Question 1 from the Audience: We are hearing that our immigrant families are afraid to apply for public benefits – benefits they are eligible for (and entitled to!) under state and federal law – but are fearful of any retaliation or enhanced scrutiny. Is this being discussed at the capitol?

Rep. Melissa Sargent: As state legislators, this is an intersection of immigration policy in which we can play a significant role. Immigrant or documentation status can be a deterrent, not just for applying and receiving public benefits, but for persons who are survivors of human trafficking or domestic violence, among others, from engaging with existing structures or systems out of fear of retribution, deportation, or racism. Some of us in the Capitol are well aware of this and work diligently to address these problems at the state level, but these efforts are often met with opposition from colleagues on the other side of the aisle.

Rep. Katrina Shankland: To my knowledge, it has not been discussed at the State Capitol, but it should be.

Question 2 from the Audience: Gov. Walker claimed he didn’t accept Medicaid Expansion funds saying “Washington might renege on the funding.” Yet, he accepts road money, money for schools, and things like defense contracts for Oshkosh Truck and Marinette Shipbuilding. Why do you think the Governor accepts some federal money but not Medicaid money?

Rep. Melissa Sargent: I can’t speak for Governor Walker, but this is a great example of the inconsistencies we’ve seen under Republican leadership for the past seven years. It’s about priorities--if providing health care access to our most vulnerable citizens was important to Governor Walker, I think he’d find a way to justify accepting federal funds just as he has for countless other initiatives, it simply isn’t a priority for him, unfortunately.

Rep. Katrina Shankland: I have said for six years that the governor appears to be allergic to our federal tax dollars. Governor Walker has turned down money for high-speed rail, early childhood development, rural broadband expansion, and the Medicaid expansion. He’s also specifically asked the federal government for more transportation money. How do those two things comport with each other? They don’t. He should have to answer why some federal money is okay to accept, but not others. This is purely political. The more public pressure you apply, the better.

Question 3 from the Audience: What can we do to get our majority-Republican legislature to reach across the aisle so we can tackle issues of health insurance, health disparities, and health inequality?  

Rep. Melissa Sargent: Quite frankly, Republicans control the Assembly, the Senate, and the Governor’s mansion, so at this point, they really don’t need to reach across the aisle to tackle any issue, health care or otherwise. It just goes back to priorities—if Republicans wanted to tackle health disparities and health inequality, they could, it just isn’t a priority.

But beyond that, health care has to be a voting issue. Constituents have to demand affordable, accessible health care, they have to communicate this demand to their legislators, and if their legislators refuse to meaningfully address the problem or represent those interests, constituents have to collectively wield the power of their ballots to find someone who will.

Rep. Katrina Shankland: Spend time in their offices asking them for support and help when it comes to health care access and affordability. Have specific asks, and ask yes or no questions. Invite them to your workplace and educate them on issues important to you. Ask them to cosponsor legislation. Ask them to vote for legislation. Don’t take no for an answer.

Question 4 from the Audience: If we had “BadgerCare for All,” could that coverage actually look better than my employer-sponsored insurance?! 

Rep. Melissa Sargent: It definitely could!

Rep. Katrina Shankland: I believe it’s possible if we worked hard to increase the Medicaid reimbursement rate and ensure the solvency of the program by charging fair, affordable premiums.  Allowing people to buy into BadgerCare would enhance competition and also ensure more people would have access to affordable insurance. Couple this with accepting our Medicaid dollars federally, which would save the state $203 million a year, and we could that savings to buoy the reimbursement rate and strengthen BadgerCare for All.  

Question 5 from the Audience: Western Wisconsin hospitals have learned that the entire University of Minnesota/Fairview Health System is pulling out of Wisconsin Medicaid/BadgerCare, citing low reimbursement rates. How can we ensure access to quality care in our rural counties?

Rep. Melissa Sargent: Well, low reimbursement rates are the #1 thing I hear, not just from rural service providers, but for people who serve low-income populations in Wisconsin. Lack of adequate reimbursement is a deterrent for practitioners who are interested in providing these critical services, so I think by addressing costs and reimbursement rates, that’s a great start for ensuring equitable access to health care.

Rep. Katrina Shankland: Increasing the Medicaid reimbursement rate is paramount! This must be the number one budget request for the 2019-21 budget, and the governor could also act unilaterally if enough public pressure is leveraged. Our providers and patients rely on a fair MA reimbursement rate, and I hope we can work together to raise the reimbursement rates so our providers can continue serving those in need.