Episode Transcript
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The following is brought to youby the committee to protect
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healthcare.
Chris (00:04):
In the emergency department, we see real time
consequences of people nothaving access to health care.
Expansion of Medicaid inWisconsin would mean less cases
to the emergency department.
It would prevent closures ofhospitals in our communities,
and most importantly, savelives.
The majority of states in thecountry have expanded Medicaid
with bipartisan support, yetlegislators in Wisconsin are
blocking expansion of Medicaid.
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They're blocking the opportunityfor our patients to have a
healthier life.
Tell your legislator to savelives and pass Medicaid
expansion.
Now the 40th state to expandMedicaid under the Affordable
Care Act.
The bipartisan expansion, signedlast month, comes after a decade
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of Republican resistance As JohnYang reports, it will be life
changing for some uninsuredNorth Carolinians tucked away in
a shopping center on WinstonSalem's southwest side, non
profit United Health Centers isa lifeline for patients.
Across three locations it serves6, 000 patients.
Most are Black, Hispanic, orLatino.
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The nearly 80 percent ofpatients who don't have
insurance pay on a slidingscale.
In one place, patients can see adoctor, get prescriptions
filled, and receive dental care.
They can even enroll inMedicaid, the federal and state
health insurance program forthose with low incomes.
Access to health care has been achallenge for low income
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residents of North Carolina, oneof 11 states that hadn't
expanded Medicaid under theAffordable Care Act.
When it's implemented, theprogram will be open to families
and individuals whose incomesare lower than 100, 000.
138 percent of the federalpoverty line.
about 20, 000 for an individual.
Before expansion, most adultswithout children or a disability
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weren't eligible at all, nomatter how low their income.
Some Wisconsin doctors arecalling on the Republican
controlled legislature to expandBadgerCare in its special
session tomorrow.
Last week, Governor Evers calleda special session to expand
Medicaid.
The bill would use nearly abillion dollars in federal
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stimulus money tied to expandingMedicaid on projects across the
state.
The governor says over 90, 000Wisconsinites will gain
coverage.
Badger care expansion will meanfewer people have to go without
health insurance affordablemedication and care that
improves their lives, ManyWisconsin residents cannot
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afford private insurance.
Wisconsin Republicans say theywill immediately gavel out of
the I'm Assembly Speaker RobinVoss.
Recently, Republicans on theJoint Committee on Finance
removed Governor Eber's budgetrequest to expand welfare in
Wisconsin.
There is no reason to expandMedicaid here BadgerCare covers
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people earning up to 100 percentof the federal poverty level.
The bottom line is that everyonewho wants insurance in our state
already has access this is justanother example of the
disincentives that the governoris putting into getting people
back to work, much like theenhanced unemployment benefits
keeping people on the sidelinesI'm Wisconsin's Lieutenant
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Governor Sarah Rodriguez, butlong before I took office, I was
a registered nurse.
I served in the Peace Corps atthe height of HIV AIDS and in
Baltimore emergency rooms at theheight of the heroin and gun
violence epidemics.
During the COVID pandemic,Wisconsin Republicans.
Failed to protect our health.
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That's why I ran for office andflipped a red district blue.
Because once a nurse, always anurse.
Welcome to pulse check,Wisconsin.
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Good morning.
Good evening.
Good afternoon.
Whatever it may be for you.
This is a Dr.
Ford from pulse check,Wisconsin.
And I want to thank you for.
For joining us for our third andfinal part of our series on the
politics.
Of public health.
We have a very.
Special.
Conclusion to the series heretoday.
What we want to do is we want toemphasize some of the key
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topics.
That are going to be top ofticket for a lot of folks here
in the state of Wisconsin.
And to be honest, a lot of theissues that we have.
In the country.
Focus around education focuses.
Around the economy and itfocuses around your healthcare.
I've had the opportunity overthe last couple of months to
travel the country to WashingtonDC.
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And.
Both here, state side as well.
And talk to people about things.
That are at the top of theirpriorities.
And healthcare comes up over andover and over again.
A lot of that has.
To do with provisions of theaffordable care act that
recently have.
pass and that are set to pass in2025.
And we have that to thank to theinflation reduction act.
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That recently was celebrated atWashington DC for a two year
anniversary.
This is going to be.
A game-changer for a lot ofpeople.
Who.
Previously had a hard timeaffording their medications or.
Frankly could not afford theirmedications.
I had the opportunity recentlyto go to the white house and.
I listened to a couple of thestories from folks who were
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affected the most by.= Theinflation reduction act.
I spoke to folks.
Folks who could retire or could.
I could afford.
Time to be with their families.
Because they no longer had towork simply for their
medications here's state side.
The state of Wisconsin.
An issue that is top of ticketfor.
Us here is our Medicaidexpansion or Badger care
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expansion There was a recentdiscussion that.
I was able to view.
View back in January at thebeginning of this year.
That.
Cover the matter of Badger careexpansion to some of the
benefits that.
We would experience here insteadof Wisconsin.
Wisconsin.
Of course being a part of thehandful of states in the union
that have.
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I have not expanded Medicaid.
This lecture was.
Really good at highlighting, notonly the benefits of Badger care
expansion, but also.
How a bill becomes a law in thestate of Wisconsin.
So I'll link that.
To our website.
So everyone who is interestedcan take a look at it, but.
But I'm also wanting to godirectly to the source and to
get.
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This person's perspective, whowas the presenter?
Because I felt she did.
A really good job at breaking itdown and distilling what we
needed.
To know, as both healthcareproviders, as well as citizens
throughout the state ofWisconsin.
Consen and the tangible effectsthat expansion of Badger care
would have on.
On us all.
As such, I am grateful to haveon with us today Lieutenant
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governor Sarah Rodriguez.
Sarah Rodriguez is our 46Lieutenant governor in the state
of Wisconsin.
She is an ER nurse, a formerhealthcare executive who worked
in various leadership.
Leadership roles over the last20 years.
Prior to her becoming Lieutenantgovernor.
She was an assembly member outof Waukesha.
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County.
And during her time as.
A state representative.
She worked on the committees onhealth insurance energy and.
Utilities science and technologyand broadband.
She brings to the role ofLieutenant governor.
Leadership.
From the healthcare perspective,as well as lived experience in.
And what we're seeing in theemergency departments day in and
day out, and some of thestrains.
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Means that our patients arefeeling.
Not only in their pocket books,but.
But in access to healthcare ingeneral.
And again, We are so proud tohave her here and I hope you
enjoy her interview.
There were a lot.
Of key topics that she discussedhere and plans and going
forward.
So would that be inset?
I wanted.
Just you
Lieutenant governor Sarah Rodriguez.
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Well.
I did an intro for you at thevery beginning for our
listeners, but I want to thankyou.
We're very grateful to have youhere, Lieutenant Governor.
Um, can you just give us alittle bit of a background of
yourself, and then we'll getinto some of the topic that we
discussed today.
Right.
Perfect.
So I am the Lieutenant Governorof Wisconsin, and I have been in
this role for a year and a half.
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almost two years now.
Pri in the assembly for two y adistrict that included Milwaukee
County.
Um, but worked in health care.
I and have been doing publi Uh,so it's been a really
interesting transition to workon public health in the
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community as well as now workingin public policy.
Even early on, I was a PeaceCorps volunteer.
I worked on HIV AIDS,reproductive health.
This has been something that'sbeen an interest of mine for my
entire life.
Yeah.
And we, we truly appreciateeverything that you do.
I can speak for myself and mycolleagues.
That it's good to have someonewho has been in the trenches
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with us to know what theproblems are at the ground level
and how to address it.
And then you actually took thestep forward in order to make
that policy and help affect thatchange.
Yeah, and I would say we needmore clinicians in policy level
positions because there are somany things that may have
unintended consequences whenpeople are making legislation or
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policies.
And if you are not entrenchedwithin the healthcare system,
you're not always aware of whatthose issues might be.
And so making sure we havephysicians and other clinicians
within within policy makingpositions is really, really
important.
And there's just not enough.
Okay.
Yeah, that's the truth, right?
Mm-Hmm.
And so, you know, one of thethings that we open this, you
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know, podcast with is the mostrecent ad that we're doing,
we're campaigning as a pac, youknow, committee to protect
healthcare in order to expandbadger care.
And so for a lot of people, wedid a kind of a intro because
this is the first time they'relearning.
There's a difference betweenBadgerCare, you know, Medicaid,
you know, Medicare, things ofthat nature.
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One of the things that we wantedto talk to you about, because I
saw a lecture that you gave atUniversity of Wisconsin back in
January and you kind of broke itdown and I felt like it was good
for healthcare providers and itwould be good for our listeners
as well.
But could you explain a littlebit about what BadgerCare
expansion would mean and whowould qualify?
So within Wisconsin BadgerCareexpansion would We cover working
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people, usually single people,at about 135 to 138 percent of
poverty, depending on if there'swhat percentage Wisconsin
decides to implement.
And right now in Wisconsin, wecover folks up to 100 percent of
poverty.
So we did expand a little bit interms of that expansion, but not
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to the Affordable Care Act'srequirement.
And what that means forWisconsin is that we do not get
federal matching funds.
And so we would be able to saveon your taxpayer dollars, my
taxpayer dollars, about 1.
6 to about 2 billion dollarsover the biennium that would
just go to our bottom line.
That we could invest inhealthcare, we could invest in
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communities.
And that doesn't even includesome of, you know, the
incentives that the federalgovernment has to be able to ask
states to expand BadgerCare orMedicaid.
That would be almost another 2billion dollars that we would be
able to have.
So it is, it's fiscallyresponsible to expand Medicaid
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here in Wisconsin, but it's alsothe right thing to do because we
have folks that want to be ableto take care of their diabetes,
want to be able to take care oftheir high blood pressure, maybe
even want to add a couple morehours that they're working.
And they can't do that becausethey'll lose their coverage.
And, and, you know, like I said,you walked the walk, ER nurse.
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And so I truly appreciate havinganother ER provider in the, in
the office, but you know, what.
What is the importance from whatyou've seen just as a practicing
nurse, what would be theimportance of patients that you
say interacted with day to dayin the emergency department?
What would be those benefits?
So you and I both know thatsometimes people come in to the
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emergency department for primarycare.
Because they don't have anyother option.
They're not covered by any othertype of insurance.
They're not covered by anythingthat's going to help them.
And so they come to theemergency department way sicker
than they should be, and forprimary care.
So if we were able to expandMedicaid, if we were able to
have those folks who would beable to see a primary care
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provider outside of theemergency department, we could
catch those things.
earlier, before they needed tobe admitted, before it became a
crisis, and we want to make surethat the emergency departments
are truly treating emergencies.
And I say this all the time, wewill treat you when you come,
but we are not a substitute forprimary care.
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And we don't do it as well asthose primary care offices do.
You need follow up, you needsomebody to monitor and help you
with your medications.
ERs are not, are not set up todo that.
And so if we were able toexpand.
Medicaid here in Wisconsin.
That would be a way that peoplecould get that primary care
outside of the emergencydepartment and catch those
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illnesses a whole lot earlierbefore it becomes a crisis.
Yeah.
And exactly that.
So I'm, as you can see, I'mgetting ready to go in and a
little bit to a shift.
So, but I will guarantee you, Iwill see a cohort of patients
that are just that, right.
It's those exacerbations ofthose preventable conditions
that have gone to extremistsbecause Folks don't want to see
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me in the emergency department.
They want to go to the primarydoctor, but they don't have
access to the medication that Ihave access to those
appointments.
One of the things that we talkabout, that's one of the
misconceptions is that whenlobbying at the state level, at
the federal level, folks thinkthat this is an issue of just
one cohort of the population,right?
So this is just an issue thatwe're seeing in the overrun
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urban emergency departments.
But there was a really good bookthat came out.
It was called the politics ofresentment that was done by Dr.
Kramer, who's at.
At University of Wisconsin thattalked about how a lot of these
issues are joined in both ruralcommunities as well in
Wisconsin.
How would expanding BadgerCareimpact those rural communities
that you've seen or that youwould see potentially?
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Well, if you look at many of ourrural communities, the vast
majority of folks do haveMedicaid when they're coming
through their hospital system.
And if they do not have thatexpanded Medicaid, they're not
getting reimbursed for theservices that they're providing.
And some of that comes out ofcharity care, some of that comes
out of their bottom line.
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Uh, but if we were able toexpand Medicaid, many of these
rural hospitals would have anadditional lifeline in terms of
reimbursement that they aregoing to be able to stay in
their communities.
It is a crisis in ruralhealthcare right now.
We have had hospitals closingall across Wisconsin and all
across the nation.
And one of the ways that wewould be able to help with some
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of those rural hospitals andrural areas is to be able to
expand Medicaid so they can getthe reimbursement for the
services that they're providing.
Yeah.
So just a general benefit formost low income families
throughout the state ofWisconsin, this is what we're
seeing.
And this is some of the thingsthat we talk about too.
Like, you know, this goes handin hand with lead poisoning,
things like that.
There are more similarities thatwe have, you know, as a
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community, as a state, uh, than,than divisions.
And so it's really good that wehighlight that.
I agree.
And to be clear, Wisconsin isonly one of nine states that has
not expanded.
Medicaid or BadgerCare here inWisconsin.
So we have had red states,purple states, blue states, all
expanding Medicaid orBadgerCare.
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And they've had really greatresults.
And one of the statistics that Ilike to have, and it may have
been in that presentation that Iput out there, is that it
doesn't affect healthcare.
It also affects whether or notyou're stable in your house.
Right.
And so evictions went down, um,when they expanded Medicaid.
And they were able to look atthat.
People were able to add morehours to their day for working.
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Their, their wages went up.
So these are real tangibleeconomic effects when we take
care of people's health.
It has enormous implications allacross the state for our
economic value, for, for whatwe're, we're bringing here.
And so, this is another way thatI think we should be able to
make that argument, that weshould be taking care of
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people's health care so thatthey can better contribute to
the economy, better contributeto their families, be more
stable.
And keep them out of thehospital where we know it's very
expensive to treat them oncethey get to that spot.
Right.
And we had a former healthcommissioner, Jeanette Koalik
that came on and she was famousfor having the old moniker of,
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you know, housing is health,right?
So if you have people that don'thave the ability to have a roof
over their head, ability to feedthemselves, healthcare is going
to come secondary to thosethings.
If you want to feed your kids,if you want to keep a house
stable.
And so we're saying that this isgoing to take that, take that
drain away from people that theycan put those funds to think and
work more days, et cetera.
Right, right.
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It's absolutely true.
The other thing that I wanted tomention is Wisconsin is now only
one of two states that has notexpanded BadgerCare or Medicaid
for 12 months postpartum.
Only one of two.
Now that is shameful for mebecause you and I both know that
You know, just having coveragefor that very short period of
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time after somebody has a baby,it's just not enough.
You see all sorts ofcomplications in that year after
someone has a child.
And so we wanted to make surethat we are able to cover those
12 months.
And Wisconsin's only one of twostates that has not done that.
And, and, you know, if we wantto take care of families, if we
want to take care of moms andbabies, this is, this is a no
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brainer to me.
We should be able to cover themfor 12 months after they have a
child.
Absolutely.
Like you said, that's the mostdangerous portion of the
postpartum state when you havewomen who are, you know,
especially first time moms, youknow, they don't have that PCP
follow up.
And I believe now it's onlyabout 60 days after, after you
deliver that you have that orsomewhere around that range.
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90 days, I believe.
90 days.
90 days.
Yeah.
Yeah.
And that's it.
And that is just, That's barelyanything, right?
I mean, I have two kids.
They're 15 and 17.
I mean, that's, that's the timeyou spend at home with them for
the most part, if you can.
And then you're back to, you'reback to work.
But, um, we know that there arecomplications after that.
And so making sure that peoplehave that coverage is, is very,
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very important.
So I, I'm actually excitedbecause we're going to have a
very new legislature coming upthis January and their hopes
brings eternal, that they'regoing to look at this data.
They're going to look at theseeconomic impacts.
And be able to not only pass the12 month postpartum expansion,
but also the overall expansionof, uh, BadgerCare here in
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Wisconsin.
One of the things that isconcerning a lot of people that
I talked to about this, becauseafter we did, you know, this,
this, this commercial about, youknow, the importance of
expanding, a lot of people areconcerned about how are they
going to afford this, right?
Like, is this going to beanother tax on them?
How can we as a state pay forthis?
Are there any funds that arecoming from anywhere else?
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Could you explain kind of thatfederal kickback that we get as
well as that incentive that wewould get?
So what happens is, is when weexpand, there's a 90 percent
match from the federalgovernment.
And so that's what I'm talkingabout when we expand.
If we expanded from about 87percent to 100 percent of
poverty, uh, we would, we arenot getting our 90 percent match
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there.
So that's around 1.
6 to about 2 billion dollarsover the biennium.
And then what happens is, isthat they have the incentives
for, for folks to be able toexpand for a period of time, and
that's around 2 billion dollarsto be able to do that.
So there's all sorts of thingswe can do with those dollars.
We could put money intoprevention.
We could increase reimbursementrates, which we know are a
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struggle out in, in certaincommunities and certain
procedures, have very lowreimbursement rates for
BadgerCare.
These are the kind of thingsthat we could use these dollars
for.
And so, as of today, and it's,it's been over 10 years that
this has been in place thinkabout the dollars that we have
missed over those 10 years.
It's an enormous amount of moneythat we have been using.
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Our taxpayers are going.
Our tax dollars are going to thefederal government.
It's going someplace else.
It's not coming back toWisconsin.
And so, that's the kind of thingthat we want to be able to use
here.
Have, have state tax dollarsstay here in Wisconsin.
Get that 90 percent match.
So that we can be able to investin our, in our communities.
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But there's just, there's somuch we can, we can do with
that.
And one of the worries that I dohear for why we haven't expanded
is that you know, the AffordableCare Act may go away, but it's
been over 10 years and you'vegot, you know, red states,
purple states, blue states thathave implemented it and they've
seen fantastic results.
That's going to be reallychallenging to reverse, and
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we've had a Republicanpresident.
And it didn't get reversed thelast time.
So I I'm confident that we havecreated a system that's working
well for states and that we'regoing to be able to have that 90
percent match going into thefuture.
Yeah.
And like you said, no, we'veseen it work.
Right.
It works in the majority of ourcountry.
Right.
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And so like recently, NorthCarolina, they did, you know,
the, the, the studies based onwhen, after they, they expanded
their Medicaid and what they sawwas, patients that went down to
the single digits that now have,primary care doctors that didn't
before, right.
Mental health facilities wereable to open up, which is huge,
especially in the day and agethat we live in now.
And the paucity of mental healthresources that we have
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throughout the country, right?
Like that's something that wedesperately need for, drug abuse
programs, things of that nature.
So these are things that aregoing to be tangible, not only
for Wisconsin Aced out, but downthe line for generations.
Yeah, no, I absolutely agree.
And so, I mean, that is one ofthe things, and we know it's
popular in Wisconsin.
When we survey people, over 60percent of individuals want us
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to bring those dollars home.
They want us to expandBadgerCare here in Wisconsin.
Um, and so, it has been veryfrustrating for me, as
Lieutenant Governor, but alsowhen I was in the Assembly, to
not even be able to get ahearing on it.
Not even be able to have theconversation about it, because
let's have that conversation.
Let's talk about the benefits ofthis, let's address some of the
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concerns, but at least let'shave that back and forth to be
able to talk about how we canexpand BadgerCare here in
Wisconsin that meets the needsof the community, because the
community members Um, and weshould be responsive to what our
constituents need and want.
And that was a good segue.
Cause I was going to say, youwant it.
I want it.
Majority of Wisconsinites wantit.
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Let's do it.
Right.
So what are the main politicaland legislative to expanding
BadgerCare in Wisconsin?
So we have had a Republican ledlegislature for many years now,
over 10 years, and they havebeen unwilling to put this to a
vote.
They've been unwilling to evenbring it to committee.
So people don't know how theprocess works in Wisconsin.
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So when I was in the assembly, Iwas, One of the authors of the,
the Medicaid or BadgerCareexpansion within the state of
Wisconsin.
And so we had co authors onthere.
We had people who are signing upsaying, yes, they support this.
And then what happens is itneeds to go to a committee,
usually something like thehealth committee, which is what
I was on.
But the leader of the assemblyor the leader of the Senate are
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the ones who decide where those,where that legislation goes.
And then the heads of thecommittees, which are, if you
are in.
Republican control, then they,it's a Republican head of the
committee, decides whether ornot to bring it to the
committee.
And it has never been brought toa committee.
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Um, and so it's never been onthe docket.
It's never been discussed.
It's never been happening.
And then in that committeesession, you talk about things,
maybe there's an amendment andthis happens.
So not even that has everhappened with with Medicaid
expansion or BadgerCareexpansion.
And then, let's say, by amiracle, it gets through the
committee, the committee voteson it, and it goes to the floor.
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Then, the head, again, of theAssembly and the Senate decides
whether to bring thatlegislation to a vote.
So there's another barrier interms of being able to actually
vote on that within the entirelegislative body.
Again, it's never been broughtto the floor.
We've tried a couple of times tosubstitute the legislation on
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other bills, but it, it, itnever has been able to, to come
for a vote.
So that's very, veryfrustrating.
And then what happens is, isthat, okay, let's say it does
come to the assembly or theSenate, Then that piece of
legislation has to be matchedbetween the Senate and the
Assembly before it goes to thegovernor to sign.
So we haven't even gottenthrough step one, right?
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But maybe step one, step one iswriting the legislation.
So we've got to step one, butwe've never been able to get it
past that.
And so what I'm really excitedabout is, if your listeners
don't know, is that we were ableto pass fair maps legislation
this last legislative cycle.
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Yes, so exciting.
We are a purple state.
We are, right?
We are about evenly splitbetween Republicans and
Democrats in terms of what we dofor statewide.
So the governor and I won withabout three percentage points
of, of, you know, just over,little over three percentage
points.
However, right now, before thisnew legislative session starts,
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right now we have a supermajority of Republicans in the
Senate and almost a supermajority of Republicans in the
Assembly.
Like you ask any normal personwho can do math, That doesn't
make sense, right?
It doesn't make sense.
It should be split about 50 50,and every once in a while it's
Democratic control, and everyonce in a while it's Republican
control.
But that's not what it lookslike today.
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But now that we have these newmaps we are going to have a
whole lot more purple districts.
Purple districts like the one Irepresented, and I live in
Waukesha County.
There will be an incentive towork across the aisle to be able
to get this type of legislation.
That community members wantthese legislators are now going
to have to be more responsive totheir constituents than they've
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had to be in the past.
And so I hope springs eternalthat we're going to be able to
get this across the finish line.
The governor is included inevery single budget he's had to
do it and it gets stripped outevery time.
Um, but that's why I think it'sso important that we not only
vote for the top of the ticket,but we vote all the way down,
making sure that thoseindividuals who are representing
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you match your values in termsof what you want to see, ask
them, are they willing to expandBadgerCare if that's one of the
top issues that you have.
Yeah, and you know, I will bedoing this is a part of a three
part special for the politics ofpublic health.
I will be doing a MAPS onecoming up.
I think it's just the two yearsthat I spent doing it with the
People's MAPS Commission.
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Let's just give it a littlebreak here.
But, but, but no, it's so true,right?
You know, we talked about duringall of our hearings in each
congressional district, howhaving that competitiveness,
having that responsiveness, thatpower of the voters in order for
to make that decision for theirelected on vice versa.
And so, you know, we're seeingnow for the first time,
potentially that, you know, thevoters will have a say.
(28:40):
And this is something that istop of the ticket for a lot of
people, you know, reproductiverights, which is our second part
of this series is one of it aswell, you know, there are a lot
of issues that folks who are onthe ticket will now, no longer
have a safe seat, no matterwhat, their constituents say,
and we need to continue to pushthat and say to Wisconsin.
No, I absolutely agree.
And we have to make sure that wecontinue to have these, these
(29:04):
fair maps that we continue tohave something that represents
the community.
Because there's a whole lot ofother things that people want to
be able to see if you ask themabout public education.
They want to make sure we'refully funding public education.
You know, if we ask them aboutclean water, clean air.
They want to see that we'recleaning up the PFAS in the
water.
This is, you know, a highpercentage of folks want us to
(29:26):
do these types of things.
And so, if we're able to, andyou talked about reproductive
rights, again, over 60 percentof individuals within the state
of Wisconsin want us to codifysomething like Roe in, you know,
in the state.
And so, we should be responsiveto that.
We should make sure that we arelistening to our constituents
and that we do what they, what,what they want us to do.
(29:49):
Yeah.
I'm going to play devil'sadvocate here.
And I'm going to have you putyourself in the shoes of, the
folks that are really against,the expansion of badger care
folks in the legislativemajority, what, what do you
think is their position?
Like, why is this something thatoutside of political realm that
they're, they're, they'revehemently opposed to?
So, and I will say what I haveheard on the floor, okay?
(30:12):
So when I was in the assembly,what I would hear on the floor
in terms of the opposition.
There's two, two differentrationales that I have heard.
One is fiscal.
And the other is philosophical.
So the fiscal argument againstBadgerCare expansion is what I
had mentioned before.
They're worried that it's goingto be overturned.
They're worried that that 90percent match is no longer going
(30:32):
to be available to states.
And now we're on the hook forthe full bill.
So again, my argument to that isthat it's been over 10 years.
And it has not happened.
And so this is something that wehave baked into healthcare here
in, you know, here in the UnitedStates.
So I, I'm not as concerned aboutthat in terms of not having
that, that match moving forward.
(30:54):
The second is philosophical.
What is the role of government?
It's the role of government toprovide a safety net for
individuals who are vulnerable.
In my opinion, it is.
It is.
It's the role of government tobe able to provide that safety
net in terms of healthcare ifthey're not able to afford it on
their own.
And I want to remind yourlisteners, these are people who
(31:14):
are working.
They just don't make enoughmoney to be able to afford the
health care and their healthinsurance.
So expensive for them.
Um, and so the philosophicalissue is, is that this is a form
of welfare, which is what I'veheard in the past, and that we
do not want to expand welfare inWisconsin.
But as you and I both know, somany people end up on
(31:39):
BadgerCare, um, within part oftheir lives.
And I'll tell you a story aboutthat.
So my father, he, um, He is aveteran.
He served during Vietnam, um,worked every day of his life
worked the Friday before he gotdiagnosed with Alzheimer's on
that Monday in his 60s.
(32:01):
So, and you and I both know thatdementia or, or those types of
issues is just a suck onfamily's finances, particularly
when he was diagnosed so early.
And so he was on BadgerCare atthe end of his life.
And it was a blessing to ourfamily to know that he was
covered, that it wasn't going tobe financially ruinous for us to
(32:22):
be able to take care of him atthe end of his life.
And so I say to that, is thatwhat you're calling welfare?
Or, is it taking care of themost vulnerable members of our
community who have made thatsocial contract, who have done
what they've needed to do, andyet have fallen on some harder
(32:43):
times.
So, this is, this is somethingthat I, I talk about a lot, and
I, and I tell people that he wason, a proud man, was on
BadgerCare at the end of hislife, because that's what he
needed to be able to have himbeing taken care of.
Yeah, and like you said, so manyWisconsinites have that same
story.
(33:03):
We just recently had theopportunity to go to the White
House where they did thecelebration of the Inflation
Reduction Act.
And you know, I got to sit downwith, you know, the head of the
CDC and, the head of CMS, etcetera.
And we heard some of thesestories from, from folks all
around the country who, now areable to see their grandkids,
right?
Because they can afford theirmedications and they can afford
(33:25):
a bus ticket or a plane ticket.
They could afford to retire,right?
Because, they can now affordtheir medications because their
insulin was kept, right?
And so, all these, all theseprograms, Medicare, Medicaid,
BadgerCare here in the state ofWisconsin, as being seen as this
form of, of, of welfare is justIt's it's fodder, And so I
guarantee you someone that youknow and someone that you love
(33:47):
will be affected by theexpansion of these programs and
I can tell you as a provider andI'm sure the Lieutenant Governor
can tell you as well, we seepatients or we saw patients
every day that that wereaffected by these and could have
had changed and could not havepresented to the emergency
department in this term thatthey did based on if they had
this funding available, right?
(34:08):
And I think you might be alittle younger than me.
But I, I remember pre ACA,right, of when taking care of
individuals who weren't able toget that type of coverage on the
individual market.
And I can remember this womanvividly who came in with chest
(34:30):
pain because she was unable toafford her antihypertensive
medication because she hadrecently been laid off.
It was part of the recession.
It was pre ACA.
She had been laid off.
She worked as an admin assistantfor years and she was 62 years
old.
So Josh just had to make it justshort of Medicare, and so she
(34:53):
was, she was just short ofMedicare, 62 years old, very
difficult to find another job onthat.
They offered her Cobra, right?
Which is when you leave, theyoffer you insurance, but you
have to pay the full price ofthat.
This is a woman who wasn'tmaking that much money and to
try to pay 1, 000, 1, 500 amonth To be able to, to get
(35:13):
something that was very littlecoverage, she wasn't able to do
it.
And so here we had, she had tobe admitted to the hospital
because of that.
Now here we've got somebody whonow we are, she can't afford
that hospital bill either.
So where is, where is that, weare paying for it either now on
the front end and we're payingless.
(35:35):
Or we're going to pay for it onthe back end as, as our
communities, because peoplecan't get the care that they
need.
And so that was a very expensiveadmission.
She was in there first for quitesome time because she had all
sorts of other things wrong withher because she didn't have the
medication that she needed.
And so our community is going tobe paying for that because we
didn't cover her on the frontend and to be able to keep that
(35:58):
continuity of care going.
Yeah.
And you know, I, I, I, I alsohad to go on COBRA for a very
short amount of time right afterresidency, sorry, before
residency, right after medicalschool.
And it was two or 3, 000.
Like, I don't know who canafford that.
Right.
And especially the coverage, ithas gaps, et cetera, et cetera.
So this is something that is nottangible for a lot of the
(36:20):
patients that we see, especiallythose, you know, the majority of
which do not want to come to theemergency department.
They don't want to be there.
Right.
And I think that's the othermisnomer that a lot of people
think, right?
Like, Oh, they're just a drainto the society.
They're going to the emergencydepartment for their primary
care.
They don't want to.
I have yet to meet anybody thatwants to do that.
I have yet to meet anybody thatwants to do it either.
I mean, they would much ratherhave their needs taken care of
(36:42):
in in a more proactive way.
And so we have an opportunityhere in Wisconsin to be able to
live our values.
And do we take care of peoplewho are vulnerable?
Do we take care of people whoneed the healthcare to be able
to continue working?
To be able to take care of theirfamilies?
Or do we not?
(37:03):
And I'm, this is why I'm lookingforward to a new legislature in
January, and, and it's, there'sa, it's almost a, there are so
many people who have left andare coming in new, it's, it's
almost a full new legislature,that I'm really hopeful that
we're going to be able to getthis across the finish line, and
all of these other types of, ofhealthcare needs.
(37:24):
that we have in Wisconsin to beable to really have that type of
conversation about how we wantto be able to take care of
people.
Yeah.
So we talk about the legislator.
The other aspect are insurancecompanies, right?
Large insurance companies andother stakeholders that play a
role in, the debate over radicalexpansion.
What role do you think that theyplay in the grand scheme of
(37:47):
things?
And how does that affect peopleday to day trying to get access
to health?
Well, you have folks who are onthe individual market in other
states.
So those larger health insurancecompanies are in other states on
the individual market offeringplans through the ACA.
So, depending on, I'm not goingto speak for the insurance
(38:08):
companies but depending on theinsurance company, they may be
supportive of, of having this gothrough if they have products
that they would like to be ableto offer on the, on the market.
So it, it could be a mixed, amixed bag for that, it,
depending on where thoseinsurance companies are.
What market that they're in butwe haven't had a big pushback
from a lot of the largerinsurance companies on on
(38:31):
expansion.
So some of them are quitesupportive.
Some of them are neutral and andI imagine some of them are are
against the legislation.
But it's it's not you know, kindof what we're seeing today.
So I I do think that that ittruly is pro a problem we can
solve, right?
We're gonna have mm-hmm, almost$4 billion to be able to solve
(38:54):
the concerns that people haveabout expansion within the state
of Wisconsin.
And I've talked to a multitudeof, of, of, you know, healthcare
systems.
I've talked to a multitude oflong-term care companies.
All of these other things.
We just had a healthcareworkforce task force.
Mm-Hmm.
This was a recommendation thatcame out of the task force.
(39:14):
To say we should be expandingbadger care and that included
just a wide range of folks allacross the state providers
themselves dental health caresystems long term care home care
all sorts of Folks they see thevalue in being able to expand
and bring those dollars homeBecause they know then we can
(39:37):
invest in the workforce Theyknow that we can invest in
mental health like you'retalking about we can raise
reimbursement rates to helppeople Particularly some of
those rural hospitals out.
That's the kind of stuff thatyou're going to be able to see
across Wisconsin.
Yeah, and we had Governor Everson in season one and and that
was right around the time thatyou know The healthcare task
force came out and I sung yourpraises at that time I said, you
(40:00):
know, I can't think of anybodyelse that I would want in charge
of that but I'm glad that youbrought that up and I'm glad
that you're you know, you guysare discussing that because
Yeah, just to harken back toseason one, you know, this is a
multidisciplinary task forcethat is addressing or looking to
address some of the issues thatwe're seeing in Wisconsin
regarding health care, healthcare policy, the nursing
(40:21):
shorters, et cetera, et cetera.
And we have lieutenant governor.
Thank for that.
Yeah, well, it was it wasactually I really enjoyed it.
I really enjoyed helping runthat task force, getting
people's opinions, and I, mycharge to everybody there is I
wanted to make sure thatwhatever we suggested was
doable.
(40:41):
And not only did we haveinterventions that are going to
cost us some dollars if we wantto be able to incentivize
people.
folks to go into health care,uh, but we also have the
BadgerCare expansion, which is,it's revenue generating.
And so we're going to be able tohave some dollars coming in the
door, too, to be able to helppay for some of these types of
investments that we have.
Um, and, and so that's what Ireally, really liked about that
(41:04):
task force is to be able to havesome real tangible solutions of
how we get people into thehealth care, um, And how do we
keep them there?
Because I, you know, you were,you were, um, you know, during
COVID you were, you were thereas an emergency room physician.
You saw the burnout of whathappened during that time.
(41:26):
I talked to a lot of my oldcolleagues and nurses left in
droves after that, because ofhow exhausting it was.
And so making sure that they,And I love this statistic.
So they do all they do these,um, surveys of specifically of
nurses, but I imagine it wouldbe the same for other healthcare
providers.
Um, they ask them what theywant, like what they want to be
(41:48):
able to have satisfaction intheir job.
Like what are the dissatisfiers?
The number one thing for nursesis to feel safe on the job.
And when I say safe, it meansthey want to be able to safely
take care of their patients.
They don't want to beoverwhelmed.
They don't want to beunderstaffed.
Um, you would think pay would benumber one because I think what
(42:09):
you're paying for is a littlemore too.
But it's not.
It's not.
It is being able to safely takecare of patients.
Because you don't necessarily gointo this profession to be a
billionaire, right?
You go into this professionbecause you want to take care of
people.
And so that is something that ifwe are able to have the entire
workforce Um, and, and recruitpeople for the entire team.
(42:33):
Everybody is going to have abetter experience on the job,
and we're going to be able toretain clinicians in Wisconsin.
Absolutely.
And the price of, you know,knowing that you're stretched or
the price of knowing that you'renot providing the best care that
you can in the setting that youhave too many patients or you
feel like you don't have theresources that drains a career,
right?
And you can do it for a finiteamount of time.
(42:55):
And you know, we're all inhealthcare and we're all type a
personalities, right?
And so we're going to do what wegot to do in order to get our
patients.
Right.
But.
That wears down on you, andunfortunately it's insidious and
you don't know it until it's toolate, right?
Well, and I've said this all thetime, I can vividly remember the
panic in the pit of my stomachwhen I had one more patient
(43:17):
wheeled in.
And I wasn't sure I was going tobe able to take care of them the
way that I wanted to be able totake care of them.
And that didn't happen all thetime when I was working, but I
can't imagine, and I wasn'tworking clinically during COVID,
I can't imagine what that waslike for, you know, a year on
end to have just one morepatient coming in.
(43:38):
And having that panic in the pitof your stomach saying, How am I
going to do this?
How am I going to stretch myselfthin enough to be able to give
care the way that these patientsdeserve?
And so I put my hats off to youon what you have done during
that time.
I know how difficult that was.
And all the clinicians that haveworked during that time.
(43:58):
Thank you so much.
So our listeners here are, youknow, always asking, what can
they do, right?
What, how can they support theexpansion of BadgerCare?
There's some smaller electionsthat are coming up.
I don't know if you heard aboutthem, but But outside of those
efforts, how can, how can folkshelp out to, you know, these
(44:19):
efforts to expand BadgerCare?
So I, you know, yes, there areelections coming up and yes, you
have to make sure that you'revoting for people who represent
your values.
You have to make sure of that.
But secondly, reaching out toyour legislatures is a really
important thing to do.
Um, make, so that they know,even if you think they're
supportive.
So I would read everything thatcame in to me.
(44:41):
I, and we would keep tallies onthat.
We would say, okay, like who'scoming in and saying that
they're supportive of this pieceof legislation and who's saying
that they're not.
And so even if you think yourlegislator is supportive, Reach
out, email, call, do something.
The other thing that I recommendis to do, like what you're
doing, is work with yourprofessional organization or
another organization that'sdoing some lobbying.
(45:03):
Um, or not lobbying, or I don'tknow if lobbying is that,
advocacy.
There we go.
Lobbying is a very specificword.
I don't want to use that.
For advocacy, To say, you know,because it's easier for me to
come into my office It's it'schallenging for me to meet with
every single person, but I canmeet with the medical
(45:25):
association I can meet with agroup of people who have some
policy priorities That that iseasier for me as lieutenant
governor to be able to do that.
So it's going to be easier forthe legislators as well.
So trying to coordinate withwhatever, um, professional
organization you have to be ableto do that advocacy I think is
(45:46):
really important too.
So keep on the lookout for that.
To be able to say, hey, how canI be helpful here?
Can I bring stories?
Because at the end of the day,um, legislators are people.
And you and I, you said we'retype A, so we really like data,
right?
We do.
So, we love data.
And I love making decisionsbased on data, right?
(46:08):
We are in the minority, myfriend.
So, most people make decisionson how they feel.
And the way to show what theimpact of BadgerCare expansion
would be is to tell a story.
So I told you the story about mydad, right?
That's, that is a personal storyfrom me about how BadgerCare or
(46:29):
Medicaid affected my family.
You as all your clinicians havestories like that, whether
they're personal or personal.
or they're from their patientsabout what this would do for
your patients, what this woulddo for your community.
And telling those stories, Ithink is really important.
Yeah.
And I feel like a lot of people,you know, and it's, it's with
(46:51):
good attention, right?
A lot of people, they get bareddown with a lot of, you know,
The negativity that they hear,you know, the news, et cetera,
et cetera.
But you would be surprised,these events, Doctor's Day,
right?
You know, just reaching out tosome of your representatives,
these folks are extremelytangible, right?
Especially at the state level,right?
So like, if you're reaching out,if you're attending these
(47:13):
events, they are always lookingfor those stories, You'll be
surprised how many folks that Iknow.
They ended up on the legislativefloor, to tell these stories,
because this is what we need tohear.
So this is the time to speak up.
This is the time to provide thatcontext because, you're
advocating not only foryourself, for your patients,
you're advocating for yourcommunities.
And that could be the change.
That could be the one story thatturns this whole thing upside
(47:35):
down.
Right.
And I absolutely agree.
And I always like to say, youknow, legislators are people
too.
Right?
We are people.
And so there might be somethingwithin that legislator's
background that will hit.
One of those stories mightremind them of something in
their own personal life.
And then you can sway an opinionthat way.
So that's what I think is reallyimportant.
(47:57):
Now, always have the data inyour back pocket.
You're always.
Always.
Always.
Having those stories is soimportant.
And, um, knowing that yourclinicians are on the front
line, seeing this day in and dayout is really, really important.
So let's say to go, but we'regoing to close out here.
Cause I want to make sure thatwe leave you time.
(48:19):
Uh, I know you're busy, anyclosing thoughts that you have
for our listeners.
So I would say that your vote isyour voice.
And making sure that you know ifyou're registered, check it
online, you can.
You can also register the day ofvoting.
So make sure that you know that.
And look, look to see, do theresearch on the candidates that
(48:40):
are out there and see where theystand on some of these things.
Make a call.
See what happens there.
And then make sure that you'reconnecting with those advocacy
groups that again reflect yourvalues so that you can bring
your voice to some of thesearguments.
It's really, really important.
And last thing, consider runningfor office.
Yes.
(49:01):
Absolutely.
And we need more.
We need more.
All right.
Lieutenant Gary, I appreciateyou so much.
We are grateful for you makingthe time and thank you for all
the data.
I'll post a couple of videosthat you've done already to go a
little bit more into how a billbecomes a law, especially in the
state of Wisconsin, and we'll bein touch.
Thank you so much.
Thank you so much for having me.
(49:22):
I appreciate it.
Absolutely.
BadgerCare plus is the.
Largest Medicaid program in thestate of Wisconsin.
And it's estimated.
To provide healthcare insuranceto more than 900,000.
Low-income residents in the cityof Wisconsin.
More than half of.
I'm being children.
Expansion of Badger care would.
(49:44):
I would add as many as 90,000people to the program that are
not.
Currently at it.
And as Lieutenant governor,Sarah Rodriguez.
Has mentioned it would unlockadditional federal funding.
That.
It is currently being held up atthe federal level.
We are wasting tax.
Dollars we're leaving money onthe table.
It's estimated.
At$1.7 billion.
(50:06):
In savings would.
Be garnered from expansion ofBadger care.
In the state of Wisconsin.
And being an emergency medicinedoctor on.
The ground level of health care.
This would be invaluable.
Double for our patients.
We not only have strains in theemergency department.
In terms of the cares that wecan provide folks, especially.
(50:27):
When they have been withoutprimary care for so long and
without those Medicaid.
Occasions that they typicallywould otherwise take if they had
access to them or.
Or had access to primary care ingeneral.
But we're also in a.
Mental health shortage as well.
We don't have.
A number of facilities in.
The state.
In order to provide mentalhealth for all the patients
that.
(50:47):
I need it when they come to theemergency department.
At the worst.
Time.
Of their crisis.
We'll see.
The use of these funds forthings like Drug treatment
programs as well for folks.
Who are affected by.
The disease process.
That is substance abuseaddiction.
You'll hear a lot in theupcoming.
(51:08):
Upcoming days as I record this Ithink we're 10 days out now from
the national election.
So you're going.
To see.
A ton of ads on TV pointing afinger.
One way or the other.
Uh, in terms of who is at fault.
For things like the fitnesscrisis who's at fault for.
Crime, et cetera, et cetera.
(51:28):
In the state of Wisconsin andthroughout.
The country.
However, what I would challengeeveryone.
Who's listening to thisrecording to do.
Is to do your own research.
The point of.
This podcast is to provide.
And you that information and toprovide you information straight
from the sources.
From experts such as Lieutenantgovernor, Rodriguez.
(51:49):
And other.
Experts that we've had on overthe last several months.
In order to.
Help you make your ownhealthcare decisions and help
you make your own decisions.
When you are trying to choose.
Who is going to represent.
You.
At a state and at a federallevel.
A lot of the work that I've doneover the years has been to
promote.
(52:10):
Your ability to do that.
To make it so that.
Your vote counts and that youare choosing your
representatives and not theother way.
Around, as we mentioned duringthe interview.
I would challenge everyone whohas listened to this.
Not only to vote your heartvote, which, you know, Would
help your communities, youropinion matters regardless.
(52:30):
Make.
Sure that you are exercisingyour civic ability to the best
of your abilities.
Again, we are 10 days out from.
The national elections.
But as we said before, They'relocal elections are going to be
the ones that are going toaffect you the most.
Most.
And some districts, we haveassembly district.
Elections coming up.
(52:51):
We have Senate districtelections coming up as well.
And I cannot emphasize more.
The need for you to vote in.
In this election, I cannotemphasize how this election is
going to.
Have longstanding.
repercussions.
On your health and your wellnessof your communities.
So, if you haven't created aplan to vote early, voting has
(53:12):
started.
And the state of WisconsinOctober 22nd.
Be sure.
That you do.
So be sure that you take theinformation that you've gained
from this.
Series.
And do some further research onthe candidates that are.
On the top it is imperative thatyou're not only.
Make sure that you're registeredto vote.
But make sure that you aregetting your family members to
vote, make sure you're gettingyour friends to vote.
(53:33):
Because, regardless of again,how you vote.
Doing.
Doing so.
Is going to affect your healthin the long run.
The time.
To listen to this series.
Think.
Lieutenant governor SarahRodriguez for joining us today.
We will start back up.
Again, pretty soon.
With our regularly scheduledprogram.
(53:54):
We got some really goodinterviews coming up.
That are going to cover.
A broad spectrum of things thatare gonna affect you and it
gonna affect your health.
In the city of Milwaukee andinstead of Wisconsin, So would
that be inset?
as always take care ofyourselves, take care of each
other.
And if you need me.
Come and see me.
The following is brought to youby the committee to protect
(00:02):
healthcare.
Chris (00:04):
In the emergency department, we see real time
consequences of people nothaving access to health care.
Expansion of Medicaid inWisconsin would mean less cases
to the emergency department.
It would prevent closures ofhospitals in our communities,
and most importantly, savelives.
The majority of states in thecountry have expanded Medicaid
with bipartisan support, yetlegislators in Wisconsin are
blocking expansion of Medicaid.
(00:26):
They're blocking the opportunityfor our patients to have a
healthier life.
Tell your legislator to savelives and pass Medicaid
expansion.
Now the 40th state to expandMedicaid under the Affordable
Care Act.
The bipartisan expansion, signedlast month, comes after a decade
(00:49):
of Republican resistance As JohnYang reports, it will be life
changing for some uninsuredNorth Carolinians tucked away in
a shopping center on WinstonSalem's southwest side, non
profit United Health Centers isa lifeline for patients.
Across three locations it serves6, 000 patients.
Most are Black, Hispanic, orLatino.
(01:12):
The nearly 80 percent ofpatients who don't have
insurance pay on a slidingscale.
In one place, patients can see adoctor, get prescriptions
filled, and receive dental care.
They can even enroll inMedicaid, the federal and state
health insurance program forthose with low incomes.
Access to health care has been achallenge for low income
(01:32):
residents of North Carolina, oneof 11 states that hadn't
expanded Medicaid under theAffordable Care Act.
When it's implemented, theprogram will be open to families
and individuals whose incomesare lower than 100, 000.
138 percent of the federalpoverty line.
about 20, 000 for an individual.
Before expansion, most adultswithout children or a disability
(01:54):
weren't eligible at all, nomatter how low their income.
Some Wisconsin doctors arecalling on the Republican
controlled legislature to expandBadgerCare in its special
session tomorrow.
Last week, Governor Evers calleda special session to expand
Medicaid.
The bill would use nearly abillion dollars in federal
(02:15):
stimulus money tied to expandingMedicaid on projects across the
state.
The governor says over 90, 000Wisconsinites will gain
coverage.
Badger care expansion will meanfewer people have to go without
health insurance affordablemedication and care that
improves their lives, ManyWisconsin residents cannot
(02:37):
afford private insurance.
Wisconsin Republicans say theywill immediately gavel out of
the I'm Assembly Speaker RobinVoss.
Recently, Republicans on theJoint Committee on Finance
removed Governor Eber's budgetrequest to expand welfare in
Wisconsin.
There is no reason to expandMedicaid here BadgerCare covers
(02:58):
people earning up to 100 percentof the federal poverty level.
The bottom line is that everyonewho wants insurance in our state
already has access this is justanother example of the
disincentives that the governoris putting into getting people
back to work, much like theenhanced unemployment benefits
keeping people on the sidelinesI'm Wisconsin's Lieutenant
(03:21):
Governor Sarah Rodriguez, butlong before I took office, I was
a registered nurse.
I served in the Peace Corps atthe height of HIV AIDS and in
Baltimore emergency rooms at theheight of the heroin and gun
violence epidemics.
During the COVID pandemic,Wisconsin Republicans.
Failed to protect our health.
(03:44):
That's why I ran for office andflipped a red district blue.
Because once a nurse, always anurse.
Welcome to pulse check,Wisconsin.
(04:40):
Good morning.
Good evening.
Good afternoon.
Whatever it may be for you.
This is a Dr.
Ford from pulse check,Wisconsin.
And I want to thank you for.
For joining us for our third andfinal part of our series on the
politics.
Of public health.
We have a very.
Special.
Conclusion to the series heretoday.
What we want to do is we want toemphasize some of the key
(05:03):
topics.
That are going to be top ofticket for a lot of folks here
in the state of Wisconsin.
And to be honest, a lot of theissues that we have.
In the country.
Focus around education focuses.
Around the economy and itfocuses around your healthcare.
I've had the opportunity overthe last couple of months to
travel the country to WashingtonDC.
(05:26):
And.
Both here, state side as well.
And talk to people about things.
That are at the top of theirpriorities.
And healthcare comes up over andover and over again.
A lot of that has.
To do with provisions of theaffordable care act that
recently have.
pass and that are set to pass in2025.
And we have that to thank to theinflation reduction act.
(05:48):
That recently was celebrated atWashington DC for a two year
anniversary.
This is going to be.
A game-changer for a lot ofpeople.
Who.
Previously had a hard timeaffording their medications or.
Frankly could not afford theirmedications.
I had the opportunity recentlyto go to the white house and.
I listened to a couple of thestories from folks who were
(06:08):
affected the most by.= Theinflation reduction act.
I spoke to folks.
Folks who could retire or could.
I could afford.
Time to be with their families.
Because they no longer had towork simply for their
medications here's state side.
The state of Wisconsin.
An issue that is top of ticketfor.
Us here is our Medicaidexpansion or Badger care
(06:31):
expansion There was a recentdiscussion that.
I was able to view.
View back in January at thebeginning of this year.
That.
Cover the matter of Badger careexpansion to some of the
benefits that.
We would experience here insteadof Wisconsin.
Wisconsin.
Of course being a part of thehandful of states in the union
that have.
(06:51):
I have not expanded Medicaid.
This lecture was.
Really good at highlighting, notonly the benefits of Badger care
expansion, but also.
How a bill becomes a law in thestate of Wisconsin.
So I'll link that.
To our website.
So everyone who is interestedcan take a look at it, but.
But I'm also wanting to godirectly to the source and to
get.
(07:11):
This person's perspective, whowas the presenter?
Because I felt she did.
A really good job at breaking itdown and distilling what we
needed.
To know, as both healthcareproviders, as well as citizens
throughout the state ofWisconsin.
Consen and the tangible effectsthat expansion of Badger care
would have on.
On us all.
As such, I am grateful to haveon with us today Lieutenant
(07:32):
governor Sarah Rodriguez.
Sarah Rodriguez is our 46Lieutenant governor in the state
of Wisconsin.
She is an ER nurse, a formerhealthcare executive who worked
in various leadership.
Leadership roles over the last20 years.
Prior to her becoming Lieutenantgovernor.
She was an assembly member outof Waukesha.
(07:54):
County.
And during her time as.
A state representative.
She worked on the committees onhealth insurance energy and.
Utilities science and technologyand broadband.
She brings to the role ofLieutenant governor.
Leadership.
From the healthcare perspective,as well as lived experience in.
And what we're seeing in theemergency departments day in and
day out, and some of thestrains.
(08:15):
Means that our patients arefeeling.
Not only in their pocket books,but.
But in access to healthcare ingeneral.
And again, We are so proud tohave her here and I hope you
enjoy her interview.
There were a lot.
Of key topics that she discussedhere and plans and going
forward.
So would that be inset?
I wanted.
Just you
Lieutenant governor Sarah Rodriguez.
(08:53):
Well.
I did an intro for you at thevery beginning for our
listeners, but I want to thankyou.
We're very grateful to have youhere, Lieutenant Governor.
Um, can you just give us alittle bit of a background of
yourself, and then we'll getinto some of the topic that we
discussed today.
Right.
Perfect.
So I am the Lieutenant Governorof Wisconsin, and I have been in
this role for a year and a half.
(09:14):
almost two years now.
Pri in the assembly for two y adistrict that included Milwaukee
County.
Um, but worked in health care.
I and have been doing publi Uh,so it's been a really
interesting transition to workon public health in the
(09:37):
community as well as now workingin public policy.
Even early on, I was a PeaceCorps volunteer.
I worked on HIV AIDS,reproductive health.
This has been something that'sbeen an interest of mine for my
entire life.
Yeah.
And we, we truly appreciateeverything that you do.
I can speak for myself and mycolleagues.
That it's good to have someonewho has been in the trenches
(09:58):
with us to know what theproblems are at the ground level
and how to address it.
And then you actually took thestep forward in order to make
that policy and help affect thatchange.
Yeah, and I would say we needmore clinicians in policy level
positions because there are somany things that may have
unintended consequences whenpeople are making legislation or
(10:21):
policies.
And if you are not entrenchedwithin the healthcare system,
you're not always aware of whatthose issues might be.
And so making sure we havephysicians and other clinicians
within within policy makingpositions is really, really
important.
And there's just not enough.
Okay.
Yeah, that's the truth, right?
Mm-Hmm.
And so, you know, one of thethings that we open this, you
(10:43):
know, podcast with is the mostrecent ad that we're doing,
we're campaigning as a pac, youknow, committee to protect
healthcare in order to expandbadger care.
And so for a lot of people, wedid a kind of a intro because
this is the first time they'relearning.
There's a difference betweenBadgerCare, you know, Medicaid,
you know, Medicare, things ofthat nature.
(11:05):
One of the things that we wantedto talk to you about, because I
saw a lecture that you gave atUniversity of Wisconsin back in
January and you kind of broke itdown and I felt like it was good
for healthcare providers and itwould be good for our listeners
as well.
But could you explain a littlebit about what BadgerCare
expansion would mean and whowould qualify?
So within Wisconsin BadgerCareexpansion would We cover working
(11:29):
people, usually single people,at about 135 to 138 percent of
poverty, depending on if there'swhat percentage Wisconsin
decides to implement.
And right now in Wisconsin, wecover folks up to 100 percent of
poverty.
So we did expand a little bit interms of that expansion, but not
(11:49):
to the Affordable Care Act'srequirement.
And what that means forWisconsin is that we do not get
federal matching funds.
And so we would be able to saveon your taxpayer dollars, my
taxpayer dollars, about 1.
6 to about 2 billion dollarsover the biennium that would
just go to our bottom line.
That we could invest inhealthcare, we could invest in
(12:11):
communities.
And that doesn't even includesome of, you know, the
incentives that the federalgovernment has to be able to ask
states to expand BadgerCare orMedicaid.
That would be almost another 2billion dollars that we would be
able to have.
So it is, it's fiscallyresponsible to expand Medicaid
(12:31):
here in Wisconsin, but it's alsothe right thing to do because we
have folks that want to be ableto take care of their diabetes,
want to be able to take care oftheir high blood pressure, maybe
even want to add a couple morehours that they're working.
And they can't do that becausethey'll lose their coverage.
And, and, you know, like I said,you walked the walk, ER nurse.
(12:51):
And so I truly appreciate havinganother ER provider in the, in
the office, but you know, what.
What is the importance from whatyou've seen just as a practicing
nurse, what would be theimportance of patients that you
say interacted with day to dayin the emergency department?
What would be those benefits?
So you and I both know thatsometimes people come in to the
(13:13):
emergency department for primarycare.
Because they don't have anyother option.
They're not covered by any othertype of insurance.
They're not covered by anythingthat's going to help them.
And so they come to theemergency department way sicker
than they should be, and forprimary care.
So if we were able to expandMedicaid, if we were able to
have those folks who would beable to see a primary care
(13:35):
provider outside of theemergency department, we could
catch those things.
earlier, before they needed tobe admitted, before it became a
crisis, and we want to make surethat the emergency departments
are truly treating emergencies.
And I say this all the time, wewill treat you when you come,
but we are not a substitute forprimary care.
(13:56):
And we don't do it as well asthose primary care offices do.
You need follow up, you needsomebody to monitor and help you
with your medications.
ERs are not, are not set up todo that.
And so if we were able toexpand.
Medicaid here in Wisconsin.
That would be a way that peoplecould get that primary care
outside of the emergencydepartment and catch those
(14:16):
illnesses a whole lot earlierbefore it becomes a crisis.
Yeah.
And exactly that.
So I'm, as you can see, I'mgetting ready to go in and a
little bit to a shift.
So, but I will guarantee you, Iwill see a cohort of patients
that are just that, right.
It's those exacerbations ofthose preventable conditions
that have gone to extremistsbecause Folks don't want to see
(14:37):
me in the emergency department.
They want to go to the primarydoctor, but they don't have
access to the medication that Ihave access to those
appointments.
One of the things that we talkabout, that's one of the
misconceptions is that whenlobbying at the state level, at
the federal level, folks thinkthat this is an issue of just
one cohort of the population,right?
So this is just an issue thatwe're seeing in the overrun
(14:58):
urban emergency departments.
But there was a really good bookthat came out.
It was called the politics ofresentment that was done by Dr.
Kramer, who's at.
At University of Wisconsin thattalked about how a lot of these
issues are joined in both ruralcommunities as well in
Wisconsin.
How would expanding BadgerCareimpact those rural communities
that you've seen or that youwould see potentially?
(15:19):
Well, if you look at many of ourrural communities, the vast
majority of folks do haveMedicaid when they're coming
through their hospital system.
And if they do not have thatexpanded Medicaid, they're not
getting reimbursed for theservices that they're providing.
And some of that comes out ofcharity care, some of that comes
out of their bottom line.
(15:39):
Uh, but if we were able toexpand Medicaid, many of these
rural hospitals would have anadditional lifeline in terms of
reimbursement that they aregoing to be able to stay in
their communities.
It is a crisis in ruralhealthcare right now.
We have had hospitals closingall across Wisconsin and all
across the nation.
And one of the ways that wewould be able to help with some
(16:01):
of those rural hospitals andrural areas is to be able to
expand Medicaid so they can getthe reimbursement for the
services that they're providing.
Yeah.
So just a general benefit formost low income families
throughout the state ofWisconsin, this is what we're
seeing.
And this is some of the thingsthat we talk about too.
Like, you know, this goes handin hand with lead poisoning,
things like that.
There are more similarities thatwe have, you know, as a
(16:24):
community, as a state, uh, than,than divisions.
And so it's really good that wehighlight that.
I agree.
And to be clear, Wisconsin isonly one of nine states that has
not expanded.
Medicaid or BadgerCare here inWisconsin.
So we have had red states,purple states, blue states, all
expanding Medicaid orBadgerCare.
(16:44):
And they've had really greatresults.
And one of the statistics that Ilike to have, and it may have
been in that presentation that Iput out there, is that it
doesn't affect healthcare.
It also affects whether or notyou're stable in your house.
Right.
And so evictions went down, um,when they expanded Medicaid.
And they were able to look atthat.
People were able to add morehours to their day for working.
(17:07):
Their, their wages went up.
So these are real tangibleeconomic effects when we take
care of people's health.
It has enormous implications allacross the state for our
economic value, for, for whatwe're, we're bringing here.
And so, this is another way thatI think we should be able to
make that argument, that weshould be taking care of
(17:30):
people's health care so thatthey can better contribute to
the economy, better contributeto their families, be more
stable.
And keep them out of thehospital where we know it's very
expensive to treat them oncethey get to that spot.
Right.
And we had a former healthcommissioner, Jeanette Koalik
that came on and she was famousfor having the old moniker of,
(17:52):
you know, housing is health,right?
So if you have people that don'thave the ability to have a roof
over their head, ability to feedthemselves, healthcare is going
to come secondary to thosethings.
If you want to feed your kids,if you want to keep a house
stable.
And so we're saying that this isgoing to take that, take that
drain away from people that theycan put those funds to think and
work more days, et cetera.
Right, right.
(18:12):
It's absolutely true.
The other thing that I wanted tomention is Wisconsin is now only
one of two states that has notexpanded BadgerCare or Medicaid
for 12 months postpartum.
Only one of two.
Now that is shameful for mebecause you and I both know that
You know, just having coveragefor that very short period of
(18:33):
time after somebody has a baby,it's just not enough.
You see all sorts ofcomplications in that year after
someone has a child.
And so we wanted to make surethat we are able to cover those
12 months.
And Wisconsin's only one of twostates that has not done that.
And, and, you know, if we wantto take care of families, if we
want to take care of moms andbabies, this is, this is a no
(18:54):
brainer to me.
We should be able to cover themfor 12 months after they have a
child.
Absolutely.
Like you said, that's the mostdangerous portion of the
postpartum state when you havewomen who are, you know,
especially first time moms, youknow, they don't have that PCP
follow up.
And I believe now it's onlyabout 60 days after, after you
deliver that you have that orsomewhere around that range.
(19:15):
90 days, I believe.
90 days.
90 days.
Yeah.
Yeah.
And that's it.
And that is just, That's barelyanything, right?
I mean, I have two kids.
They're 15 and 17.
I mean, that's, that's the timeyou spend at home with them for
the most part, if you can.
And then you're back to, you'reback to work.
But, um, we know that there arecomplications after that.
And so making sure that peoplehave that coverage is, is very,
(19:37):
very important.
So I, I'm actually excitedbecause we're going to have a
very new legislature coming upthis January and their hopes
brings eternal, that they'regoing to look at this data.
They're going to look at theseeconomic impacts.
And be able to not only pass the12 month postpartum expansion,
but also the overall expansionof, uh, BadgerCare here in
(19:57):
Wisconsin.
One of the things that isconcerning a lot of people that
I talked to about this, becauseafter we did, you know, this,
this, this commercial about, youknow, the importance of
expanding, a lot of people areconcerned about how are they
going to afford this, right?
Like, is this going to beanother tax on them?
How can we as a state pay forthis?
Are there any funds that arecoming from anywhere else?
(20:18):
Could you explain kind of thatfederal kickback that we get as
well as that incentive that wewould get?
So what happens is, is when weexpand, there's a 90 percent
match from the federalgovernment.
And so that's what I'm talkingabout when we expand.
If we expanded from about 87percent to 100 percent of
poverty, uh, we would, we arenot getting our 90 percent match
(20:40):
there.
So that's around 1.
6 to about 2 billion dollarsover the biennium.
And then what happens is, isthat they have the incentives
for, for folks to be able toexpand for a period of time, and
that's around 2 billion dollarsto be able to do that.
So there's all sorts of thingswe can do with those dollars.
We could put money intoprevention.
We could increase reimbursementrates, which we know are a
(21:02):
struggle out in, in certaincommunities and certain
procedures, have very lowreimbursement rates for
BadgerCare.
These are the kind of thingsthat we could use these dollars
for.
And so, as of today, and it's,it's been over 10 years that
this has been in place thinkabout the dollars that we have
missed over those 10 years.
It's an enormous amount of moneythat we have been using.
(21:24):
Our taxpayers are going.
Our tax dollars are going to thefederal government.
It's going someplace else.
It's not coming back toWisconsin.
And so, that's the kind of thingthat we want to be able to use
here.
Have, have state tax dollarsstay here in Wisconsin.
Get that 90 percent match.
So that we can be able to investin our, in our communities.
(21:45):
But there's just, there's somuch we can, we can do with
that.
And one of the worries that I dohear for why we haven't expanded
is that you know, the AffordableCare Act may go away, but it's
been over 10 years and you'vegot, you know, red states,
purple states, blue states thathave implemented it and they've
seen fantastic results.
That's going to be reallychallenging to reverse, and
(22:07):
we've had a Republicanpresident.
And it didn't get reversed thelast time.
So I I'm confident that we havecreated a system that's working
well for states and that we'regoing to be able to have that 90
percent match going into thefuture.
Yeah.
And like you said, no, we'veseen it work.
Right.
It works in the majority of ourcountry.
Right.
(22:27):
And so like recently, NorthCarolina, they did, you know,
the, the, the studies based onwhen, after they, they expanded
their Medicaid and what they sawwas, patients that went down to
the single digits that now have,primary care doctors that didn't
before, right.
Mental health facilities wereable to open up, which is huge,
especially in the day and agethat we live in now.
And the paucity of mental healthresources that we have
(22:50):
throughout the country, right?
Like that's something that wedesperately need for, drug abuse
programs, things of that nature.
So these are things that aregoing to be tangible, not only
for Wisconsin Aced out, but downthe line for generations.
Yeah, no, I absolutely agree.
And so, I mean, that is one ofthe things, and we know it's
popular in Wisconsin.
When we survey people, over 60percent of individuals want us
(23:10):
to bring those dollars home.
They want us to expandBadgerCare here in Wisconsin.
Um, and so, it has been veryfrustrating for me, as
Lieutenant Governor, but alsowhen I was in the Assembly, to
not even be able to get ahearing on it.
Not even be able to have theconversation about it, because
let's have that conversation.
Let's talk about the benefits ofthis, let's address some of the
(23:32):
concerns, but at least let'shave that back and forth to be
able to talk about how we canexpand BadgerCare here in
Wisconsin that meets the needsof the community, because the
community members Um, and weshould be responsive to what our
constituents need and want.
And that was a good segue.
Cause I was going to say, youwant it.
I want it.
Majority of Wisconsinites wantit.
(23:54):
Let's do it.
Right.
So what are the main politicaland legislative to expanding
BadgerCare in Wisconsin?
So we have had a Republican ledlegislature for many years now,
over 10 years, and they havebeen unwilling to put this to a
vote.
They've been unwilling to evenbring it to committee.
So people don't know how theprocess works in Wisconsin.
(24:18):
So when I was in the assembly, Iwas, One of the authors of the,
the Medicaid or BadgerCareexpansion within the state of
Wisconsin.
And so we had co authors onthere.
We had people who are signing upsaying, yes, they support this.
And then what happens is itneeds to go to a committee,
usually something like thehealth committee, which is what
I was on.
But the leader of the assemblyor the leader of the Senate are
(24:42):
the ones who decide where those,where that legislation goes.
And then the heads of thecommittees, which are, if you
are in.
Republican control, then they,it's a Republican head of the
committee, decides whether ornot to bring it to the
committee.
And it has never been brought toa committee.
(25:03):
Um, and so it's never been onthe docket.
It's never been discussed.
It's never been happening.
And then in that committeesession, you talk about things,
maybe there's an amendment andthis happens.
So not even that has everhappened with with Medicaid
expansion or BadgerCareexpansion.
And then, let's say, by amiracle, it gets through the
committee, the committee voteson it, and it goes to the floor.
(25:24):
Then, the head, again, of theAssembly and the Senate decides
whether to bring thatlegislation to a vote.
So there's another barrier interms of being able to actually
vote on that within the entirelegislative body.
Again, it's never been broughtto the floor.
We've tried a couple of times tosubstitute the legislation on
(25:45):
other bills, but it, it, itnever has been able to, to come
for a vote.
So that's very, veryfrustrating.
And then what happens is, isthat, okay, let's say it does
come to the assembly or theSenate, Then that piece of
legislation has to be matchedbetween the Senate and the
Assembly before it goes to thegovernor to sign.
So we haven't even gottenthrough step one, right?
(26:07):
But maybe step one, step one iswriting the legislation.
So we've got to step one, butwe've never been able to get it
past that.
And so what I'm really excitedabout is, if your listeners
don't know, is that we were ableto pass fair maps legislation
this last legislative cycle.
(26:27):
Yes, so exciting.
We are a purple state.
We are, right?
We are about evenly splitbetween Republicans and
Democrats in terms of what we dofor statewide.
So the governor and I won withabout three percentage points
of, of, you know, just over,little over three percentage
points.
However, right now, before thisnew legislative session starts,
(26:50):
right now we have a supermajority of Republicans in the
Senate and almost a supermajority of Republicans in the
Assembly.
Like you ask any normal personwho can do math, That doesn't
make sense, right?
It doesn't make sense.
It should be split about 50 50,and every once in a while it's
Democratic control, and everyonce in a while it's Republican
control.
But that's not what it lookslike today.
(27:11):
But now that we have these newmaps we are going to have a
whole lot more purple districts.
Purple districts like the one Irepresented, and I live in
Waukesha County.
There will be an incentive towork across the aisle to be able
to get this type of legislation.
That community members wantthese legislators are now going
to have to be more responsive totheir constituents than they've
(27:33):
had to be in the past.
And so I hope springs eternalthat we're going to be able to
get this across the finish line.
The governor is included inevery single budget he's had to
do it and it gets stripped outevery time.
Um, but that's why I think it'sso important that we not only
vote for the top of the ticket,but we vote all the way down,
making sure that thoseindividuals who are representing
(27:56):
you match your values in termsof what you want to see, ask
them, are they willing to expandBadgerCare if that's one of the
top issues that you have.
Yeah, and you know, I will bedoing this is a part of a three
part special for the politics ofpublic health.
I will be doing a MAPS onecoming up.
I think it's just the two yearsthat I spent doing it with the
People's MAPS Commission.
(28:17):
Let's just give it a littlebreak here.
But, but, but no, it's so true,right?
You know, we talked about duringall of our hearings in each
congressional district, howhaving that competitiveness,
having that responsiveness, thatpower of the voters in order for
to make that decision for theirelected on vice versa.
And so, you know, we're seeingnow for the first time,
potentially that, you know, thevoters will have a say.
(28:40):
And this is something that istop of the ticket for a lot of
people, you know, reproductiverights, which is our second part
of this series is one of it aswell, you know, there are a lot
of issues that folks who are onthe ticket will now, no longer
have a safe seat, no matterwhat, their constituents say,
and we need to continue to pushthat and say to Wisconsin.
No, I absolutely agree.
And we have to make sure that wecontinue to have these, these
(29:04):
fair maps that we continue tohave something that represents
the community.
Because there's a whole lot ofother things that people want to
be able to see if you ask themabout public education.
They want to make sure we'refully funding public education.
You know, if we ask them aboutclean water, clean air.
They want to see that we'recleaning up the PFAS in the
water.
This is, you know, a highpercentage of folks want us to
(29:26):
do these types of things.
And so, if we're able to, andyou talked about reproductive
rights, again, over 60 percentof individuals within the state
of Wisconsin want us to codifysomething like Roe in, you know,
in the state.
And so, we should be responsiveto that.
We should make sure that we arelistening to our constituents
and that we do what they, what,what they want us to do.
(29:49):
Yeah.
I'm going to play devil'sadvocate here.
And I'm going to have you putyourself in the shoes of, the
folks that are really against,the expansion of badger care
folks in the legislativemajority, what, what do you
think is their position?
Like, why is this something thatoutside of political realm that
they're, they're, they'revehemently opposed to?
So, and I will say what I haveheard on the floor, okay?
(30:12):
So when I was in the assembly,what I would hear on the floor
in terms of the opposition.
There's two, two differentrationales that I have heard.
One is fiscal.
And the other is philosophical.
So the fiscal argument againstBadgerCare expansion is what I
had mentioned before.
They're worried that it's goingto be overturned.
They're worried that that 90percent match is no longer going
(30:32):
to be available to states.
And now we're on the hook forthe full bill.
So again, my argument to that isthat it's been over 10 years.
And it has not happened.
And so this is something that wehave baked into healthcare here
in, you know, here in the UnitedStates.
So I, I'm not as concerned aboutthat in terms of not having
that, that match moving forward.
(30:54):
The second is philosophical.
What is the role of government?
It's the role of government toprovide a safety net for
individuals who are vulnerable.
In my opinion, it is.
It is.
It's the role of government tobe able to provide that safety
net in terms of healthcare ifthey're not able to afford it on
their own.
And I want to remind yourlisteners, these are people who
(31:14):
are working.
They just don't make enoughmoney to be able to afford the
health care and their healthinsurance.
So expensive for them.
Um, and so the philosophicalissue is, is that this is a form
of welfare, which is what I'veheard in the past, and that we
do not want to expand welfare inWisconsin.
But as you and I both know, somany people end up on
(31:39):
BadgerCare, um, within part oftheir lives.
And I'll tell you a story aboutthat.
So my father, he, um, He is aveteran.
He served during Vietnam, um,worked every day of his life
worked the Friday before he gotdiagnosed with Alzheimer's on
that Monday in his 60s.
(32:01):
So, and you and I both know thatdementia or, or those types of
issues is just a suck onfamily's finances, particularly
when he was diagnosed so early.
And so he was on BadgerCare atthe end of his life.
And it was a blessing to ourfamily to know that he was
covered, that it wasn't going tobe financially ruinous for us to
(32:22):
be able to take care of him atthe end of his life.
And so I say to that, is thatwhat you're calling welfare?
Or, is it taking care of themost vulnerable members of our
community who have made thatsocial contract, who have done
what they've needed to do, andyet have fallen on some harder
(32:43):
times.
So, this is, this is somethingthat I, I talk about a lot, and
I, and I tell people that he wason, a proud man, was on
BadgerCare at the end of hislife, because that's what he
needed to be able to have himbeing taken care of.
Yeah, and like you said, so manyWisconsinites have that same
story.
(33:03):
We just recently had theopportunity to go to the White
House where they did thecelebration of the Inflation
Reduction Act.
And you know, I got to sit downwith, you know, the head of the
CDC and, the head of CMS, etcetera.
And we heard some of thesestories from, from folks all
around the country who, now areable to see their grandkids,
right?
Because they can afford theirmedications and they can afford
(33:25):
a bus ticket or a plane ticket.
They could afford to retire,right?
Because, they can now affordtheir medications because their
insulin was kept, right?
And so, all these, all theseprograms, Medicare, Medicaid,
BadgerCare here in the state ofWisconsin, as being seen as this
form of, of, of welfare is justIt's it's fodder, And so I
guarantee you someone that youknow and someone that you love
(33:47):
will be affected by theexpansion of these programs and
I can tell you as a provider andI'm sure the Lieutenant Governor
can tell you as well, we seepatients or we saw patients
every day that that wereaffected by these and could have
had changed and could not havepresented to the emergency
department in this term thatthey did based on if they had
this funding available, right?
(34:08):
And I think you might be alittle younger than me.
But I, I remember pre ACA,right, of when taking care of
individuals who weren't able toget that type of coverage on the
individual market.
And I can remember this womanvividly who came in with chest
(34:30):
pain because she was unable toafford her antihypertensive
medication because she hadrecently been laid off.
It was part of the recession.
It was pre ACA.
She had been laid off.
She worked as an admin assistantfor years and she was 62 years
old.
So Josh just had to make it justshort of Medicare, and so she
(34:53):
was, she was just short ofMedicare, 62 years old, very
difficult to find another job onthat.
They offered her Cobra, right?
Which is when you leave, theyoffer you insurance, but you
have to pay the full price ofthat.
This is a woman who wasn'tmaking that much money and to
try to pay 1, 000, 1, 500 amonth To be able to, to get
(35:13):
something that was very littlecoverage, she wasn't able to do
it.
And so here we had, she had tobe admitted to the hospital
because of that.
Now here we've got somebody whonow we are, she can't afford
that hospital bill either.
So where is, where is that, weare paying for it either now on
the front end and we're payingless.
(35:35):
Or we're going to pay for it onthe back end as, as our
communities, because peoplecan't get the care that they
need.
And so that was a very expensiveadmission.
She was in there first for quitesome time because she had all
sorts of other things wrong withher because she didn't have the
medication that she needed.
And so our community is going tobe paying for that because we
didn't cover her on the frontend and to be able to keep that
(35:58):
continuity of care going.
Yeah.
And you know, I, I, I, I alsohad to go on COBRA for a very
short amount of time right afterresidency, sorry, before
residency, right after medicalschool.
And it was two or 3, 000.
Like, I don't know who canafford that.
Right.
And especially the coverage, ithas gaps, et cetera, et cetera.
So this is something that is nottangible for a lot of the
(36:20):
patients that we see, especiallythose, you know, the majority of
which do not want to come to theemergency department.
They don't want to be there.
Right.
And I think that's the othermisnomer that a lot of people
think, right?
Like, Oh, they're just a drainto the society.
They're going to the emergencydepartment for their primary
care.
They don't want to.
I have yet to meet anybody thatwants to do that.
I have yet to meet anybody thatwants to do it either.
I mean, they would much ratherhave their needs taken care of
(36:42):
in in a more proactive way.
And so we have an opportunityhere in Wisconsin to be able to
live our values.
And do we take care of peoplewho are vulnerable?
Do we take care of people whoneed the healthcare to be able
to continue working?
To be able to take care of theirfamilies?
Or do we not?
(37:03):
And I'm, this is why I'm lookingforward to a new legislature in
January, and, and it's, there'sa, it's almost a, there are so
many people who have left andare coming in new, it's, it's
almost a full new legislature,that I'm really hopeful that
we're going to be able to getthis across the finish line, and
all of these other types of, ofhealthcare needs.
(37:24):
that we have in Wisconsin to beable to really have that type of
conversation about how we wantto be able to take care of
people.
Yeah.
So we talk about the legislator.
The other aspect are insurancecompanies, right?
Large insurance companies andother stakeholders that play a
role in, the debate over radicalexpansion.
What role do you think that theyplay in the grand scheme of
(37:47):
things?
And how does that affect peopleday to day trying to get access
to health?
Well, you have folks who are onthe individual market in other
states.
So those larger health insurancecompanies are in other states on
the individual market offeringplans through the ACA.
So, depending on, I'm not goingto speak for the insurance
(38:08):
companies but depending on theinsurance company, they may be
supportive of, of having this gothrough if they have products
that they would like to be ableto offer on the, on the market.
So it, it could be a mixed, amixed bag for that, it,
depending on where thoseinsurance companies are.
What market that they're in butwe haven't had a big pushback
from a lot of the largerinsurance companies on on
(38:31):
expansion.
So some of them are quitesupportive.
Some of them are neutral and andI imagine some of them are are
against the legislation.
But it's it's not you know, kindof what we're seeing today.
So I I do think that that ittruly is pro a problem we can
solve, right?
We're gonna have mm-hmm, almost$4 billion to be able to solve
(38:54):
the concerns that people haveabout expansion within the state
of Wisconsin.
And I've talked to a multitudeof, of, of, you know, healthcare
systems.
I've talked to a multitude oflong-term care companies.
All of these other things.
We just had a healthcareworkforce task force.
Mm-Hmm.
This was a recommendation thatcame out of the task force.
(39:14):
To say we should be expandingbadger care and that included
just a wide range of folks allacross the state providers
themselves dental health caresystems long term care home care
all sorts of Folks they see thevalue in being able to expand
and bring those dollars homeBecause they know then we can
(39:37):
invest in the workforce Theyknow that we can invest in
mental health like you'retalking about we can raise
reimbursement rates to helppeople Particularly some of
those rural hospitals out.
That's the kind of stuff thatyou're going to be able to see
across Wisconsin.
Yeah, and we had Governor Everson in season one and and that
was right around the time thatyou know The healthcare task
force came out and I sung yourpraises at that time I said, you
(40:00):
know, I can't think of anybodyelse that I would want in charge
of that but I'm glad that youbrought that up and I'm glad
that you're you know, you guysare discussing that because
Yeah, just to harken back toseason one, you know, this is a
multidisciplinary task forcethat is addressing or looking to
address some of the issues thatwe're seeing in Wisconsin
regarding health care, healthcare policy, the nursing
(40:21):
shorters, et cetera, et cetera.
And we have lieutenant governor.
Thank for that.
Yeah, well, it was it wasactually I really enjoyed it.
I really enjoyed helping runthat task force, getting
people's opinions, and I, mycharge to everybody there is I
wanted to make sure thatwhatever we suggested was
doable.
(40:41):
And not only did we haveinterventions that are going to
cost us some dollars if we wantto be able to incentivize
people.
folks to go into health care,uh, but we also have the
BadgerCare expansion, which is,it's revenue generating.
And so we're going to be able tohave some dollars coming in the
door, too, to be able to helppay for some of these types of
investments that we have.
Um, and, and so that's what Ireally, really liked about that
(41:04):
task force is to be able to havesome real tangible solutions of
how we get people into thehealth care, um, And how do we
keep them there?
Because I, you know, you were,you were, um, you know, during
COVID you were, you were thereas an emergency room physician.
You saw the burnout of whathappened during that time.
(41:26):
I talked to a lot of my oldcolleagues and nurses left in
droves after that, because ofhow exhausting it was.
And so making sure that they,And I love this statistic.
So they do all they do these,um, surveys of specifically of
nurses, but I imagine it wouldbe the same for other healthcare
providers.
Um, they ask them what theywant, like what they want to be
(41:48):
able to have satisfaction intheir job.
Like what are the dissatisfiers?
The number one thing for nursesis to feel safe on the job.
And when I say safe, it meansthey want to be able to safely
take care of their patients.
They don't want to beoverwhelmed.
They don't want to beunderstaffed.
Um, you would think pay would benumber one because I think what
(42:09):
you're paying for is a littlemore too.
But it's not.
It's not.
It is being able to safely takecare of patients.
Because you don't necessarily gointo this profession to be a
billionaire, right?
You go into this professionbecause you want to take care of
people.
And so that is something that ifwe are able to have the entire
workforce Um, and, and recruitpeople for the entire team.
(42:33):
Everybody is going to have abetter experience on the job,
and we're going to be able toretain clinicians in Wisconsin.
Absolutely.
And the price of, you know,knowing that you're stretched or
the price of knowing that you'renot providing the best care that
you can in the setting that youhave too many patients or you
feel like you don't have theresources that drains a career,
right?
And you can do it for a finiteamount of time.
(42:55):
And you know, we're all inhealthcare and we're all type a
personalities, right?
And so we're going to do what wegot to do in order to get our
patients.
Right.
But.
That wears down on you, andunfortunately it's insidious and
you don't know it until it's toolate, right?
Well, and I've said this all thetime, I can vividly remember the
panic in the pit of my stomachwhen I had one more patient
(43:17):
wheeled in.
And I wasn't sure I was going tobe able to take care of them the
way that I wanted to be able totake care of them.
And that didn't happen all thetime when I was working, but I
can't imagine, and I wasn'tworking clinically during COVID,
I can't imagine what that waslike for, you know, a year on
end to have just one morepatient coming in.
(43:38):
And having that panic in the pitof your stomach saying, How am I
going to do this?
How am I going to stretch myselfthin enough to be able to give
care the way that these patientsdeserve?
And so I put my hats off to youon what you have done during
that time.
I know how difficult that was.
And all the clinicians that haveworked during that time.
(43:58):
Thank you so much.
So our listeners here are, youknow, always asking, what can
they do, right?
What, how can they support theexpansion of BadgerCare?
There's some smaller electionsthat are coming up.
I don't know if you heard aboutthem, but But outside of those
efforts, how can, how can folkshelp out to, you know, these
(44:19):
efforts to expand BadgerCare?
So I, you know, yes, there areelections coming up and yes, you
have to make sure that you'revoting for people who represent
your values.
You have to make sure of that.
But secondly, reaching out toyour legislatures is a really
important thing to do.
Um, make, so that they know,even if you think they're
supportive.
So I would read everything thatcame in to me.
(44:41):
I, and we would keep tallies onthat.
We would say, okay, like who'scoming in and saying that
they're supportive of this pieceof legislation and who's saying
that they're not.
And so even if you think yourlegislator is supportive, Reach
out, email, call, do something.
The other thing that I recommendis to do, like what you're
doing, is work with yourprofessional organization or
another organization that'sdoing some lobbying.
(45:03):
Um, or not lobbying, or I don'tknow if lobbying is that,
advocacy.
There we go.
Lobbying is a very specificword.
I don't want to use that.
For advocacy, To say, you know,because it's easier for me to
come into my office It's it'schallenging for me to meet with
every single person, but I canmeet with the medical
(45:25):
association I can meet with agroup of people who have some
policy priorities That that iseasier for me as lieutenant
governor to be able to do that.
So it's going to be easier forthe legislators as well.
So trying to coordinate withwhatever, um, professional
organization you have to be ableto do that advocacy I think is
(45:46):
really important too.
So keep on the lookout for that.
To be able to say, hey, how canI be helpful here?
Can I bring stories?
Because at the end of the day,um, legislators are people.
And you and I, you said we'retype A, so we really like data,
right?
We do.
So, we love data.
And I love making decisionsbased on data, right?
(46:08):
We are in the minority, myfriend.
So, most people make decisionson how they feel.
And the way to show what theimpact of BadgerCare expansion
would be is to tell a story.
So I told you the story about mydad, right?
That's, that is a personal storyfrom me about how BadgerCare or
(46:29):
Medicaid affected my family.
You as all your clinicians havestories like that, whether
they're personal or personal.
or they're from their patientsabout what this would do for
your patients, what this woulddo for your community.
And telling those stories, Ithink is really important.
Yeah.
And I feel like a lot of people,you know, and it's, it's with
(46:51):
good attention, right?
A lot of people, they get bareddown with a lot of, you know,
The negativity that they hear,you know, the news, et cetera,
et cetera.
But you would be surprised,these events, Doctor's Day,
right?
You know, just reaching out tosome of your representatives,
these folks are extremelytangible, right?
Especially at the state level,right?
So like, if you're reaching out,if you're attending these
(47:13):
events, they are always lookingfor those stories, You'll be
surprised how many folks that Iknow.
They ended up on the legislativefloor, to tell these stories,
because this is what we need tohear.
So this is the time to speak up.
This is the time to provide thatcontext because, you're
advocating not only foryourself, for your patients,
you're advocating for yourcommunities.
And that could be the change.
That could be the one story thatturns this whole thing upside
(47:35):
down.
Right.
And I absolutely agree.
And I always like to say, youknow, legislators are people
too.
Right?
We are people.
And so there might be somethingwithin that legislator's
background that will hit.
One of those stories mightremind them of something in
their own personal life.
And then you can sway an opinionthat way.
So that's what I think is reallyimportant.
(47:57):
Now, always have the data inyour back pocket.
You're always.
Always.
Always.
Having those stories is soimportant.
And, um, knowing that yourclinicians are on the front
line, seeing this day in and dayout is really, really important.
So let's say to go, but we'regoing to close out here.
Cause I want to make sure thatwe leave you time.
(48:19):
Uh, I know you're busy, anyclosing thoughts that you have
for our listeners.
So I would say that your vote isyour voice.
And making sure that you know ifyou're registered, check it
online, you can.
You can also register the day ofvoting.
So make sure that you know that.
And look, look to see, do theresearch on the candidates that
(48:40):
are out there and see where theystand on some of these things.
Make a call.
See what happens there.
And then make sure that you'reconnecting with those advocacy
groups that again reflect yourvalues so that you can bring
your voice to some of thesearguments.
It's really, really important.
And last thing, consider runningfor office.
Yes.
(49:01):
Absolutely.
And we need more.
We need more.
All right.
Lieutenant Gary, I appreciateyou so much.
We are grateful for you makingthe time and thank you for all
the data.
I'll post a couple of videosthat you've done already to go a
little bit more into how a billbecomes a law, especially in the
state of Wisconsin, and we'll bein touch.
Thank you so much.
Thank you so much for having me.
(49:22):
I appreciate it.
Absolutely.
BadgerCare plus is the.
Largest Medicaid program in thestate of Wisconsin.
And it's estimated.
To provide healthcare insuranceto more than 900,000.
Low-income residents in the cityof Wisconsin.
More than half of.
I'm being children.
Expansion of Badger care would.
(49:44):
I would add as many as 90,000people to the program that are
not.
Currently at it.
And as Lieutenant governor,Sarah Rodriguez.
Has mentioned it would unlockadditional federal funding.
That.
It is currently being held up atthe federal level.
We are wasting tax.
Dollars we're leaving money onthe table.
It's estimated.
At$1.7 billion.
(50:06):
In savings would.
Be garnered from expansion ofBadger care.
In the state of Wisconsin.
And being an emergency medicinedoctor on.
The ground level of health care.
This would be invaluable.
Double for our patients.
We not only have strains in theemergency department.
In terms of the cares that wecan provide folks, especially.
(50:27):
When they have been withoutprimary care for so long and
without those Medicaid.
Occasions that they typicallywould otherwise take if they had
access to them or.
Or had access to primary care ingeneral.
But we're also in a.
Mental health shortage as well.
We don't have.
A number of facilities in.
The state.
In order to provide mentalhealth for all the patients
that.
(50:47):
I need it when they come to theemergency department.
At the worst.
Time.
Of their crisis.
We'll see.
The use of these funds forthings like Drug treatment
programs as well for folks.
Who are affected by.
The disease process.
That is substance abuseaddiction.
You'll hear a lot in theupcoming.
(51:08):
Upcoming days as I record this Ithink we're 10 days out now from
the national election.
So you're going.
To see.
A ton of ads on TV pointing afinger.
One way or the other.
Uh, in terms of who is at fault.
For things like the fitnesscrisis who's at fault for.
Crime, et cetera, et cetera.
(51:28):
In the state of Wisconsin andthroughout.
The country.
However, what I would challengeeveryone.
Who's listening to thisrecording to do.
Is to do your own research.
The point of.
This podcast is to provide.
And you that information and toprovide you information straight
from the sources.
From experts such as Lieutenantgovernor, Rodriguez.
(51:49):
And other.
Experts that we've had on overthe last several months.
In order to.
Help you make your ownhealthcare decisions and help
you make your own decisions.
When you are trying to choose.
Who is going to represent.
You.
At a state and at a federallevel.
A lot of the work that I've doneover the years has been to
promote.
(52:10):
Your ability to do that.
To make it so that.
Your vote counts and that youare choosing your
representatives and not theother way.
Around, as we mentioned duringthe interview.
I would challenge everyone whohas listened to this.
Not only to vote your heartvote, which, you know, Would
help your communities, youropinion matters regardless.
(52:30):
Make.
Sure that you are exercisingyour civic ability to the best
of your abilities.
Again, we are 10 days out from.
The national elections.
But as we said before, They'relocal elections are going to be
the ones that are going toaffect you the most.
Most.
And some districts, we haveassembly district.
Elections coming up.
(52:51):
We have Senate districtelections coming up as well.
And I cannot emphasize more.
The need for you to vote in.
In this election, I cannotemphasize how this election is
going to.
Have longstanding.
repercussions.
On your health and your wellnessof your communities.
So, if you haven't created aplan to vote early, voting has
(53:12):
started.
And the state of WisconsinOctober 22nd.
Be sure.
That you do.
So be sure that you take theinformation that you've gained
from this.
Series.
And do some further research onthe candidates that are.
On the top it is imperative thatyou're not only.
Make sure that you're registeredto vote.
But make sure that you aregetting your family members to
vote, make sure you're gettingyour friends to vote.
(53:33):
Because, regardless of again,how you vote.
Doing.
Doing so.
Is going to affect your healthin the long run.
The time.
To listen to this series.
Think.
Lieutenant governor SarahRodriguez for joining us today.
We will start back up.
Again, pretty soon.
With our regularly scheduledprogram.
(53:54):
We got some really goodinterviews coming up.
That are going to cover.
A broad spectrum of things thatare gonna affect you and it
gonna affect your health.
In the city of Milwaukee andinstead of Wisconsin, So would
that be inset?
as always take care ofyourselves, take care of each
other.
And if you need me.
Come and see me.
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