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A measles outbreak in the southwestern corner of Wisconsin continues to grow.

As of Friday, the state Department of Health Services has identified 41 confirmed and 7 probable cases across Iowa, Lafayette and Grant counties.

All but one of the people infected with measles in Wisconsin this year have been unvaccinated, according to state data. Just over half of the cases have been in children and teens, while 44% are in adults.

State and local health officials are working to stop the highly-contagious virus from spreading further. But that work is being made more complicated by low vaccination rates in some communities.

DHS spokesperson Jennifer Miller said in an email that while the situation remains fluid, “we are seeing confirmed cases in pockets of our communities where individuals are under-vaccinated or unvaccinated.”  

“Whenever there are pockets of lower immunization coverage — whether due to geographic location, health care access, or personal reasons — highly contagious viruses can spread quickly,” Miller wrote.

Like the rest of the U.S., childhood vaccination rates have fallen in Wisconsin as parents’ uncertainty, and in some cases skepticism, around vaccines has spread in the wake of the COVID-19 pandemic. 

But state data shows some of the southwestern communities have had declining uptake of the measles, mumps and rubella vaccine series well before pandemic. 

Only 60% of two-year-olds in Lafayette County had received one or more of the shots in 2025. Grant County’s rate was just under 64%.

Iowa County, where the majority of the recent measles cases have been located, had a rate similar to the statewide average at nearly 81%. But it’s still well below the threshold needed to prevent an outbreak at 95%.

Plain community may be affected

One community in the region that may be affected by lower vaccination rates are the Amish and Mennonite faith groups. The Christian communities are collectively known as Plain people because of their selective use of modern technology and conservative style of clothes.

Wisconsin has the fourth-largest Amish population of any state in the country, with an estimated 27, 535 Amish people living in the state as of 2025. The population data from Elizabethtown College in Pennsylvania shows more than 3,000 Amish live across Grant, Lafayette and Iowa counties.

Mark Louden, a University of Wisconsin-Madison professor of Germanic linguistics, is an interpreter and cultural liaison for the state’s Plain communities. He said the Plain people in Grant and Lafayette Counties have strong family ties to Lancaster County, Pennsylvania. 

“There’s a lot of back and forth, just like people traveling back and forth, visiting and so forth, especially this time of year,” he said.

Lancaster County is home to the largest Amish settlement in the U.S. and is at the center of a major outbreak of measles that has sickened more than 300 people in Pennsylvania.

Louden said that while Amish and Mennonites have community standards for technology, health care choices are left up to individuals and their families.

“Even the most conservative or traditional groups out there do access Western healthcare,” Louden said. “While there may be some families that have their kids not vaccinated at all, that’s pretty exceptional.”

Louden characterized Plain communities as “vaccine cautious.” He said they’re more likely to choose which shots they want their children to get instead of just following a recommended vaccination schedule.

But he said their caution or even distrust of vaccines doesn’t just come from their cultural beliefs.

“(It) has been amplified by what they hear from their non-Plain neighbors, who are going down internet rabbit holes and watching certain networks,” Louden said.

Jack Sauer, chair of the Lafayette County Board of Supervisors, said like many places in the U.S., his county used to have higher rates of vaccination. But he questioned how much national rhetoric that questions childhood vaccinations, including from leaders of President Donald Trump’s administration, have had an impact.

“If you listen to anyone on the federal level, there’s a lot of going back and forth on whether the immunizations are good for you or bad for your or whatever they are,” Sauer said. “But I know when I was growing up, which was a long time ago, they were pretty well acceptable.”

Given the rapid spread of cases in neighboring Iowa County, he expects to see more cases in his county before the outbreak is over.

Iowa County Health Officer Debbie Siegenthaler said in an email that her department is working to identify cases and potential exposures and make sure people have access to testing and vaccination.

She strongly encouraged residents to check their vaccination status through the Wisconsin Immunization Registry or through their healthcare provider, especially as children head back to school.

“With increasing number of cases, we want residents to be aware of measles even if they have not been notified of a direct exposure,” Siegenthaler said in the email.

The county is holding a community vaccination clinic at the Mineral Point Rescue Squad office on Monday, Aug. 24 from 12 p.m. to 5 p.m.

This story was originally published by WPR.

Low vaccination rates drive southwest Wisconsin measles outbreak 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 health leaders worry future work requirements for Medicaid recipients will create both an administrative and ethical burden for doctors and other providers.

Starting next year, adults ages 19 to 64 will be required to work, go to school or volunteer for 80 hours per month to qualify for coverage under the safety-net program. 

The new rule, which was included in Republicans’ “One Big Beautiful Bill Act” last year, provides exemptions for several groups, including people who are pregnant, live with children under 19 and those with a recognized disability.

There is also an exemption for people with serious or complex medical conditions, or those considered “medically frail.”

In guidance released in June, the Centers for Medicare and Medicaid Services, or CMS, said state Medicaid programs should consider not only a person’s diagnosis or condition but also “the extent to which the condition impairs an individual’s ability” to meet the new requirements.

But Dr. Ken Schellhase, a primary care physician and member of the Wisconsin Medical Society, said making that determination is not simple, even for a doctor.

“That will require training and skills that the typical primary care doc does not have,” he said. “Honestly, that’s a big reason why most docs in primary care practices don’t do the official disability evaluations for Social Security.”

Doctors working in occupational medicine or rehabilitation are specially trained to objectively determine someone’s functional capacity, Schellhase said, but few such providers practice in those fields.

Speaking to reporters on July 30, Wisconsin Department of Health Services Secretary Kirsten Johnson said the state needs more guidance from CMS as it develops a system for verifying who qualifies for the exemption. 

She said DHS plans to use existing records like medical billing to verify that someone is unable to meet the work requirements. CMS will also allow recipients during the first year to self-attest that they are unable to work.

Scott Stewart, CEO of the Wisconsin Primary Health Care Association, said the existing system for health insurance claims is not designed to indicate a person’s level of impairment or their ability to work.

“It’s set up to say this is what a patient has, but it’s not set up to say anything more than that,” Stewart said. “You have to really also think about the privacy aspects of that. Now you’re saying that I have to potentially give a patient’s chart, which they have to sign off on in terms of HIPAA, to say that they are medically frail and meet all definitions?”

Schellhase worries that involving medical charting and billing could influence how doctors care for their patients, including how quickly they make a diagnosis. He described someone seeking for treatment of asthma symptoms.

“Not everybody who wheezes has asthma, and so sometimes we struggle with as a diagnosis code,” he said. “Do we put in just wheezing? Or have we seen it enough times, but it’s just not absolutely confirmed that yeah, this person probably has asthma? There’s a lot of gray area in that.”

He said patients with conditions not considered severe enough for exemption could see their health decline if they lose health insurance. And he worries the new process will create a conflict of interest for doctors who have a professional obligation to help, not harm, their patients.

“We’re supposed to be that patient’s advocate, to do whatever’s in our power to help them and get them the help that we think that they need,” he said. 

Stewart, whose organization represents the state’s federally supported community health centers, said increasing paperwork requirements have lead to more people losing access to care.

He’s concerned that health systems will be incentivized to help patients qualify for an exemption to keep their coverage so providers can continue to bill the program for care.

“We’ve seen issues with the Medicare Advantage program and things like that in the same way, around wanting patients to have access to these programs, but having the kind of perverse financial incentive to get them on (the program),” he said.

WPR contacted several major Wisconsin health systems for comment on the potential impact of the work requirements but received no responses. 

The Wisconsin Hospital Association, or WHA, declined WPR’s interview request. In a statement, WHA’s senior vice president for finance and payment, Christian Moran, said the association appreciates DHS’s efforts to “minimize additional regulatory burdens on hospitals and providers while helping eligible individuals maintain Medicaid coverage and reducing the risk of higher uncompensated care in Wisconsin hospitals.”

Moran wrote that WHA will continue to watch the state agency’s plans as more details become available.

This story was originally published by WPR.

Wisconsin doctors worry Medicaid work rules will create ethical, administrative burdens 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.