Bill to make Medicaid eligibility harder paused after flurry of opposition

Yahoo

16-04-2025

Sandra Lomeli testifies at a public hearing April 10, 2025, against a bill imposing new restrictions on the process for confirming eligibility for Medicaid. (Wisconsin Examiner photo)
Legislation that would add new restrictions to the process of qualifying for Medicaid is on hold in the Wisconsin Capitol after meeting with resounding opposition at an Assembly hearing less than a week ago.
At a meeting Tuesday to vote on two other bills, State Rep. Dan Knodl (R-Germantown) told the Assembly Committee on Public Benefit Reform that he chairs that the Medicaid measure 'has some work to be done yet.'
The bill's author, Rep. William Penterman (R-Columbus), told the Wisconsin Examiner in an email message Tuesday that the legislation 'is still in the Assembly Committee on Public Benefit Reform. The conversation on how to improve the bill is ongoing.'
An opponent of the measure, however, suggested that opposition testimony had prevailed in keeping it from moving forward.
'I think you all realized how terrible and harmful that legislation was,' said committee member Rep. Ryan Clancy (D-Milwaukee), directing his comment at his four Republican colleagues. 'We heard two and a half hours of testimony overwhelmingly against that [bill].'
Clancy spoke before voting against two other bills that the committee passed 4-2 along party lines — one making sweeping revisions to Wisconsin's unemployment insurance (UI) system, and the other barring local governments from instituting guaranteed basic income programs using tax dollars.
Medicaid covers acute and long-term medical care for low-income people as well as people with disabilities. It's funded jointly with federal and state money and managed by the state under federal rules and guidelines.
With some exceptions, recipients must have incomes at or below the federal poverty guideline. Most Medicaid recipients must be reviewed once a year to confirm they are still eligible for the program.
AB 163 would direct the Wisconsin Department of Health Services (DHS) to conduct eligibility reviews every six months.
It also would add restrictions on the verification process — forbidding the state from automatically renewing Medicaid beneficiaries, forbidding the state from automatically filling in electronic forms with the recipient's information except for their name and address, and cutting off a person's ability to enroll in Medicaid for six months for failing to report a change that might make them ineligible.
Penterman, the only witness who testified at the bill's April 10 public hearing, highlighted the statistic that 20% of Wisconsin residents are on Medicaid.
He described the legislation as an effort to 'reassess and restore integrity to the system by ensuring that only those who are truly needy and truly qualified for this coverage receive benefits.'
But the recurring message from a stream of hearing witnesses — the vast majority of them people with disabilities who rely on Medicaid for long-term health care in their homes or in the community or their family caregivers — was that the current eligibility requirements are already burdensome, and strict enough to keep out people who aren't eligible.
'We heard from so many people who do a tremendous amount of work to prove to the state that they have low enough income, low enough assets, that they are who they say they are, that they meet the functional screen and all of the other requirements that the department has [for them] to be able to get in or stay in the program,' said Tamara Jackson, legislative policy representative for the Wisconsin Board of People with Developmental Disabilities, in an interview Tuesday.
The hearing came just two days after the bill was introduced April 8. Its fast track prompted an overnight opposition campaign by Medicaid recipients.
'We heard from people across the state who had said that they had contacted their state lawmakers about this particular bill and had really used it as an opportunity to tell them what they do to be allowed in the Medicaid program,' Jackson said.
Recent Congressional action on federal legislation to extend tax cuts enacted in 2017 has included spending targets that would appear to make Medicaid reductions inevitable. Medicaid recipients have been following those debates and making public appeals to oppose cuts in the program — priming them to oppose the state proposal as well.
'I think that people are paying attention, and the reason there were so many contacts is because Medicaid is so important to folks and they're willing to show up and talk about it,' Jackson said.
At the very start of the April 10 hearing, Penterman alluded to communications he had already received from advocates and said he planned an amendment to exempt people with developmental disabilities from some of the bill's restrictions. He introduced the amendment later that day.
Several witnesses, however, criticized limiting the amendment to people with developmental disabilities, arguing that the bill's requirements would be needlessly onerous for many other people.
Sandra Lomeli of Pewaukee was one of the hearing witnesses against the Medicaid bill. She is the mother of two adult children with severe disabilities who are able to get long-term care through Medicaid. One requires 24-hour care as a sexual assault survivor, she said.
Lomeli is also covered by BadgerCare Plus, the Wisconsin Medicaid plan for primary and specialty health care and hospitalization, because being her children's family caregiver limits her working hours to a part-time nonprofit position.
She told the committee that she fills both sides of a ream's worth of forms each year to confirm her children's Medicaid eligibility. She said she spends 54 hours completing those forms and 10 hours confirming her own eligibility each year.
In her testimony Lomeli challenged lawmakers to enlist Medicaid participants and advocates if they wanted to write legislation to improve the program.
It appeared to Lomeli that her suggestion 'took people by surprise that we would even be at the table,' she said in an interview Tuesday. 'I don't think they valued that we could add value — because if they did, somebody would have reached out.'
She said she doesn't consider the legislation dead, however, which concerns her.
'The issue is not off the table yet,' Lomeli said. 'They're just going to reword it. We have won the battle now. We haven't won the war.
While setting the Medicaid bill aside Tuesday, the Committee on Public Benefit Reform advanced two others with only Republican votes.
AB 164 would rename Wisconsin's unemployment insurance system as a 're-employment assistance' program with new requirements for workers and for the state agency that administers it.
Those include requiring recipients, who must currently make four work searches a week, to make two of those in the form of direct contacts with prospective employers. It also adds a variety of additional counseling procedures and requirements for people who receive unemployment benefits.
Department of Workforce Development Secretary-designee Amy Pechacek submitted written testimony expressing 'concerns about this proposal due to the anticipated reporting burden for employers, potential costs, bureaucratic requirements, and lack of sustainable funding.'
Gov. Tony Evers vetoed similar legislation in 2023, citing similar complaints as well as the fact that it did not go through the state's joint labor-management unemployment advisory council.
AB 165 would bar local governments from using tax dollars to create guaranteed income programs without a work or training requirement. Evers vetoed a similar bill to that one in 2023 as well, on the grounds it usurped local control.
Rep. Christian Phelps (D-Eau Claire) made the same argument against the current legislation.
Knodl defended the both bills as helping to 'protect the integrity of these systems, and that's important if we want them to be sustainable in the future.'
Clancy argued that both should have been put on pause along with the Medicaid bill.
'But all three of those . . . bills are fundamentally the same,' Clancy said. 'They are kicking people when they are down. They are hitting people at their most vulnerable, and frankly, in 2025, when national and state Republican policies have meant that people have more needs. We should not be attacking those social safety nets.'
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