presence that has drawn weekly protests from students and community members since June.
A spokesperson for the General Services Administration, the real estate arm of the federal government, said the GSA “remains focused on supporting this administration’s goal of optimizing the federal footprint, and providing the best workplaces for our federal agencies to meet their mission,” the spokesperson wrote in a statement to NNS.
Demonstrators have been calling on the university to cut ties with the agency.
MSOE officials say the university inherited the federal lease when it purchased the building in 2023 and does not have the legal authority to remove ICE.
Alan Madry, professor emeritus at Marquette University Law School, said there is no question the federal government has eminent domain authority in such situations.
The federal government has the legal power to take or use property for public purposes even if a private landowner or local government objects.
In a statement to NNS, ICE said the transition “will follow a phased approach to ensure a smooth and efficient process” and that the agency “remains committed to maintaining continuity of operations as the office becomes fully operational.”
Processing centers are typically used to conduct interviews and sometimes hold people for the short term rather than overnight detention.
The ICE spokesperson did not provide a timeline for the move, but said the new location at 11925 W. Lake Park Drive will operate as a processing center, not a detention facility.
In a statement, Jeremy McGovern, spokesperson for the Milwaukee Department of Neighborhood Services, said the city has no additional inspections scheduled for the Lake Park Drive site and that the certificate of occupancy is already in place.
Because the federal government is not subject to local zoning and permit requirements, McGovern said, the city cannot determine when the site becomes active and has limited knowledge about the federal timeline.
The university says it intends to use the Knapp Street building for academic purposes once ICE leaves. But Noah Dinan, a sophomore studying software engineering at the school, said the lack of clarity about the move raises troubling possibilities.
The transition could take years, or ICE could expand its Milwaukee operations rather than relocate, said Dinan, who is a member of the university’s chapter of the Young Democratic Socialists of America.
The organization has circulated petitions, contacted alumni and joined the weekly Friday protests.
Dinan also pointed to the financial incentives of leasing to ICE.
According to the General Services Administration’s September 2025 lease inventory, the federal government is paying the university about $2.1 million per year to occupy the Knapp Street site through April 2028.
Despite the news that ICE has plans to transition from Knapp Street to its new property, Dinan said he and other students plan to continue protesting.
“Our campaign is one of sanctuary,” Dinan said.
Jonathan Aguilar is a visual journalist at Milwaukee Neighborhood News Service who is supported through a partnership between CatchLight Local and Report for America.
ICE plans to leave Milwaukee School of Engineering facility 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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