March 7, 2011
Changes to Administration of Aid Programs Could Hurt Poor Families
Among the changes to the medical assistance and the food stamp programs included in Governor Walker’s budget is a proposal to move the responsibility for determining eligibility for these aid programs from county offices to the state.
“Today, someone who is struggling to get by can walk into the Dane County Job Center on Aberg Avenue in Madison, talk with a county employee about available assistance programs, and get help completing the online application for food stamps and medical assistance…Under the model proposed in Walker’s budget, people from all over the state who need assistance would apply by computer, phone or mail to centralized centers, say county officials.”
This would make it more difficult for people to get help in applying for these forms, as there would no longer be county employees available to help with them. Exacerbating that issue is another Walker proposal–to move administration of the Supplemental Nutrition Assistance Program (SNAP; the food stamps program) into the Department of Children and Families. The program is currently administered by the Department of Health Services, along with medical assistance programs. Citizens can currently apply for the two programs on a single form, increasing the odds that they will receive all the public aid that they are eligible for. By moving SNAP to a different department, applying for these programs may require two different application processes. This could lead to decreased enrollment and increase the number of eligible people who are not receiving the assistance they need.
Funding for Some Student Financial Aid Programs Decreased or Eliminated In Walker’s Budget
Programs directly related to women’s health are not the only ones that affect women’s health and well-being. Expenditure changes in the Governor’s proposed budget related to education and the availability of financial aid will also affect Wisconsin women.
The Higher Educational Aids Board is made up of the State Superintendent of Public Instruction and ten members appointed by the Governor from various higher educational institutions around the state. It administers state financial aid programs, as well as the Minnesota-Wisconsin tuition reciprocity agreement. Some of the scholarships and grants they administer include the Wisconsin Higher Education Grant Program, the Minority Teacher Loan Program, the Minority Undergraduate Retention Grant, and the Indian Student Assistance Grant.
In the section on the Higher Educational Aids Board, Governor Walker’s budget makes several proposals that would make it harder for Wisconsin students, particularly low-income students, to access higher education. For example:
- He proposes suspending funding for the Wisconsin Higher Education Grant Program for fiscal years 2012 and 2013, in order to help balance the budget. This program “provides grant assistance to undergraduate, Wisconsin residents enrolled at least half-time in degree or certificate programs at University of Wisconsin, Wisconsin Technical College, and Tribal institutions. Awards are based on financial need.” It provides grants of between $250 and $3,000 annually.
- He proposes eliminating the Wisconsin Covenant Scholars Program after September 30,2011. This program “was created to inspire young people to plan early for a successful high-school career that will lead to higher education.” In return for meeting certain requirements, like maintaining a B average throughout high school, Wisconsin eighth graders that sign the pledge “will be recognized as a Wisconsin Covenant Scholar, earn a place within our partnered systems of higher education, and receive a financial aid package, based on their family’s financial need, to help make college affordable.” For students who are now entering college, having signed the pledge when they were in eighth grade, the budget includes approximately $19 million dollars in funding for grants in fiscal year 2013–financial aid to which future generations of students will not have access.
Without these funds available, it will be increasingly difficult for students in Wisconsin to access higher education, and may prevent some from going to college at all. This is important because, not only does a college degree lead to higher lifetime earnings, attending college has health and other non-financial benefits as well. Just a few examples include:
- “At every age and income level, the report shows that there’s some correlation between more education and better health. Those with a bachelor’s degree or higher most often reported being in “excellent” or “very good health,” according to a 2005 survey from the National Center for Health Statistics.”
- “Graduates of a four-year college are also less likely to smoke than their peers.”
- “Those who finished college also reported being more active. In 2005, for instance, more than 60 percent who were in the 25-34 age range said they exercised “vigorously” at least once a week. That’s compared with 31 percent of high school graduates who said the same.”
Source: http://www.insidehighered.com/news/2007/09/13/collegeboard
March 4, 2011
Cutting FoodShare for Immigrants
“The Governor recommends reducing funding to reflect the elimination of the state-only FoodShare program, which provides FoodShare benefits to legal immigrants who do not meet federal residency requirements.” (Department of Health Services Governor’s Budget Recommendations)
Federal food stamp benefits are available to qualified immigrants who receive SSI disability income, are under 18 years of age, or have lived in the U.S. continuously for five years as a qualified immigrant. Each month, the State-Option FoodShare Program provides vital food assistance for approximately 1,500 immigrants who do not meet these federal requirements.
Many of these immigrants are able-bodied adults who are unable to find work in the tight labor market or disabled adults who have been unable to access SSI disability benefits. Others may be pregnant women who are unable to find jobs or unable to work due to their pregnancy. Denying food stamp benefits to recent immigrants will result in lower maternal and child health for this group because access to food stamps yields increased birth weights, especially for infants with the lowest birth weights, and decreased neonatal infant mortality.
This cut will also increase food insecurity among children as immigrant parents lose their food stamp benefits, decreasing the ability of the household to buy sufficient and balanced meals. Food insecurity is linked with behavior problems and limits the ability of students to achieve their academic potential.
March 2, 2011
Family Planning Cuts in the Budget Proposal
CONTRACEPTIVE EQUITY
UPDATE: The repeal of Contraceptive Equity was removed from the budget.
The Governor’s budget would result in the Elimination of Contraceptive Equity: “The Governor recommends eliminating the requirement that health insurance policies provide coverage for contraceptives prescribed by a health care provider and outpatient medical services related to contraceptives.”
Contraceptives are the most widely used prescription drugs by women of reproductive age, and over 90% of women use at least one kind of contraceptive method during their lifetime. Women pay 68% more than men do in out-of-pocket health care costs, and much of these costs are for reproductive health care, including prescription contraceptives. Costs for supplies alone can run approximately $360 per year for oral contraceptives; $180 per year for Depo-Provera; $450 for Norplant; and $240 for an IUD. While these costs can be prohibitive for women, covering birth control actually results in cost savings for employers. The National Business Group on Health, an organization representing over 160 large national and multi-national employers, has estimated that failing to provide contraceptive coverage actually costs employers 15-17% more than providing the coverage (Promoting Healthy Pregnancies: Counseling and Contraception as the First Step; Family Health in Brief, 2000).
Because only women use prescription birth control, excluding birth control coverage under prescription drug plans singles out women. Historically, it has taken state laws to ensure that health insurance plans cover women’s health issues. Advocates have secured insurance mandates in WI that require coverage of maternity and newborn care; coverage of mammograms and breast reconstruction surgery; and direct access to obstetricians and gynecologists. On June 29, 2009 Governor Doyle signed the state budget, which included Contraceptive Equity. Contraceptive Equity went into effect in Wisconsin on January 1, 2010.
Walker’s budget threatens to repeal the progress made over the last year by again limiting women’s access to contraception. These threats extend far beyond reproductive freedom. Unintended pregnancy has been linked with numerous negative maternal and child health outcomes. Contraception also allows women to invest in higher education and participate more fully in the nation’s workforce, contributing more broadly to issues of gender equity. The Guttmacher Institute reports that the benefits of contraception for women and children are extensive and well-documented.
Learn more about contraceptive equity at Planned Parenthood of Wisconsin or the Wisconsin Alliance for Women’s Health.
FAMILY PLANNING SERVICES FOR MEN
Walker’s budget also seeks to eliminate Medicaid payments for family planning services for men. As of May 2010, Wisconsin’s Family Planning Waiver allowed coverage of select family planning services–including family planning-related office visits, condoms, and testing and treatment of sexually transmitted infections–for males age 15-44 who have an income that is at or below 200 percent of the Federal Poverty Level (FPL).
This expansion of family planning services allowed men to take responsibility for preventing unintended pregnancy by providing them free access to contraceptives and information through family planning office visits. Furthermore, it allowed for improved sexual health by removing the cost barrier to STI testing and treatment. The de-funding of family planning services for men will result in more unintended pregnancies and transmission of STIs, negatively impacting both men and women.
STATE FAMILY PLANNING FUNDING
Federal Title V Maternal Child Health (MCH) Grants and state general purpose revenue together fund local public health departments and private organizations to provide family planning and reproductive health services in more than 50 counties. Together, these funds are pivotal to maintaining access to family planning services, including lifesaving cancer screenings, testing and treatment for sexually transmitted infections (STIs), patient education and counseling, pregnancy diagnosis, prenatal counseling, referrals and other health services. According to the Department of Health Services, women’s health programs that prevent unintended pregnancies save taxpayers about $140 million each year and prevent over 11,000 unintended pregnancies.
Walker’s Budget eliminates all state GPR funding for family planning – $1.9 million per year or $3.8 million over the biennium. Over 30,000 patients each year receive critical preventive health care at state funded family planning clinics in their communities. This cut will weaken the state family planning provider network by cutting a critical source of funding for local clinic operations. Eliminating this funding may force some clinics to close and will drastically limit women’s ability to access basic health care services, leading to more unintended pregnancies, later cancer diagnoses, and higher costs for Wisconsin taxpayers. These cuts would force the Wisconsin State Laboratory of Hygiene to stop offering cervical cancer screenings, HPV screenings and biopsies for uninsured women or require them to bill the family planning clinics, who would in turn bill their patients. The elimination of these state funds could also jeopardize $10 million in federal MCH block grant funding which supports programs designed to promote healthy birth outcomes, reduce infant mortality and provide health care and support for special needs children.
March 1, 2011
Overview of Walker’s Budget Proposal’s Program Cuts
A full copy of the budget proposal can be found here.
BadgerCare Medical Assistance:
Seek permission from the federal government to tighten eligibility standards. If the federal government does not give the state permission to toughen its standards for who gets Medicaid, the state would eliminate coverage to families that earn more than 133% of the federal poverty level. Overall, the efforts would mean an estimated $500 million in less spending on Medicaid.
Reduce what is covered under BadgerCare by creating “customized” benefit plans.
Restrict Family Care, which uses Medicaid funding to pay for in-home services for the elderly and those with disabilities, to current enrollees and begin a study of its cost-effectiveness. Milwaukee County already has a waiting list of about 2,000 people who want to get into the program, so this cut would further restrict access to in-home services.
Wisconsin Works (W-2) Income Support:
Cut the already meager monthly income support payment by $20. Under the proposed budget, the maximum amount of support a family could receive would be just $653 a month.
Reinstate a minimum weekly work requirement of 28 to 30 hours a week, limiting participants’ leeway to substitute vocational or college studies for a portion of the work requirement.
Wisconsin Shares Child Care Assistance:
Start a waiting list for Wisconsin Shares, the state’s subsidized child care program for low-income families. The budget would also increase co-payments for some families. These actions will decrease the availability of child care for low-income working parents and W-2 participants, making it more difficult for them to find and maintain employment.
Reduce state aid for K-12 education by $834, a 7.9% cut from the 2009-’11 budget. The bill simultaneously freezes property taxes for local governments and reduces by 5.5% the maximum amount per student that public school districts are able to receive in state aid and property taxes, limitations which prevent local governments from filling the gap from the loss of state aid with increases in property taxes.
End new enrollees in the Wisconsin Covenant Program, which gives the state’s best students additional financial aid, up to $2,500 based on need, to attend UW System schools.
Split UW-Madison from the UW System and cut $125 million in funding. Other state public universities would face 11% budget cuts, a total of $125 million. “Because a detached UW-Madison will be allowed to raise tuition as it sees fit, huge pressure will be placed on the abandoned fleet to remain ” UW-Oshkosh Chancellor David Wells said. “Significantly less state funding and ’affordable,’ tuition for the fleet means access with diminished quality for the 130,000 students – the 77% majority – who call, or will call, the fleet schools their educational homes.”
February 23, 2011
State Assembly Works Through the Night on Budget Repair Bill Amendments
The state Assembly has been working through the night, going through over 100 amendments to the budget repair bill proposed by Assembly Democrats.
Democratic representatives have introduced amendments dealing with the proposed changes to collective bargaining, medical assistance programs, and more. For example, amendment 10, offered by Representatives Pasch and Richards, would ” delete “Authorization for modifications to programs; study.” and substitute “Study of potential changes to Medical Assistance program.” Instead of allowing the Department of Health Services authority to change Medical Assistance programs, this amendment would only allow for the study of potential changes to these programs. The second part of this amendment would, if adopted, remove the lines of the bill that give DHS power to require greater cost-sharing, modify existing benefit packages, and more.
However, this is largely a delay technique as the Democrats attempt to filibuster the bill. While it is encouraging to see greater attention paid to the medical assistance provisions in the budget repair bill, these amendments will likely all be voted down, given that Republicans are the majority party in the Assembly.
Budget Repair Bill Targets Women
This petition was put forth by the Wisconsin chapter of the National Organization for Women (NOW). It explains how Governor Walker’s budget repair bill disproportionately affects women.
“We, the undersigned, protest the disproportionate effects that Special Session Senate Bill 11 (JR1SB-11), Governor Walker’s so-called “Budget Repair” Bill, would have on women. As Dr. Jeffrey H. Keefe of Rutgers University writes in an Economic Policy Institute report released on Feb. 10, 2011, “Compared with Wisconsin private sector employees, Wisconsin state and local government employees on average are… more likely to be female (56% versus 46%).”
In addition to targeting this group of employees as a whole, JR1SB-11 would strip most collective bargaining rights from occupations that are predominantly filled by women. At the same time, it preserves such rights for occupations mostly filled by men.
This bill eliminates bargaining rights for nurses, teachers, home care providers and child care workers. By far, the majority of these workers are women. For instance, according to Wisconsin Department of Public Instruction statistics from 2010, approximately 44,000 public school teachers are female, while only 16,000 are male.
At the same time, the bill exempts local police, firefighters and state troopers from its union-busting provisions. According to a report by the U.S. Department of Justice, 73% of law enforcement workers were male and only 27% were female in 2006. For firefighters, the statistics are even starker. In 2008, Cornell’s Institute for Women and Work found that women make up fewer than four percent of firefighters in the United States . Strikingly, the study’s authors write, “Not one paid woman firefighter has ever worked in more than half the nation’s departments.” The study commends Racine , WI as one of the locations nationwide with the highest percentage of female firefighters at almost 18%.
As history suggests, unions not only improve wages and working conditions for working people everywhere, but also increase workplace productivity and enhance services to the community. Governor Walker may never have intended to launch an attack on Wisconsin ’s women. However, by targeting their unions, that would indeed be the unfortunate effect of his bill.”
February 22, 2011
BadgerCare Cuts: Losing Federal Dollars for Wisconsin
BadgerCare is funded through a combination of state and federal dollars. The federal contribution comes in the form of matching funds, money that is contingent upon how much the state itself spends on its Medicaid program (known as BadgerCare in Wisconsin). The portion of the total payment for covered services that is supported by federal matching funds (known as the federal medical assistance percentage, or FMAP) varies by state. In Wisconsin, FMAP is usually around 60%, though it has been increased to approximately 70% from October 1, 2008 through July 1, 2011. That is, when FMAP is at its normal level of 60%, for every state dollar spent, the federal government provides $1.50 for BadgerCare.
For this reason, spending cuts at the state level are magnified by the loss of federal matching funds. Cutting BadgerCare to balance the budget will do even deeper damage than the state numbers suggest. Every $1 that Governor Walker chooses not to spend on services provided through BadgerCare reduces the overall BadgerCare budget by $2.50. We believe reducing state spending through cuts to BadgerCare will hurt Wisconsin families much more than it will assist in balancing the budget.
February 21, 2011
Title X Family Planning Program
A federal budget amendment that cuts the entire $317 million program of aid for family planning and bars Planned Parenthood from receiving any federal funds for any purpose passed the House with a margin of 26 votes, five of which were from Wisconsin representatives. Representatives Sean Duffy, Tom Petri, Reid Ribble, Paul Ryan, and F. James Sensenbrenner voted yes; Representatives Tammy Baldwin, Ron Kind, and Gwen Moore voted no.
The Title X Family Planning program is the only federal grant program dedicated solely to providing comprehensive family planning and related preventive health services. Approximately 75% of U.S. counties have at least one clinic that receives Title X funds, and these funds are pivotal to maintaining wide access to family planning services, especially for low-income or uninsured individuals. In addition to contraceptive services, Title X clinics provide patient education and counseling to promotes positive birth outcomes and healthy families; breast and pelvic examinations; breast and cervical cancer screening; STD and HIV prevention education, counseling, testing and referral; and pregnancy diagnosis and counseling.
Contraceptive services provided by Title X clinics reduce unintended pregnancies, which in turn reduces abortions. Furthermore, money invested in Title X services provide future taxpayer savings by reducing future Medicaid costs. For this reason, cutting Title X is not a cost-saving measure and will actually increase the deficit in the long term. The Guttmacher Institute estimates:
“Contraceptive services at Title X–supported family planning centers helped women and couples avoid 973,000 unintended pregnancies, which would have resulted in 433,000 unplanned births and 406,000 abortions. Without these services, unintended pregnancy and abortion in the United States would be one-third higher. And by helping women avoid unintended pregnancies, Title X–supported centers saved taxpayers $3.4 billion in 2008, amounting to $3.74 saved for every $1 spent providing contraceptive care.”
In Wisconsin
Title X–supported centers provided contraceptive care to 52,200 women in Wisconsin in 2008. The impact of these funds include:
•In 2008, contraceptive services provided at Title X–supported centers in Wisconsin helped women avoid 10,800 unintended pregnancies, which would have resulted in 4,800 births and 4,500 abortions.
•In 2006, contraceptive services provided at Title X–supported centers in Wisconsin helped women younger than age 20 avoid 3,319 unintended pregnancies.
•In the absence of these services, the level of abortion in Wisconsin would be 42% higher.
•In the absence of these services, the level of teen pregnancy in Wisconsin would be 36% higher.
•By helping women avoid unintended pregnancies and the births that would follow, the services provided at Title X–supported centers in Wisconsin saved $41,863,000 in public funds in 2008.
Note: While The Guttmacher Institute (the source of the estimates in this post) advocates for women’s ability “to exercise their reproductive rights and responsibilities,” factcheck.org writes: “Guttmacher ‘provides the most highly respected statistics on the sexual health of women and men. Its figures on abortion are widely cited by the media as well as by groups on both sides of the political aisle.’ So far as we know, they are the most accurate figures available.”
February 20, 2011
Health and Reproductive Rights in President Obama’s Budget
While local events related to Governor Walker’s budget repair bill have dominated the public’s attention in Wisconsin and beyond for the past week, the federal budget for FY 2012 is currently being debated in Washington. Many of the decisions made in Washington will have repercussions for funding and options available to state policymakers.
Our nation’s chief executive largely acted to protect program’s for women and girls in his budget. However, it will face strong opposition in Congress. There has been heated debate over H.R. 1 Full-Year Continuing Appropriations Act, the House Republican’s counter to President Obama’s proposed budget. According to the National Women’s Law Center, H.R. 1 would cut or reduce funding for programs including:
—Title X family planning program that provides comprehensive family planning and related preventive health services to low-income women: Eliminated
—Teen Pregnancy Prevention Program: Eliminated
—Community health centers: Funding cut by almost 60 percent.
–Maternal and Child Health block grant: Funding cut by 7.6 percent
This bill has been called “the most politically driven assault on women’s health in American history” by Planned Parenthood Federation of America president Cecile Richards.
In contrast, President Obama’s budget would increase funding for Title X, teen pregnancy prevention, and community health centers. It proposes a small (1.2 percent) cut in maternal and child health block grants.
Many painful cuts will have to be made in this year’s federal budget, and, ultimately, no one will be left fully content with the results. However, we believe that women’s health programs such as Title X funding and funding for community health centers produce benefits outweighing their costs, both now and in the long-term.
Wisconsin Women's Health Budget Project 