Progressive Thinking

This week Senator Kathleen Vinehout writes about the importance of working together to make health insurance a success. State politicians need to “quit rooting for failure” and instead “put their constituents first.

MADISON - A focus on solutions could make a special legislative session on health insurance a success.

Governor Walker recently told the Associated Press “We want to make sure nobody falls through the cracks.” If this is the goal, the best solution would be to continue providing public insurance until eligible folks have gotten signed up for the new Marketplace.

The governor has called on Legislators to extend his deadline to drop BadgerCare coverage for tens of thousands of low-income Wisconsinites because of difficulties folks experienced in getting signed up for the federal health insurance Marketplace.

Many low-income parents of children on BadgerCare and folks on HIRSP will lose their public insurance the first of the year and have until December 15th to sign up for Marketplace insurance to ensure uninterrupted coverage.

Computer glitches and widespread confusion caused a paltry 877 people in Wisconsin to actually choose a plan through the federal Marketplace healthcare.gov in the first month of the website’s operation. Only about 1 in 200 people who buy insurance in Wisconsin on their own actually chose a plan for 2014 through the Marketplace.

Minnesota, who has its own Health Marketplace MNsure, saw double the number of residents who contacted the Marketplace, were determined eligible and actually choose a health plan. Minnesota has an extensive marketing campaign to enroll people in the state-based Marketplace. Wisconsin leaders chose not to implement a state-wide marketing campaign.

Recent research shows costs in Minnesota are substantially lower than in Wisconsin. Failure to sign up large numbers of residents, especially younger people, in Wisconsin could add to these higher costs.

Wisconsin officials are critical of the troubles with the federal website and its failures in Wisconsin but appear uninterested in state-wide marketing efforts, rate reviews or the creation of a statewide Marketplace- all activities Minnesota has used to lower costs.

Extending the deadline before folks lose public insurance is a good start for Wisconsin.

But lawmakers should go further and assure people don’t lose BadgerCare or HIRSP until they’ve got other coverage.

A March 31, 2014 federal deadline exists for anyone buying insurance on their own. After that deadline folks won’t be able to buy coverage for 2014. The open enrollment window will not open again until October 2014 for 2015 coverage.

This means if people who buy insurance on their own do not get signed up for the Marketplace by April 1, 2014, they will be unable to get health insurance to cover them through 2014. Only a few exceptions exist related to changing family circumstances.

Half a million people in Wisconsin do not have insurance. Our focus must be on getting people coverage they can afford. Lawmakers should use the governor’s special session to immediately cover 85,000 people without minor children who make less than the federal poverty level of roughly $11,500 a year. This coverage was approved in the budget and is on track to go into effect in January.

In addition, the state should not drop coverage on low-income families until they are signed up for the new health Marketplace. State officials should explore the unique bipartisan approach used by the Democratic governor and Republican lawmakers in Arkansas.

Health is vital to life. We must not lose our focus on providing health security to Wisconsin. States that are succeeding in health care changes are those states that have put aside politics and focused on solutions.

For example, the governors in Washington, Kentucky and Connecticut recently wrote in a Washington Post op-ed:

People keep asking us why our states have been successful. Here’s a hint: It’s not about our website…

The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding health-care coverage and have avoided the temptation to use health-care reform as a political football.

The three governors asked politicians to “quit rooting for failure” and instead “put their constituents first. Health reform is working for the people of Washington, Kentucky and Connecticut because elected leaders on both sides of the aisle came together to do what is right for their residents.”

Reports show that Minnesota residents will pay less for health care coverage than Wisconsinites. The path each state chose to follow related to the Affordable Care Act contributes to those differences.

MADISON - “Why is Minnesota paying less for health insurance than Wisconsin?” the doctor asked me.

He was one of many to say lawmakers better get to work to lower insurance costs. Many people who buy insurance on their own have complained to me about high insurance costs.

Folks near Minnesota told stories about how much easier it was for those in the Gopher State to get low cost insurance. A study released by Citizen Action of Wisconsin corroborates these stories.

The report analyzed data from the Department of Health and Human Services (DHHS) showing Minnesota residents consistently pay less than Wisconsin residents. I read the DHHS report and found the average lowest monthly premiums in the 36 states reporting numbers was $249 for a Bronze Plan. The average cost for this plan in Wisconsin was $38 more than the national average. The study used a weighted average to adjust for population differences within the states.

In Minnesota, a similar plan was $144 a month, half the cost of Wisconsin’s plan!

The gap grew for older people and, especially, for people in western Wisconsin. Particularly striking is the difference in two western Wisconsin cities. On average, premiums in Eau Claire were 116% higher than Minnesota and premiums in La Crosse were 136% higher than the weighted average in Minnesota.

Citizen Action estimated premiums in Wisconsin will be $1,824 more a year for the lower cost Silver (middle) Plan than in Minnesota.

Many people asked how this could happen. What does Minnesota know that Wisconsin does not? What decisions could Wisconsin lawmakers make to turn these differences around?

First, it is important to note that Wisconsin does not significantly differ from Minnesota in per person health costs. Wisconsin is slightly more expensive but per person costs in both states are a little under $6,000 a year.

Second, Minnesota made very different decisions than Wisconsin last year. Minnesota chose a state-based Marketplace, chose to keep parents up to 200% of the federal poverty level (FPL) on Medicaid, and chose to expand coverage of Medicaid for all people up to 133% of FPL. This means a single person who makes up to about $15,000 a year can get on the Gopher State’s version of BadgerCare. The state also chose to vigorously use rate review authorities.

Wisconsin, on the other hand, decided to let folks buy insurance through the federal Marketplace. The Governor and lawmakers who voted for the state budget dropped BadgerCare coverage for any adult who made a little more than $11,000 a year. The state decided to not use its rate review authorities.

All these choices made a difference in the Marketplace rates people will pay in the next year. For example, the choice to not expand Medicaid cost those buying insurance in the Marketplace an estimated 8 – 10% more according to a recent study by the Rand Corporation. This is because people who lose Medicaid are poorer and likely in poorer health. When added to the state’s Marketplace pool, costs increase.

Sicker people are likely to seek out the Marketplace. Those who are healthy may sit out this period of enrollment. This creates much higher premiums. It is also why Minnesota conducted extensive advertising to encourage sign-up; something Wisconsin chose not to do.

Years ago when I wrote the legislation to create a state-based Marketplace, I learned from the experience of other states that marketing, especially to young people, was the single most important factor in getting a well-balanced pool of enrollees and keeping costs down.

It is no accident that those who oppose the Marketplace are running ads to discourage young people from signing up.

All the premium numbers I’ve mentioned are before federal credits. These subsidies go to lower income folks which will offset premiums. So those hit the hardest by higher Wisconsin costs will be middle income insurance buyers.

It’s time to put politics aside and create a Badger state-based exchange. The work is done in Senate Bill 12. I call on my colleagues to hold a public hearing on the bill.  If we can’t outshine the Gophers, lets at least keep up with them.

Republicans in Madison have pushed through changes to Wisconsin’s education system, to expand private choice and charter schools and provide state tax dollars to these private entities. The loss of state aid strikes at our cash strapped public schools.

ALMA - “I just don’t understand vouchers, choice, and charter schools,” the man told me. “Could you explain?”

Public education is undergoing a radical change. What was predominately a local school governed by a locally elected school board is poised to become a plethora of choices: private religious schools, independent privately operated charter schools, voucher schools, for-profit schools, virtual schools, and public schools.

All paid for with tax dollars.

State officials recently announced enrollment information related to statewide private school vouchers. Lawmakers who supported the state budget voted to expand the payment for private schools with public money, known as voucher schools. The information released shows four out of five students who received public money for private tuition were already enrolled in a private school.

Data on the performance of these alternatives to public schools is inconclusive, poor or not available.

According to the recently released 2012-13 report cards for virtual charter schools, half of virtual school students were receiving their education from a school that did not meet expectations. Virtual charter schools are on-line schools paid for with public money.

Twenty years of experience with private vouchers in Milwaukee shows no major differences in the performance of private voucher students with public school students. The Legislative Audit Bureau in 2011 reviewed the final of five years of study to conclude students in Milwaukee who attend private schools with vouchers show few differences on standardized tests than their cohorts in public schools.

The 25 private schools in the new statewide voucher expansion received state money – over $7,000 per student – but are not required to conduct standardized state required testing for several years. Several of my Senate colleagues and I urged accountability for private schools similar to that of public schools but so far this hasn’t happened. Instead lawmakers are heading in the opposite direction

Efforts in the Senate Education Committee would expand another type of choice: a charter school that could be operated by a private out-of-state company; again paid for with public money.

This legislation -Senate Bill 76 - would allow charter schools to expand even if the school board that authorized them did not want the expansion.

All this change in public education has many people confused. Most of Wisconsin hasn’t seen the use of taxpayer money for private education. Many public schools have cut back to the bones. Parents, school board members and superintendents are asking me, “Why fund these unaccountable, private schools at the cost to our public schools?”

Data released by state education officials report almost half of public school districts will see further cuts in state money. The deepest cuts – limited to 15% by law- will go to 64 mostly rural schools. After the 15% cuts are taken out, schools then must pay their share of the independent charter schools in the Milwaukee area. Local school boards tell me this is simply not fair.

The push away from funding local public schools is part of a national effort to privatize public education. This effort is detailed in a new book by Diane Ravitch. She was appointed to public education positions by both President George H.W. Bush and President Clinton and is critical of both President George W. Bush and President Obama.

Ravitch describes efforts to transform education into “an entrepreneurial sector of the economy”. These efforts are “funded to a large degree by major foundations, Wall Street hedge fund managers, entrepreneurs and the U.S. Department of Education.”

She describes this movement to “eliminate the geographical based system of public education as we have known it for the past 150 years and replace it with a competitive market- based system of school choice – one that includes traditional public schools, privately managed charter schools, religious schools, voucher schools, for-profit schools, virtual schools and for-profit vendors of instruction.”

Few of the details Ravitch mentions are part of public discussions among policy-makers. Yet observing the action of the Legislature, the influence of those who seek education transformation is undeniable.

Wisconsin must wake up to the forces behind changes in schools. Once folks know details, I suspect few would support education funds to unaccountable schools created as investment opportunities.

People from western Wisconsin travelled to Madison last week to testify against Senate Bill 349, a bill that rolls back locals’ ability to protect their citizens.  Many local elected officials also came to testify against the bill and expressed serious concerns about the chipping away of local control.

MADISON - “Our aim when drafting the ordinance was not to stop mining in the Town of Cooks Valley but to protect the health, safety and welfare of the citizens of our town,” said Town Clerk Victoria Trinko.

She recently testified at a public hearing about Senate Bill 349, a bill to roll back locals’ ability to protect citizens.

The bill, introduced by Senator Tiffany, would overturn a unanimous 2012 Supreme Court decision supporting a local ordinance to protect the health and safety of residents residing in the Town of Cooks Valley in Chippewa County.

Specifically at issue is the ability of local government to pass an ordinance to protect citizens from frac sand mining. Cooks Valley is an unzoned township. The town followed the law and adopted local police powers that gave them authority to enact a frac sand mine ordinance. Senator Tiffany’s bill would take this power away.

But SB 349 goes much farther. It takes away any ability of counties, towns, cities or villages to protect health and safety with regard to water, air and blasting unless this authority is expressly given to locals in another part of the law. The bill strikes down part of the law granting police powers and home rule as authority for sand mine ordinances. If the bill becomes law, it would prohibit local rules related to not only protecting but even monitoring air or water.

It became clear during the hearing that eliminating local power to protect health and safety was the intention of the bill.

Wisconsin Manufacturers and Commerce (WMC) testified in favor of the bill. The group said local rules to protect the environment, health or community “simply add confusion and stifle responsible growth and business.” WMC’s lobbyist testified local standards were “based on political not health” concerns.

In sharp contrast, Ms Trinko from Cooks Valley listed by date the environmental problems with the Chippewa Sands mine located a half-mile away from her home. She spoke of dust billowing from the mine. Over a year period she was diagnosed with asthma and installed expensive home air filtration. She said she must “wear a protective mask when I am outside for any length of time.” While on vacation her symptoms completely disappeared only to reappear when she returned home.

Health and safety is also a worry of residents near Arcadia in Trempealeau County. Representative Danou joined me to testify about concerns we’ve heard from many constituents. The residents, including many children, living in two subdivisions are surrounded by five sand mines within five miles of their homes. These residents expressed so much anxiety to the Trempealeau County Board that supervisors unanimously passed a one-year moratorium against further sand mines and ordered air monitoring to be done near the mines and the subdivisions.

In my discussions with legislative attorneys, I learned if SB 349 becomes law, it is likely the Trempealeau Country moratorium could be overturned and monitoring could be stopped.

The state should not tell locals to stick their heads in the sand when the life-long health of children is at stake.

Over 100 citizens got up at dawn to travel from western Wisconsin to testify at the hearing. They listened all day as lobbyists- none who lived near the mines- spoke about the benefits of the bill. Many locals testifying against the bill were forced to wait until late to testify - by that time folks riding the bus had to leave.

One traveler was Nan Horton from Ettrick. She was prepared to tell the committee the bill “ignores the need for citizens to have a voice in decisions affecting their own health, safety, property values and general welfare.”

Similarly, Heather Anderson from Chippewa County wanted to ask, “Who has spoken to the parent who set a birthday party picnic table only to find the plates were dusted with sand in a short period and had to bring the picnic inside?”

Shortly after the hearing, Senator Dale Schultz released a statement declaring, “After hearing from constituents and listening to local elected officials in my district I cannot support Senate Bill 349.”

I urge more lawmakers to listen to their constituents and do the same!

A bill is being fast-tracked through the legislative process. It is being sold as standardizing rules for sand mines but has implications for local powers to protect water, air or the use of explosives. The bill would make it more difficult for local government to be reimbursed for damage done to local roads and comes on the heels of several new laws that limit the powers of local government.

MADISON - “Lose local government and you will lose America,” warns the banner on the Wisconsin Towns Association website. The head of this organization has recently spent a lot of time at the Capitol.

Rick Stadelman, Executive Director of the Wisconsin Towns Association, is the smartest man I know working the Capitol. He hasn’t slowed down a bit since he announced his upcoming retirement. He’s working very hard to let folks know about a bill that would strip local powers to protect health and safety.

The bill, introduced by Senator Tiffany, is reportedly aimed at standardizing rules for sand mines. But the bill would stop any local protection of water, air or the use of explosives. In addition, a complex new process would make it very difficult for locals to be reimbursed for damage done to local roads.

The proposal would prevent locals from monitoring their own air and water. Every town, city, village and county in the state would be stopped from any local efforts to protect air and water.

In addition, many local sand mine ordinances, agreements and, possibly moratoriums, would be null and void.

The proposal, it appears, was written to overturn a 2012 unanimous Supreme Court decision (Zwiefelhafer v Town of Cooks Valley) that allowed a town to use its police powers to adopt a sand mine ordinance when the town did not have zoning.

But the bill goes much farther than overturning ordinances in towns without zoning.

The bill would thwart any action at all by locals to protect air and water. Questions remain about local people’s ability to protect themselves in an emergency. Also, because of limits to local’s ability to negotiate road repair use agreements, there are questions about any agreements farmers or loggers have to use local roads with overweight equipment.

Unfortunately this bill appears to be on the fast track. I’ve received dozens of calls and hundreds of emails in just a few days asking me to stop the taking of local powers. I’ve urged those opposed to make their views known to members of the Senate mining committee.

This legislation is one of many aimed at taking away local powers. In the last three years, dozens of new laws and legislative proposals have targeted taking away people’s ability to govern themselves through local ordinances.

Legislation stopping locals from doing anything to protect renters now sits on the Governor’s desk. Also awaiting the Governor’s signature is legislation to stop locals from setting rules about firing an arrow or a crossbow in a city.

Many recently passed limits are related to restricting environmental protections: lost is local control for setting limits on erosion at construction sites; lost is local control over shorelines; lost is local control over siting radio, TV and cell towers; and lost are other limits on zoning.

Some laws related to personnel take way local power to require firefighters and police live within a city. Another law prevents any requirement to offer sick leave – paid or unpaid.

Some new laws seem to be a solution in search of a problem – like taking away local authority to limit the sale of certain foods and beverages – the so-called “Big Gulp”.

Milwaukee has taken many direct hits to its local powers. The Legislature passed bills to change the County Board; to restrict its powers and to change the Milwaukee Technical College Board.

Many other changes affected local budgets and fees making it more difficult for local people to obtain the resources to accomplish the plans people make for their own communities.

Local government is the best example of democracy. Decisions are made in our neighborhoods. We can run into local officials at the grocery store and let them know how we feel.

Local businesses or residents that need help can call their local government and get answers right away. But that’s not going to happen when politicians from hundreds of miles away make decisions affecting our neighborhoods.

The only reason Senator Tiffany’s bill is being pushed is because it is easier for certain interests to control the state Legislature than to control local people.

Passing Tiffany’s bill is wrong and would take one more step to losing democracy.