Republicans argue that states are the "laboratories of democracy" that should be charged with developing new, innovative ways for delivering quality health care more efficiently. But that point is far harder to make in the face of Gov. Scott Walker's (R-Wisconsin) effort to shut the public out of a debate about Medicaid cuts and shield legislators from having to weigh in on cutting benefits and services for the neediest Americans:
The new state budget bill grants broader power to Gov. Scott Walker's administration to remake BadgerCare Plus and other state health programs with little legislative oversight, a situation that worries advocates for the roughly 1 million people covered by those programs.
The major question: how the governor's Department of Health Services will use that authority as it cuts a projected $466 million in costs from the programs over the next two years.
"We don't know exactly what will be coming down the pike," said Bob Jacobson, a spokesman for the Wisconsin Council on Children & Families. "And we don't know how we can have a voice in those decisions when the Legislature has been taken out of the picture." [...]
The budget-repair bill passed earlier this year gave the Department of Health Services the authority to make changes in the programs without legislative approval but required the department to hold public hearings.
The budget bill passed last week dropped the public hearing requirement. The exemption would remain in effect throughout the governor's term.
The pending changes in the programs could range from new rules on eligibility and cost sharing to managing care for people with severe mental illnesses.
This also doesn't bode well for the GOP's push to block grant the Medicaid program. After all, if states like Wisconsin — or any other Republican state that isn't very invested in maintaining government-sponsored health care programs — are already demonstrating that they're more interested in slashing enrollment rolls than developing any truly revolutionary health delivery models, you can easily predict how they would react to a block grant that does not keep up with projected health care costs.