From WisPolitics.com/WisBusiness.com …
— Wisconsin Manufacturers & Commerce is applauding a recently signed executive order on health care cost transparency, while the Wisconsin Hospital Association says President Trump “is one of the only people” recognizing that health insurers are also subject to transparency laws.
In a statement yesterday, WMC Associate Vice President of Government Relations and Senior Political Advisor Rachel Ver Velde said the president’s move will “bring badly needed transparency” to health care costs.
The order directs federal officials to create a plan for implementing an earlier 2019 executive order requiring health insurers and hospitals to disclose cost information, according to the release.
“Wisconsin has the fourth highest hospital prices in the country, and we will never be able to lower prices unless we allow patients to make market-based spending decisions based on cost and quality,” Ver Velde said. “But they cannot do so when prices remain hidden.”
Meanwhile, WHA in a separate statement said Trump is acknowledging that health insurers, third party administrators and self-funded employers in Wisconsin are also subject to the federal price transparency law, “but you’d barely know it.”
“The mega health insurance companies, the impact they have on health care cost and their obligations under the federal health care price transparency law has been and continues to be glaringly ignored by some here in Wisconsin,” WHA said. “Hopefully, that’s now changing, at least in Washington, D.C.”
WMC argues enforcing the new policy “will be critical,” claiming just 30% of Wisconsin hospitals are fully complying with transparency rules. The group says it’s “particularly happy to see President Trump return the regulation’s focus to the consumer-friendly 300 shoppable services requirement, rather than allowing the problematic price estimator tools.”
WHA’s website has multiple pricing information tools, including its Price Finder mapping function and PricePoint application focused on specific services.
The group points to California health care pricing platform Turquoise Health in 2024 ranking Wisconsin as “best in the nation” for complying with federal price transparency laws and touts the hard work and commitment of hospitals in the state. WHA says it’s been working with Wisconsin hospitals to ensure they “stay ahead of ever-changing” federal transparency requirements and remains committed to this effort.
“At the same time, we call on federal regulators to enforce transparency laws fairly,” WHA said. “It’s time to hold mega health insurers and middlemen accountable, entities that extract billions from the healthcare system while avoiding the increased scrutiny they deserve.”
WHA says the executive order clarifies that health care transparency oversight “rests with the federal government rather than a hodgepodge of state transparency laws” that are always misaligned with federal requirements.
See WMC’s full statement here and WHA’s statement here.
— A coalition of Wisconsin groups that rely on Medicaid funding is warning a budget resolution passed by the U.S. House puts businesses in “every Wisconsin county” at risk of Medicaid funding cuts.
The Wisconsin Medicaid Coalition yesterday issued a report showing Medicaid provided $11 billion to nearly 40,000 businesses in the state in 2023, arguing any spending cuts targeting the federal health care program would “have a devastating impact” on the state economy.
Its report says more than 23% of residents in every Wisconsin county rely on Medicaid dollars to fund health care, including services for mental health and long-term care, while some counties in the state have up to 65% of their population in a Medicaid program.
Kim Hawthorne, CEO of Scenic Bluffs Community Health Centers in Monroe County, says Medicaid funding is a “key driver” for her rural community, helping to keep clinics and nursing homes open. She notes Medicaid dollars make up about half of all revenue at community health centers in Wisconsin.
“Especially in rural areas, Medicaid funding is the difference between having care options or having closures,” she said in a statement. “At Scenic Bluffs, nearly 45% of our patients rely on Medicaid as the payer for their care — many of whom would be uninsured or unable to afford necessary services without it.”
While the house resolution is targeting hundreds of billions in cuts that could hit the Medicaid program, the coalition argues, Dem Gov. Tony Evers is again calling for expanding the state’s BadgerCare program in his budget proposal. Legislative Republicans continue to reject that approach.
BadgerCare Plus, the state’s program that provides health care coverage for low-income residents, is funded in part by Medicaid, according to an overview from the state Department of Health Services. Wisconsin is one of 10 states that didn’t take the federal Medicaid expansion under the Affordable Care Act.
In a report yesterday, the conservative Wisconsin Institute for Law & Liberty argued expanding Medicaid in the state would make health care more expensive while reducing quality. The group found states that did take the expansion spent $215.59 more per capita on health care each year, an increase of 2.1% compared to non-expansion states.
Plus, WILL said there’s “no guarantee” that Medicaid recipients will get needed care, noting 96.1% of doctors accept new private insurance patients while just 74.3% accept new Medicaid patients.
“Expanding Medicaid is a Trojan horse for higher costs without the promise of improved care,” WILL Policy Associate Miranda Spindt said in a statement. “Wisconsin would be better off finding ways to lower health care costs by reducing government intervention, and by allowing innovation to improve the quality of care for all Wisconsinites.”
See the coalition’s release and WILL’s release below.
See a county-level breakdown of Medicaid funding in Wisconsin.
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