Citizen Action of Wisconsin’s Memo re: COVID-19 to Governor Evers

MEMORANDUM 

To: Governor Tony Evers Administration
From: Robert Kraig

RE: Brief Memo on COVID-19 Emergency Response Related to BadgerCare and Private Health Coverage
Date: March 21, 2020

On a Health Matters coalition call earlier this week, Jamie Kuhn, the Governor’s Outreach Director, requested from health advocates short bullet points on actionable policy proposals. 

Citizen Action of Wisconsin put out a press release on important policy options on Friday, based on the information available to us at the time.  As your administration is in much better position to have the latest information, and has the full expertice of state government to draw on, I am going to just distill our policy proposals, minus the public explanations and framing necessary for a news release.

The Governor is correct to strongly urge social distancing to slow down and contain the spread of COVID-19. Given the testing failure, however, many are already infected and the disease is in its incubation period, silently infecting many friends, coworkers, and family members. Some with symptoms are not seeking treatment due to fear of crippling health care costs. It is vital public safety to remove all cost barriers to testing and treatment. Statewide opinion research we released last week with the help of the Health Value Hub and Robert Wood Johnson Foundation shows that the fear of unaffordable costs deterred almost half of Wisconsinites from seeking needed medical care and treatment in the last year. Given the testing backlog this means making it clear through immediate policy change that both testing and treatment will be cost free with no out of pocket costs. When testing is available more widely, national and international experts think we will need to move to community-wide testing. This will also require a guarantee of no cost sharing for testing or treatment to induce younger and healthier people to seek testing even if they feel well. 

Citizen Action’s policies we propose are:

  1. Wisconsin has the authority to propose emergency waivers to the federal government, which can be approved within days of submission by CMS under federal emergency rules. A number of states have already proposed waivers and received approval. These waivers, if used to the full extent of the precedent set in previous national emergencies,  can make it much easier to enroll in BadgerCare and to retain it, including online and phone enrollment, extension of renewal deadlines, suspension of cancellations, and elimination of barriers such as premiums, copays, work requirements, and many other administrative hurdles and barriers. Critically, Wisconsin could adopt a “presumptive eligibility” policy that allows medical providers, community health centers, and others to enroll people in BadgerCare without any income test if they appear eligible. This is especially helpful in an environment where there are mass layoffs and it would be time consuming to confirm that a family was eligible when unemployment insurance claims are likely to overwhelm the state’s processing capacity. The Coronavirus Relief Act which passed Congress this week increases the federal share of Medicaid costs in Wisconsin to 65.5%, offsetting part of the state cost for expanding BadgerCare enrollment.
  2. The massive level of cost sharing in most private health insurance plans also deters people from seeking COVID-19 testing and treatment, endangering public health. A number of states already mandated that health insurance plans cover COVID-19 testing and treatment with no consumer cost sharing. So far, OCI has only recommended that insurers suspend copays and deductibles. It would be prudent for Wisconsin to actually ban cost sharing as a danger to public health, as according to Kaiser 3 states have done (as of Friday) for all testing and treatment and any future vaccine, and 10 states have done for all testing and a future vaccine. If this creates too much of a burden on health insurance and self-insured plans, Wisconsin could also outlaw hospital price gouging by requiring them to accept Medicare rates (or some percentage such as 150% of those rates) for all treatment for any condition that results from a COVID-19 test. There is no justification for hospitals and medical providers to charge unreasonable prices for their services during this state and national emergency. Most independent  Health care experts believe that negotiated private insurance rates in the U.S. are the most expensive in the world, and are not justified.
  3. Wisconsin should immediately expand BadgerCare by accepting the Medicaid Expansion authorized and funded by the Affordable Care Act (ACA). Without ACA Medicaid Expansion, “presumptive eligibility” will not work for many adults who do not fit into specific Medicaid eligible categories and are (or appear to be) above the federal poverty line. In addition, as Wisconsin is losing $340 million in the current state budget because it turned down the ACA Medicaid expansion funding, this revenue could immediately be deployed in the fight to contain COVID-19. Accepting Medicaid Expansion would allow Wisconsin to use presumptive eligibility to get the state close to universal health coverage and to reassure the public that cost should not deter them from seeking COVID-19 testing and treatment. It would also defray some and perhaps all of the state’s costs for increased enrollment resulting from all of the emergency measures we propose.
  4. Wisconsin should follow the State of Washington in seeking a waiver to expand Medicaid eligibility well above the ACA Medicaid expansion level of 138% of Federal Poverty Level. Citizen Action urges you to consider this for all of the reasons stated above, especially the effective use of presumptive eligibility to cover as many Wisconsinites as possible. Private insurance, unless you can effectively ban all cost sharing, cancellations and renewal requirements, is inappropriate for people who have little or no financial margin. Also it will be much harder to enroll people in private insurance than a streamlined BadgerCare enrollment process, and the Trump Administration has not as of yet even created a new special enrollment period for ACA marketplace plans for COVID-19. There is nothing magical about 100% or 138% of FPL, and they are not based in any way on the actual ability to manage and pay for private health insurance and medical cost sharing.

Emergency Powers Give Wisconsin Authority to use BadgerCare to Fight Coronavirus

For Immediate Release: March 20, 2020
Contact: Robert Kraig (414) 322-5324 robert.kraig@citizenactionwi.org

Emergency Powers Give Wisconsin Authority to use BadgerCare to Fight Coronavirus

Federal Emergency Declaration opens new avenues to guarantee everyone is tested and treated without cost sharing, fully covering all uninsured Wisconsinites

Statewide: Under pressure from a number of states seeking to stem the alarming speed of novel coronavirus transmission, the federal government late last week issued emergency regulations that would allow Wisconsin to use BadgerCare to guarantee that everyone in Wisconsin has health coverage during the pandemic. This would dramatically improve Wisconsin’s odds for slowing the coming pandemic by removing a major barrier to seeking testing and treatment. The federal government took similar steps during the H1N1 epidemic and in the aftermath of Hurricane Katrina.

If Wisconsin acts boldly and swiftly, this federal declaration gives the Wisconsin state government new power to slow the speed of the pandemic, and potentially save tens of thousands of lives. According to public health experts, one of the most critical things we can do to protect both the afflicted and the general public is to maximize the number of people with symptoms who immediately seek testing and treatment. COVID-19 is so contagious that delays in seeking medical care can lead to the infection of thousands of additional people. After we have tested and treated everyone with symptoms, and the federal government has addressed the shortage of testing kits, it is essential to test and treat community wide, because the disease is spread by seemingly healthy people without symptoms.

The fear of financially crippling health care bills in the profit-centered American health care system is a grave risk not only to affected individuals and their families but the entire community because it actually discourages people from seeking medical care.

The Coronavirus Relief Act passed by Congress this week guarantees free testing for COVID 19, which is a critical step forward, but is silent on the cost of any treatment for that disease or any other underlying illnesses discovered by testing. Without free treatment, many will be deterred from seeking medical help – especially people who lack health coverage, a rapidly expanding group in an economy experiencing mass layoffs!

A survey of 1,000 Wisconsinites in every corner of the state released last week by Citizen Action, in partnership with the Health Value Hub and the Robert Wood Johnson Foundation, found that nearly half of Wisconsinites have gone without needed medical care because of fear of the cost in the last year! This dangerous situation will be intensified by the large number of people losing their income during the pandemic. The affordability crisis in the American healthcare system is dangerous in normal times; during a pandemic, it is a deadly threat to the health of everyone in Wisconsin!

A preliminary analysis of the new emergency rules by Citizen Action of Wisconsin has identified two major steps Wisconsin can take to use BadgerCare to contain COVID-19. We also propose a third vital step that Wisconsin can take to make sure those who have private health insurance will not be deterred from seeking treatment due to unaffordable copays and deductibles associated with even the best American health insurance plans. Many of these proposals are already being pursued by other states. (The Evers Administration may be developing plans internally that are not yet public which include some of these proposals.)

Step 1: Wisconsin has the authority to propose waivers to the federal government, which can be approved within days of submission. These waivers can make it much easier to enroll in BadgerCare and to retain it, including online and phone enrollment, extension of renewal deadlines, suspension of cancellations, and elimination of barriers such as premiums, copays, work requirements, and many other administrative hurdles. 

Critically, Wisconsin could adopt a “presumptive eligibility” policy that allows medical providers, enrollment staff, schools, and community health centers to enroll people in BadgerCare without any income test if they appear eligible. This is especially helpful in an environment where there are mass layoffs and it would be time consuming to confirm that a family was eligible when unemployment insurance claims are likely to overwhelm the state’s processing capacity. The Coronavirus Relief Act which passed Congress this week increases the federal share of Medicaid costs in Wisconsin to 65.5%, offsetting part of the state cost for expanding BadgerCare enrollment.

Step 2: Wisconsin should immediately expand BadgerCare by accepting the Medicaid Expansion authorized and funded by the Affordable Care Act (ACA). Without ACA Medicaid Expansion, “presumptive eligibility” will not work for many adults who do not fit into specific Medicaid eligible categories and are (or appear to be) above the federal poverty line. In addition, as Wisconsin is losing $340 million in the current state budget because it turned down the ACA Medicaid expansion funding, this revenue could immediately be deployed in the fight to contain COVID-19. Accepting Medicaid Expansion would allow Wisconsin to use presumptive eligibility to get the state close to universal health coverage and to reassure the public that cost should not deter them from seeking COVID-19 testing and treatment. It would also defray some and perhaps all of the state’s costs for increased enrollment resulting from all of the emergency measures we propose.

Step 3: The massive level of cost sharing in most private health insurance plans also deters people from seeking COVID-19 testing and treatment, endangering public health. Our recent statewide survey showed that almost half of respondents had avoided medical treatment and services in the last year, and most of them had health insurance coverage. A number of states already mandated that health insurance plans cover COVID-19 testing and treatment with no consumer cost sharing. So far, Wisconsin has only recommended that insurers suspend copays and deductibles. It would be prudent for Wisconsin to actually ban cost sharing as a danger to public health. If this creates too much of a burden on health insurance and self-insured plans, Wisconsin could also outlaw hospital price gouging by requiring them to accept Medicare rates for all treatment that results from a COVID-19 test. There is no justification for hospitals and medical providers to charge unreasonable prices for their services during this state and national emergency.

“We need bold leadership now more than ever. This unprecedented public health emergency focuses our attention on the reality that we are all interconnected, and that leaving people out of our healthcare system risks the lives of everyone in the community,” said Robert Kraig, Executive Director of Citizen Action of Wisconsin. “Tens of thousands of Wisconsinites who could otherwise have avoided infection may be needlessly put at risk if we don’t come together to assure that no one in Wisconsin delays or avoids treatment because they can’t afford the high cost of healthcare.”

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Ron Johnson’s Opposition to Paid Sick Days Threatens to Delay or Weaken Coronavirus Response

For Immediate Release: March 16, 2020
Contact: Robert Kraig (414) 322-5324 robert.kraig@citizenactionwi.org

Ron Johnson’s Opposition to Paid Sick Days Threatens to Delay or Weaken Coronavirus Response

Statewide: Over the weekend Senator Ron Johnson’s made national headlines for his vocal opposition to sick leave provisions in the Coronavirus Relief Bill which passed the U.S. House of Representatives Friday with the full support of the Trump Administration. The bill is so essential to public health during this unprecedented global emergency, it passed on Friday on a bipartisan basis by an overwhelming vote of 363-40. The bill is now pending in the U.S. Senate.

Senator Johnson may be carrying water for major right-wing business interests such as Club for Growth and National Federal of Independent Businesses, who are putting their ideological opposition to paid family leave over the safety of the American people. According to news reports, Johnson may have influenced 4 GOP Congressmen from Wisconsin who voted against the coronavirus bill on Friday.

The paid sick days provision is designed to make sure that workers do not risk their jobs when they do the right thing by staying home when they are sick, to take care of loved ones, or to look after their children who are without school or child care. Johnson’s preferred solution is unemployment insurance, which means workers would be forced to choose between job loss and helping contain the coronavirus.

“Time is of the essence in containing a pandemic. Despite the loopholes in this bill that exempt too many big corporate employers, passing the Coronavirus Relief Bill immediately and as written is a public health necessity,” said Robert Kraig, Executive Director of Citizen Action of Wisconsin. “The bill also includes free testing, which is critical to containing the spread of this life-threatening virus. The clock is ticking, and if Senator Johnson’s obstruction delays or even waters down the bill, it could risk hundreds of thousands of lives.”

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Health Care Value Survey Shows Wisconsinites Concerned About Affordability and Quality of Care: Provides both statewide and regional data

For Immediate Release: March 11, 2020
Contacts: Claire Zautke, (414) 940-3375, claire@citizenactionwi.org
Robert Kraig (414) 322-5324, robert.kraig@citizenactionwi.org

Health Care Value Survey Shows Wisconsinites Concerned About Affordability and Quality of Care

Provides both statewide and regional data

Statewide: Nationally, consumer worry about health care affordability is well documented but now—for the first time—a new survey reveals how affordability concerns and ideas for action play out in Wisconsin. Altarum Healthcare Value Hub, a national nonpartisan research organization supported by the Robert Wood Johnson Foundation, in partnership with Citizen Action of Wisconsin, administered a Consumer Healthcare Experience State Survey (CHESS) in Wisconsin. The survey of more than 1,000 Wisconsin adults was conducted from October 29, 2019 to November 6, 2019. Among its results, the Survey found that:

  • More than half (53%) experienced healthcare affordability burdens in the past year.
  • Four out of five (79%) are worried about affording healthcare in the future.
  • Nearly half (47%) of people who needed health care during the year encountered one or more cost barriers to getting care, including skipped needed dental care (31%), delayed going to the doctor or receiving a procedure (27%), and did not fill a prescription (18%).
  • Health care was listed as a top issue that the government should address in the upcoming year by 73% of respondents. The next most frequently cited issue was the economy, selected by only 43% of respondents.
  • Across party lines, they expressed strong support for government-led solutions.

Dr. Robert Kraig, Executive Director of Citizen Action of Wisconsin, which brought Altarum’s CHESS to Wisconsin, offers the following quote:

“This devastating new report on the state of health care affordability in Wisconsin should be a wake-up call to Wisconsin lawmakers, who in the current legislative session devoted virtually no attention to addressing the skyrocketing cost of medical services, medications, and health insurance. The extensive opinion research that serves as the basis for this report is the first deep dive in many years into the lived experience of Wisconsinites in coping with our health care system. It establishes beyond all doubt that there is an affordability crisis in every region of the state. This crisis has reached a breaking point and demands bold and immediate action from state government. There are many critical data points in this report, which should be must-reading for all state policymakers. The top two, stunning findings that jump out for me the most are that nearly half of all Wisconsinites have gone without care or medications because they could not afford it, and that health care affordability is by far the top public issue, easily beating the economy and taxes.”

Below are links to Data Briefs with statewide and regional survey results.

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Federal Court Decision Threatens Health Coverage in Wisconsin

For Immediate Release–December 19, 2019

Contact: Robert Kraig (414) 322-5324 robert.kraig@citizenactionwi.org

Wisconsinites with pre-existing conditions, marketplace health insurance, at grave risk of having coverage taken away by right-wing federal judges

Milwaukee: Late yesterday, the unending drive by conservative politicians to rip health coverage away from millions Americans, and re-legalize insurance discrimination, came a step closer to tearing apart the health care system. A Republican dominated Fifth Circuit Court of Appeals panel ruled in favor of the Trump administration in Texas vs. United States, striking down the Affordable Care Act’s individual mandate. President Donald Trump and U.S. Attorney General William Bar are using the case as a vehicle for invalidating the entire ACA, including the popular protections against pre-existing condition discrimination. The judges, both Republican appointees, remanded the decision on the other elements of the ACA to the same right-wing lower court judge who already struck it down last year. 

This morning, Citizen Action of Wisconsin teamed up with Wisconsin Attorney General Josh Kaul and Protect Our Care to hold a media briefing on the implications of this development for Wisconsin. You can listen to the entire media call here. Speakers made the case that judicial action invalidating the ACA is a clear and present danger.

In addition, Citizen Action is urging lawmakers to codify the ACA’s consumer protections and health insurance regulations in state law to protect Wisconsinites in the event of a damaging U.S. Supreme Court decision. Senate Bill 37, sponsored by Sen. Jon Erpenbach, is a huge step in this direction. Citizen Action is also urging lawmakers to create a plan, triggered by an adverse court decision striking down the ACA, to replace marketplace plans for people who buy insurance on their own and the federal subsidies that make them more affordable.

If the ACA was struck down the following provisions would be eliminated from federal law:

      • Guaranteeing coverage to individuals with pre-existing conditions, impacting an estimated 852,000 to 2.436 million Wisconsinites.
      • Prohibition of price discrimination against individuals with pre-existing conditions. In Wisconsin without this protection a patient with a pregnancy could be charged $17,060 more, and someone with metastatic cancer could be charged $140,510 more.
      • Free coverage of preventative care such as mammograms and colonoscopies for 2,804,258 Wisconsinites.
      • Mental health parity.
      • Prohibition of gender discrimination in coverage and pricing.
      • Prohibition of age discrimination in pricing, the so-called “age tax.” 
      • Prohibition of lifetime and annual care limits.
      • Protections against junk health care plans by requiring that all essential health benefits be covered.
      • Substance abuse coverage.
      • Resources and funds to hold insurance companies accountable to regulation.

In addition, 153,000 Wisconsinites would have their health coverage taken away if the ACA was struck down, according to a recent study by the Urban Institute. 

Milwaukee resident Megan McGee, who lives with pre-existing conditions, described her reaction to the ruling and the threat to the ACA: “I’ve had back problems and birth complications. I’m told there are no long-term effects of either. But will insurers care? Without the ACA, could I get kicked off my insurance plan? When I think about the possibility of the ACA being overturned, I don’t worry about one thing. I worry about many things: what will happen to me, my 2 year old, a family member who is mentally ill, and my 2 employees.”

“The federal court nullification of the ACA is a predictable human-made disaster that would wreak havoc with the lives and livelihoods of hundreds of thousands of Wisconsinites,” said Robert Kraig, Executive Director, Citizen Action of Wisconsin. “We urge state lawmakers to take action to put the popular federal protections against pre-existing condition discrimination and other insurance industry abuses in state law, and beyond the reach of activist federal judges.”

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Citizen Action Statement on Introduction of National Prescription Drug Reform (H.R. 3)


For Immediate Release: September 19, 2019
Contact: Robert Kraig, robert.kraig@citizenactionwi.org, (414) 322-5324

Citizen Action Statement on Introduction of National Prescription Drug Reform (H.R. 3)

photo by: www.weisspaarz.com.

Milwaukee: Today U.S. House Speaker Nancy Pelosi unveiled a bold new proposal to curb prescription medicine prices through negotiations, new penalties for non-compliant drug companies and international price indexing. Citizen Action of Wisconsin Executive Director Robert Kraig made the following statement in response to the Lower Drug Costs Now Act (H.R. 3) announcement:

“We’ve heard a lot of promises from politicians about lowering drug prices, but so far there’s been limited meaningful action at the Federal level. Speaker Pelosi’s H.R. 3 is a major step in the right direction. It would require prescription drug corporations to actually negotiate drug prices with government or pay a penalty. The proposal also levels the playing field between the cost of medicines in the United States and other comparable nations, where people pay much less for the same drugs. While it doesn’t solve every problem, this bill is great news for millions of people in our state and around the country who struggle to afford medicine because the drug corporations have kept prices high and put medicine out of reach for patients. Every lawmaker in Congress should stand up in support of this critical first step to comprehensive prescription drug reform.”

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Highlighting the Human Face of BadgerCare Expansion

For months now, Citizen Action of Wisconsin has been fighting for BadgerCare expansion. And although expansion did not happen in the budget, we are not done fighting. 

Earlier this summer, Governor Tony Evers, Senator Jon Erpenbach, and Representative Daniel Riemer introduced BadgerCare expansion legislation. We are under no illusion that the bill’s path forward will be easy. So far, Republican legislators have been unwilling to publicly support expansion, even if they are open to the idea. That is why we are redoubling our efforts to highlight the real-life consequences of failing to expand BadgerCare, and the ways in which our neighbors and community would benefit from expansion.

At Citizen Action, we know that the way to move hearts and minds on this important issue is to put the human faces of BadgerCare expansion front and center. Take, for example, the story of our Co-Op Organizer Noah Reif. When the expansion bill was introduced in August, Noah told us her story and explained why she supports expansion: 

“BadgerCare expansion would mean almost 1,400 hard-working Eau Claire County residents would be eligible to receive quality, affordable care. As an individual, I benefited from state health insurance plans when I was diagnosed with type 1 diabetes at 2 years old. Simply put, I would not be here if not for Wisconsin’s investment in me and my family. BadgerCare expansion is an opportunity to extend that life-saving investment to other people like me who need it.”

If you have a health care experience that you would like to share with us, please reach out to our organizer Mireya Mercado at Mireya@citizenactionwi.org

Here are some of the ways that BadgerCare expansion would help Wisconsinites:

  • Improve access to preventative care and save lives: Reducing the number of people without insurance means more people can receive preventative care. Not only does this make our health care system more effective and affordable for everyone, but it helps prevent unnecessary deaths – especially those caused by disease, accidents, injuries, and drug abuse.
  • Reduce insurance coverage disparities: The Affordable Care Act cause significant gains in health care coverage among Wisconsinites. However, significant racial disparities in coverage still exist in our state. For example, Latinx Wisconsinites are uninsured at rates three times higher than the state’s White residents. Expanding BadgerCare eligibility to 138% of the Federal Poverty line would go a long way in reducing this disparity.
  • Improve health care coverage for children: When Scott Walker forced tens of thousands of parents off BadgerCare in 2014, the number of uninsured children living above the poverty level increased sharply. Wisconsin was once a national leader in insuring children. With BadgerCare expansion and an investment in children and families, we could be again.
  • Prevent financial hardships for low-income, working adults and families: The Legislative Fiscal Bureau estimated that over 80,000 additional adults would be covered by BadgerCare if the program were expanded up to 138% of the Federal Poverty Line. Many of the individuals who would benefit from expansion are eligible for marketplace or employer-sponsored insurance under the current system, but cannot afford the premiums, deductibles, or copays of the plans available to them. Every day, people are forced to choose between paying for health care coverage, or necessities like food, housing, and other bills. Choosing health care over other needs can be a terrible financial burden. Expanding BadgerCare would help ease that burden for tens of thousands of Wisconsinites.

We believe that everyone in Wisconsin ought to receive and be able to afford high-quality health care when they need it. We also know that many people in our community face tremendous barriers to receiving the health care they deserve. At Citizen Action, we are working hard to elevate the needs and voices of those individuals. 

If, like us, you believe that health care is a human right and you want to help us put a human face on this issue, please consider joining one of our Organizing Co-ops.

Lower Drug Prices Now!

Prescription drugs are integral to our health care system and most medical treatments. People across Wisconsin depend on prescription drugs, whether in their everyday lives or for lifesaving treatments. And yet, recent years have seen the prices of many prescription drugs skyrocket. Prescription drug prices jumped 10.5 percent over in just the first six months of 2019–an increase four times greater than inflation.

High prices put essential drugs out of reach for many Americans. Nearly three-in-ten people in the United States report not taking medicine as prescribed because of the cost. This includes not filling a prescription, taking an inappropriate alternative treatment, and cutting pills in half or skipping doses.  

Furthermore, an estimated quarter of people with diabetes lower or skip doses because they cannot afford the insulin that keeps them alive. 

The consequences of these actions are dire. Nationally, lack of medication adherence accounts for up to half of all treatment failures and one-quarter of hospital and nursing home admissions.

While cost of the four most popular types of insulin tripled within a decade and forced patients to ration care, Eli Lily–the nation’s largest insulin producer–continued to reap billions of dollars in revenue. In 2018 alone, Eli Lilly brought in $9 billion in revenue from their diabetes medication while paying $0 in federal income taxes under the Trump tax law.

Drug companies are more interested in preserving their profits and monopoly power than our health and well-being. Drug companies spent $172 million on lobbying in 2018–more than any other industry–to protect their monopolies and protect their power to dictate prices. In fact, Trump’s new North American Free Trade Agreement deal (NAFTA 2.0) could raise drug prices on many widely used drugs, including vaccines and some newer cancer treatments, by preventing competition from generic drugs and handcuffing Congress’ ability to enact policies to reduce prices.

Prescription drug companies often justify their soaring prices with claims that investment in new, life-saving medicines costs money. But that claim is false. Big Pharma companies spend far more on marketing than they do on research and development. Instead, it is taxpayers like us who fund the development of new drugs. Taxpayer-funded research through National Institutes of Health contributed to every one of the 210 drugs approved between 2010 and 2016, and the U.S. federal government is the world’s largest funder of biomedical research. 

Yet, many Americans cannot afford the life-saving medicine their tax dollars help to develop. 

That’s why Citizen Action of Wisconsin is a proud member of the national Lower Drug Prices Now campaign. The campaign demands that Congress put people over Pharma profits by adopting comprehensive reform of the pharmaceutical industry. 

If you want to join our fight against Big Pharma, join your local Citizen Action of Wisconsin co-op!

Wisconsin’s Caregiver Crisis

Between 2016 and 2026, the direct care workforce will grow more than any single occupation in the country, and more than 7.8 million direct care job openings will need to be filled in the United States. In Wisconsin, the number of Home Health Aide and Personal Care Aide positions are both projected to increase by 30 percent, requiring an additional 21,300 workers.

However, direct care jobs often offer low compensation, no paid leave or guaranteed health care, and minimal training or support. In 2018, the national median hourly wage for a direct care worker was only $11.83, less than $25,000 per year for a full-time worker. But 1 in 3 workers worked only part-time or part-year, making the national median income for direct care workers only $19,100. And, only about half of all caregivers receive health insurance from their employer.

In Wisconsin, the median hourly wages of Home Health and Personal Care workers are only $11.66 and $11.43, respectively.

As a result, many workers leave direct care or choose not to pursue these jobs at all.

Devaluing of these critical positions also reinforces race, class, and gender economic disparities. Of the 4.3 million direct care workers in the United States, 87% are women, 57% are people of color, and 25% are immigrants.

The growing demand for caregiving and poor quality of direct care jobs has created a shortage of care workers and unaffordability of caregiving services. However, the State of Wisconsin can ensure that long-term care services and supports remain affordable and accessible to people who need them through strategic investments. Citizen Action of Wisconsin supports investing in caregivers through:

  • Higher, family-sustaining wages

Many direct care workers live paycheck-to-paycheck. Nationally, low wages are a primary reason cited by direct care workers for leaving these roles—particularly in economically stable times, when candidates for direct care jobs might instead choose to pursue less arduous, better-paying jobs in other industries. Higher wages are needed to attract job-seekers, retain works who would otherwise leave the profession, and improve the financial security of workers.

  • Guaranteed health care coverage

Nationally, fewer than half of direct care workers outside of nursing homes receive health insurance from their employer. Purchasing health insurance on the private market can be cost prohibitive for workers earning less than a living wage. Guaranteed health care coverage would raise the value of direct care professions and help attract and retain workers.

  • Guaranteed paid leave

Guaranteed paid leave for direct care workers would also increase the desirability of these jobs. Care workers would also be able to afford to take time off from work for their own families’ care needs, such as caring for an ailing relative or new child.

  • Pathways for professional development

Career advancement opportunities in direct care enable workers to take on more expansive and satisfying roles, which can reduce turnover and make the job more competitive with other comparable industries. Additionally, some research has found that when direct care workers take on advanced roles, they improve care for clients, reduce unnecessary emergency room visits, and potentially save health care costs. Advanced roles can be created to: aide clients with care coordination and transitions; support clients with complex chronic conditions; assist with clinical observation and reporting; educate clients on health promotion and medication adherence; mentor newly hired aides; and help with entry-level training.

  • Enhanced training and professional support for workers

A well-prepared direct care workforce will ensure that workers have the skills, knowledge, and confidence to succeed in their roles—and that older people and people with disabilities receive high-quality supports. Increased funding for training programs and professional supports from the state can help care workers and agencies feel more respected and valued.

 

If you want to support our work on this important issue, please join one of our organizing co-ops!

 

National data and content from “Workforce Matters: The Direct Care Workforce and State-Based LTSS Social Insurance Programs” by Robert Espinoza, Stephen Campbell, and Kezia Scales, PHI and Caring Across Generations, 2019. Wisconsin data retrieved from the Bureau of Labor Statistics on September 4, 2019.