Budget Bill Exacerbates Problems with Transfer of Responsibility for Medicaid Policy-Making

Tuesday, June 14, 2011 at 8:51 PM by

The Joint Finance Committee’s version of the budget bill delegates sweeping power to the Department of Health Services (DHS) to make changes relating to Medicaid and BadgerCare eligibility, services, cost-sharing, and enrollment procedures. Until January 2015, those policy choices, formerly the responsibility of state legislators and the Governor, would be handed over to an unelected official, the DHS Secretary.

These provisions, which have now been removed from the budget repair bill (Act 10) and folded into the biennial budget, raise constitutional concerns regarding the separation of powers between the legisaltive and executive branches.  Like Act 10, the proposal strips from Wisconsin citizens our right to hold state legislators accountable for the policy changes that could affect hundreds of thousands of Wisconsinites.

A new WCCF blog post provides a link to a June 5th Legislative Reference Bureau drafter’s note, which raises questions about the constitutionality of the power shift.  In addition, the blog post explains how the JFC version exacerbates the problem of excluding the public because it allows the sweeping grant of authority to be exercised by the DHS Secretary without using rulemaking or holding so much as a single public hearing.

Read more in the new WCCF blog post: “From Bad to Worse: New JFC Version of Medicaid Power Shift Compounds the Problems.”

2 Responses to “Budget Bill Exacerbates Problems with Transfer of Responsibility for Medicaid Policy-Making”

  1. Anonymous says:

    The JFC version of the budget bill goes back to the language on Medicaid that was in the so-called budget repair bill (the bill that eventually wound up as Act 10) as it was first introduced. Under that language, no hearing or posting would be required for rules that can be contrary to statute.

    The final language in Act 10 is somewhat less offensive, in that while DHS can still create rules that are contrary to statute they have to follow the typical promulgation process to do so.

    Now that Act 10 is on its way to becoming law, it remains to be seen whether language allowing the rules changes with no public input stays in the bill.

  2. Jon Peacock says:

    You make a very good point that the Supreme Court decision Tuesday puts Act 10 into place, so including this in the biennial budget bill is redundant. One would hope that the Assembly or Senate would remove it — leaving us with what you aptly described as the “somewhat less offensive” version of the power shift.

    However, Wednesday night the Assembly voted along party lines to keep the amended (more offensive) version in the budget bill. We’ll soon see if the Senate believes that DHS ought to at least hold a public hearing before they rewrite the Medicaid laws that used to be the responsibility of the Legislature.