For the next week or so, the Department of Health Services (DHS) will have the power to make changes in Medicaid and BadgerCare policy that conflict with state statutes, by adopting rules that may supersede the statutes. That power took effect after the State Supreme Court overturned the ruling that had blocked implementation of the budget repair bill (Act 10).
Sometime next week the Governor will sign the biennial budget bill, which will repeal the Medicaid provisions in Act 10 and will replace them with similar provisions that remove the requirement to adopt rules to change key elements of Medicaid and BadgerCare. That change removes the only assurance that there would be a public hearing before the DHS Secretary pronounces policy decisions changing state law. The rulemaking requirement is replaced with a requirement that before DHS seeks federal approval of a plan amendment or waiver that would lead to a change conflicting with state statutes, it must submit the proposal to the Joint Finance Committee for review. The sweeping new authority granted to DHS will expire in January 2015.
This week WCCF released a one-page comparison of the Medicaid policy-making changes in Act 10 with those in the biennial budget bill. We also updated a comprehensive paper explaining the shift in authority for Medicaid policymaking, and some of the potential changes.
For further commentary on this issue see the next blog post.
Jon Peacock