Progressive Thinking

Many people share the same concerns related to health care, the condition of the roads, and specific legislation that will help their home business. Others share their work with those who struggle with addiction.

ALMA, WI - I love county fairs. I love the sights, sounds, smells and the tastes of the fair. Moreover, I love all the people. Adorable little kids wander around with snow cones. Grandparents catch up on family news. Hardworking 4-Hers show cattle, cakes and cookies.

I especially love the opportunity for conversations with voters about what’s important. The relaxed atmosphere of the fair invites good conversations about what’s going on and how our state should help.

Cookies, roads and health care took up much of my conversations.

Several home bakers spoke with me about a recent court decision that found a group of home bakers could sell cookies and cakes at a local farmers’ market. But, the court decision did not apply to all of our state’s home bakers, which frustrated Charlene of Hixton and Ashley of Merrilllan.

Charlene told me home baking “will come to a screeching halt” if lawmakers don’t pass legislation called the “Cookie Bill.” The proposal, which I support, allows people to sell up to $25,000 of baked goods at farmers’ markets. I voted in favor of this bill in committee and in the full Senate. However, for reasons unknown, the Assembly won’t take up the bill.

Ashley has sold home baked goods for over a decade. The cinnamon rolls at Molly’s café in Black River Falls were her creation. She pointed out that “we give people a choice when they can pick up fresh baked goods made that day.”

Several bakers invited me to the Jackson County Farmers’ Market by the Lunda Center on Thursday from 2:00pm - 6:00pm and Saturday from 9:00am - 1:00pm.

Bad roads were also on people’s minds. Due to no increase in road aid from the state, Jackson County officials were forced to turn black top roads back to gravel. One man told me, “We’ve got to fix the roads. We can’t keep borrowing money and sending it to southeast Wisconsin. Roads are the backbone of Wisconsin.” He read my column about increasing the gas tax by a nickel. “My mom said to raise it by twelve-cents,” he directed me.

Health care was a hot topic too.

Bobby from Eau Claire shared her concerns about chronically ill patients she works with struggle to get needed care. She told me how the type of insurance a patient has can dictate what care they receive, not the doctor’s orders. “If you have regular Medicare or Medicaid, you can get the treatment you need,” she said. “But if you have another insurance – that is paid for by Medicaid or Medicare – you have to go through this long prior authorization process.”

Bobby also pointed out that “people can’t afford the premiums, the deductibles. We need a one-payer system that puts everyone on the same level playing field.”

I heard over and over again stories about the middle class feeling squeezed.

People shared their struggles in daily life, such as a woman whose nine-year old son kept trying to pull her away. His two front teeth were missing. She signed up for food stamps after her partner was injured and couldn’t work. Trying to keep her family fed meant trips to the food pantry.

I also met people reaching out to help those less fortunate. Donna spends her life helping foster children. “Thirty-eight percent of kids in foster care end up homeless. Half of children who are homeless used to be in foster care,” she told me. She started her own nonprofit called Network for Youth to help foster kids.

I talked with Tena who is just as passionate about the mission to rescue people from the destructive path of addiction. She started a group called #StoptheStigma.

“We ask no questions. We make no judgements. We meet our people where they are. We save people one individual at a time,” she said. Tena is Ho-chunk. Many of her fellow workers are also Ho-Chunk.

She emphasized that, “our people are everyone suffering from addiction… We speak up for all who cannot speak for themselves, for the rights of all who are destitute.”

The county fair is a snapshot of our lives; people facing struggles and people who are the heroes; people who make our communities great and so special. It is always an honor and joy for me to engage with them in conversation.

As lawmakers and citizens consider the Governor's proposal to bring Foxconn to the State of Wisconsin, it is critical to be aware of all the details of the state’s commitments to lure Foxconn and the precedent this will create for other companies considering coming here.

MADISON - Great News! A big tech company called Foxconn is coming to southeast Wisconsin and bringing with it a lot of new jobs. The new company will build a big factory and make flat screens for computers.

The Governor tells us the company will create 13,000 jobs that pay nearly $54,000. Other businesses will benefit because the company will buy things from Wisconsin businesses.

But, as Paul Harvey used to say, “Here’s the Rest of the Story.”

For its part, Wisconsin will pay $3 billion in tax credits and other subsidies over 15 years to the company. Tax credits are refundable – meaning if the company owes nothing in taxes, they will still get a check from the taxpayers of Wisconsin for the amount of the tax credits. It is important to note that manufacturing companies already pay almost nothing in state income tax.

Foxconn announced the company would create up to 3,000 new jobs. Local people will not get any benefit of property tax dollars from the factory for 30 years. We don’t yet know who the local community is but rumors point to Racine.

The bill to authorize the project was made public late Friday.

In the proposed legislation, there is no mention of 13,000 or 3,000 jobs. Tax credits can be awarded for full time jobs with a salary of $30,000 in Racine or $22,600 for a job in Milwaukee.

At a salary of $30,000 in Racine for 3,000 jobs, the state would be paying all the salary of the workers for 15 years at a cost of $90 million a year. At $3 billion in state dollars, the state will be paying a million per job – more than the total cost of all the new jobs.

Marketwatch, a publication of Dow Jones, analyzed the deal. How, the author asks, will this plant find and keep its workers in an economy with 3.2% unemployment by paying less than state average wages?

The answer may be found in an assumption made in the economic analysis paid for by the company and touted by the Governor’s office. Job numbers reflect “job location” and could be filled by residents or nonresidents.

The company will pay nothing in sales tax for building materials, supplies, equipment and services. This provision is directly at odds with the economic analysis. If sales taxes are not paid, the projected state and local tax benefits fall in the short term by half and in the long term by a quarter.

Other details one might ponder.

The bill borrows over a quarter billion to fix the Interstate between Milwaukee and the state border. This move helps finesse the impasse on the state’s transportation budget.

The Governor adds five new enterprise zones to be given away. Remember enterprise zones make refundable tax credits – a check that goes to the company’s owners even if they pay nothing in state taxes. Some legislators are cautious of these giveaways. Efforts beyond what is needed for the Foxconn deal might be seen as a way to expand giveaways later without legislative oversight.

Nestled in the bill is the authorization for local government to write no-bid contracts; exemptions from state environmental protections including for navigable waters and wetlands. The company is not required to submit an environmental impact analysis to the state. The bill changes the law related to diversion of water under the Great Lakes Compact. Some rules related to permitting utilities do not apply to the project. The claw back provisions are only permissive, not mandatory.

And nothing about the company’s obligation to the state is set. The three-page Memorandum of Understanding (MOU) released by the Governor’s office ends with a vague paragraph that reads all the terms of the MOU are “subject to final negotiations” with the State and Mr. Gou “acknowledging the importance of finalizing an agreement” by the end of September.

All of the environmental and economic concerns must be taken into consideration in the context of an industry rapidly moving toward automation and robotic workers; a company with a history of not delivering promised jobs. And a company with a history of abusing its relationship with its workers.

All of the details should be public before the legislature approves the project.

We wouldn’t want to buy a $3 billion lemon.

Sen. Vinehout writes about the introduction of her Badger Health Benefit Authority bill to create a state health marketplace. She shares how Wisconsin can do better for serving all with affordable and accessible health care.

MADISON - An older man contacted me recently with a problem. A visit to the doctor left him with thousands in unpaid bills. Medicare deemed the tests “routine” and not a “medical necessity.” But the gentleman was told, for his occupation, the tests were absolutely necessary.

He was left with a medical bill costing more than his 2017 income.

The top-notch staff at the Department of Health Services (DHS), discovered the man was likely eligible for Medicaid. But the man wasn’t interested.

The constituent relations department within DHS has been a godsend over the years, helping me solve many difficult medical cases. I’m very grateful for their help. I’m sure they saved many lives by connecting people to health coverage. But, if a person doesn’t want state help, there is little they or I can do.

Unless we change our state health care system and the perception of seeking assistance.

What if everyone had affordable health care? If you hadn’t signed up, you could sign up the first time you saw the doctor, physician’s assistant or nurse practitioner.

Behind the scenes, hospitals and clinics know they’d be paid. If you were eligible for Medicaid, you’d get the benefits. Seamlessly, payers would pay bills, providers would be paid and people would no longer pay any insurance premiums.

You could choose a provider in your area from several options. Your plan would include comprehensive benefits including maternity and mental health coverage.

If you lost your job, you could keep your health coverage. If you took a new job or started your own business, you could keep your health coverage.

Employers no longer would worry about health coverage. Sure, they could offer extra benefits if they wanted, but basic coverage would be disconnected from employment – taking a huge irritation off a company’s plate.

Health care doesn’t have to be so complicated. Other countries have figured out how to solve this problem. And Wisconsin can too.

In fact, ten years ago this summer, Wisconsin actually had a plan on the table to create such a system. Senate Democrats introduced Healthy Wisconsin, a plan written by Senators Erpenbach, Miller and myself. Under our plan, coverage would have cost 14.5% of payroll – split between employers and employees.

This summer, an idea to offer BadgerCare for all attracted attention. I support the plan and see the idea as a first step. Details of the plan are sparse, but it would require the Trump administration to allow a public option in Wisconsin on the federal marketplace Healthcare.gov.

Minnesota’s Governor Dayton introduced a plan to offer MinnesotaCare as a public option. He used the state’s authority and the state’s own health care marketplace, MNsure. He put together a plan that leveraged federal dollars and the state’s large Medicaid pool to add self-employed and small business people. According to the Minnesota Department of Health, the cost would be entirely funded by premiums and tax credits.

GOP controlled Legislators didn’t deliver Dayton’s request, but Minnesota is a lot closer to moving to a public option than Wisconsin. Wisconsin needs the flexibility of our own marketplace to explore options that work best for our state. That’s why I recently introduced a bill to create Wisconsin’s own health care marketplace.

Senate Bill 359 and Assembly Bill 445, the companion co-authored by Representative Sargent, creates a unique badger-based approach to a health marketplace. Using innovations to balance high quality, cost control and wide access, Wisconsin can have its own approach.

We can move toward a system that minimizes the everyday hassles of health insurance and eliminates the fear of a loss of coverage just when you need it the most.

Access to affordable, high quality health care is a duty of our society to everyone. Health care for all is a moral responsibility of our people to each other. Finding the best way to pay for and deliver the care should be the topic of discussion. Instead, some public officials propose dropping coverage and cutting state budgets. Harsh talk stigmatizes Medicaid.

Instead, let’s share our vision of what health care for all looks like for each of us. And, meanwhile, support leaders who find ways to work together and take steps toward our mutual vision.

Senator Vinehout shares what she learned at the Stockholm Art Fair about dwindling health care options in Western Wisconsin.

STOCKHOLM, WI - “My father-in-law is losing his health insurance,” Pam told me. She stopped to chat as we perused the booths at the Stockholm Art Fair.

Stockholm, population 66, has one of the best art fairs in western Wisconsin. Judging by the license plates, the fair is high on the list for Minnesotans too.

The 44^th annual fair was held on the grounds of the city park overlooking Lake Pepin, the widest spot in the Mississippi River. Over 100 artists were eager to share their health care stories and sell their creations. There were few bugs. Weather was warm, but not too hot. Colors were everywhere.

The air smelled of fresh roasted nuts, gyro meat and kettle corn. Organic beef, wood-fired locally sourced pizza and maple ice cream kept hunger at bay.

Talented regional musicians kept folks entertained as neighbors sat on straw bales under a tent. Many shared treasures and pointed out favorite artists.

Under the surface, though, folks worried. My conversations were almost exclusively about health care.

Pam told me how a local health plan, La Crosse-based Health Tradition is quitting the federal marketplace Healthcare.gov next year. Others shared how loved ones recently received letters from Anthem or Health Tradition dropping coverage next year.

Recently, Wisbusiness.com reported roughly 23,000 will be affected by the pull out of Anthem and Health Tradition. Insurers blame the “uncertainty in federal operations, rules and guidance including cost sharing reduction subsidies.” This statement translates into: as Congress debates cutting help to people who need it, companies realize they may not have the customers to make a plan work.

In the insurance world, the larger the pool, the lower the risk. But if folks don’t have help buying insurance and younger people get cheaper plans, the folks that are left – sicker and older – end up with more expensive plans and, maybe, none at all.

The Affordable Care Act is not perfect. But it was carefully balanced to share the risk – the basic element of keeping health care affordable for all.

Many artists and musicians are self-employed. The Affordable Care Act and Healthcare.gov created a way for self-employed and small business owners to buy health coverage. Many artists I spoke with are older, coming to the profession later in life. Many of us over fifty have pre-existing conditions and need regular health care.

Artists expressed concerns about the limited health coverage available in Buffalo and Pepin counties. These counties recently joined the dubious ranks of counties with only one health plan under the Healthcare.gov marketplace. Because of federal uncertainty, five counties, include La Crosse, are down to only one provider next year under the marketplace.

Farmers feared losing health coverage or changing long-standing relationships with providers.

The fear of losing health care is stressful – I heard and felt it as conversation after conversation shifted to health insurance.

As I watched the vibrantly dressed people soaking in the imaginative art, I thought about how experiencing the art fair provided a balm for our stressful lives.

Gazing at the pottery I nearly bumped into a retired physician and his wife. He also saw the attraction people found to art as a way to heal our stressed world. He shared his experiences over the years.

“When I ask ‘How are you?’ what do you think is the number one complaint I get?” he asked.

“Patients say to me ‘I’m stressed, Doctor.’ When I open up the hood and look inside, I see stress.”

“Art brings beauty. It softens the heart,” the doctor shared. The art fair helps make it better.

I watched men in florescent orange with camo, a woman in sheer black lace with her back covered in tattoos and another in a brightly colored African Dashiki.

People came together creating their own art among all the wares for sale. In all of this diversity was a beautiful harmony.

Somehow, we must take this approach to health care. A plan unique for each person. Respecting our own individuality and needs. Also, in harmony with others. Sharing the risk. Working for all.

Senator Vinehout discusses the importance of acting soon on the budget, and to coming up with solutions to fix Wisconsin’s transportation funding shortfall.

MADISON - A tall man stopped me in the hall of the Capitol. “Can’t you just increase the gas tax?” he asked me. “I’m here to ask my Republican Senator to increase the gas tax. We need to fix the roads.”

He smiled. Then said, “Hi, my name is Steve. I’m a Republican. I just don’t think it’s conservative to keep borrowing to maintain the roads. We’ve got to pay for what we spend.”

Steve was earnest in his desire to find a solution to the road budget. I’ve heard similar concerns from folks attending my recent town hall meetings.

Many people asked me to raise the gas tax. This tax is the largest part of the road fund, accounting for over half of the fund. The gas tax hasn’t been increased since April 2006.

Prior to 2006, the law required automatic indexing or changing the tax to follow inflation. If indexing wasn’t repealed, we’d be paying seven cents more for fuel according to the nonpartisan Legislative Fiscal Bureau (LFB).

As Steve and I talked about road funding problems and possible solutions, he shared, “My Republican Senator said increasing the gas tax wouldn’t solve all the problems.”

Increasing the tax by five cents a gallon would generate about a third of the money needed to close the budget gap. This change is a good first step.

Increasing the gas tax by a nickel would cost the average driver of a vehicle that gets 30 miles per gallon (MPG) about $14 a year. For those of us with old farm pickup trucks getting 15 MPG and driving 16,000 miles a year, we’d pay about $53 more a year.

Most of us are actually paying less in gas tax than we did ten years ago because our vehicles are more fuel efficient. In 2006, the average fuel economy was 20 MPG. LFB reported this fuel economy average will increase to almost 23 MPG by the end of the next state budget. Analysts estimated the average Wisconsin driver will be paying almost $21 a year less in fuel tax by the end of the next budget than we did in 2006.

LFB analysts remind us that drivers paying less in fuel tax for the same miles driven means that “while the state’s roads receive the same impact [wear and tear], fuel tax revenues associated with those miles driven have fallen, making it more difficult for the state to maintain and reconstruct its roads.”

Increasing the gas tax is a change that would be easy for the state to administer. It would put money in the state’s coffers from the folks who are actually using the roads, including our many wonderful tourists from neighboring states.

Finding votes to increase the tax has been difficult and accounts, in part, for the delay in passing the budget. Unlike some states, Wisconsin continues to operate under the details of the old budget until the Legislature passes a new budget.

But a recent memo from LFB suggests there are some warning signs to lawmakers who think they have all summer and fall to answer the question, How to pay for roads?

A delay of three months would mean the Department of Transportation could not proceed with some projects as planned. A delay of four months would affect the ability of counties, cities and towns to plan for the coming year and set their property tax levies. A delay into August could affect how much federal money the state receives for roads.

Fiscal Bureau analysts explained to lawmakers in the memo that the feds redistribute road money not used by states as their fiscal year closes. To be eligible for new money, states must show they are ready to use the money. A delay in passing the state budget would likely limit the ability of the state to comply with the rules feds attach to the money.

Leaving federal money on the table makes no sense. We’ve got to find solutions and get the budget passed.

While raising the gas tax won’t solve all our problems, getting agreement on a modest fuel tax increase would be good first step.