There is a lot to get excited about in this budget. Our Policy Team has made their way through the nearly 600 page documents and here is out top 5 list:
 
BadgerCare Expansion: Governor Walker and the Republicans callously rejected federal funds available to Wisconsin under the Affordable Care Act (ACA). This budget expands BadgerCare to cover an additional 83,000 Wisconsinites while saving taxpayers $834 million over the next 6 years. Because low-income, uninsured women and more likely to forego healthcare and preventative services because of costs, this is a necessity for Women in Wisconsin.

Healthy Women, Healthy Babies Initiative: Wisconsin’s infant mortality rates for African-American babies are the highest in the nation. This budget includes a $28 million investment to support healthier pregnancies and births, including funds to pilot a Medicaid doula reimbursement program.

Focus on Childcare: Finding affordable, quality child care is one of the biggest hurdles for getting and keeping a job. This is particularly true for women as primary care givers. This budget includes a $376.9 million increase in child care subsidies and focuses on economically disadvantages areas. 
 
Repeal of harmful hurdles: This budget fixes some serious abuses of power that Walker and the Republicans jammed in the lame duck session. This budget restores the ability of our Attorney General to settle cases and eliminates the legislatures ability to intervene in lawsuits.

Local Preemption Repeal: This budget repeals the prohibition that prevents local government from passing paid family leave and other local initiatives. While we strongly believe paid family leave should be a statewide initiative, this repeal would allow local governments to lead the way until our legislature is willing to enact real change for all Wisconsin workers and families.  

 
WAWH will be advocating for these and other important budget items that align with our vision: Every Wisconsin woman - at every age and every stage of life - is able to reach her optimal health, safety and economic security. These items must not be taken out of the budget.
 
What can you do?

• Call or e-mail your state legislators and ask them to keep these items in the budget. Let them know how you feel and why this is important to you. www.supportwomenshealth.org/know-your-legislators.html
• Follow our more in-depth budget analysis at https://www.wawhbudgetproject.org

Governor Evers Budget Prioritizes Real People Living Real Lives
 
Statement from Sara Finger, Executive Director of the Wisconsin Alliance for Women’s Health (WAWH):
 
“Last night, attending Governor’s Evers budget address with my 9-year-old daughter, I felt so proud to share with her such a kind and strong message of respect for the needs of real people. We have a Governor listening to what people need and tackling the tough issues long neglected.
 
“Governor Evers’ plan to expand BadgerCare is one of the most cost-effective ways our state can help families. There are people in every corner of our state that don’t have access to affordable healthcare. Governor Walker and the Republican-led legislature played a callous political game when they refused federal funds available under the ACA to expand BadgerCare. Governor Evers is providing a path where an estimated 83,000 Wisconsinites would gain access to health insurance coverage under BadgerCare.
 
“From doula reimbursement to infant mortality prevention to revitalizing the well woman program, this is a budget to be excited about. The Wisconsin Alliance for Women’s Health supports Governor Evers strong measures that shift the state focus to proactive solutions to improve the lives of women and girls in Wisconsin”.

Today, the Wisconsin Alliance for Women's Health released this statement in response to the Trump-Pence administration issuing a Title X gag rule. This rule would ban health care providers receiving Title X family planning funds from providing patients with all pregnancy counseling options or referrals for abortion care.  This latest attack is strongly opposed by the medical community. This rule will take effect in 60 days if unchallenged.
 
“The Trump-Pence Title X Gag rule requires healthcare professionals to censure what medically accurate medical information women are allowed to receive during their visit. The last thing women need is for President Trump to play doctor and decide what information they are or are not entitled to hear at their visits.
 
“This is another patriarchal political stunt by the Trump-Pence administration that takes medical decision-making power away from women. This administration is playing a dangerous game with women’s health to satisfy their dwindling base.  
 
“Wisconsin Alliance for Women’s Health strongly supports a woman’s right to make their own health decisions. We will continue to work to ensure all women have access to healthcare and access to medically accurate information. We vehemently oppose the Trump-Pence Title X Gag rule.”

MADISON – Wisconsin Alliance for Women's Health (WAWH) Executive Director, Sara Finger, released the following statement on February 7, 2019:
 
“Recently, and especially in the past 48 hours, we have witnessed a malicious disinformation campaign, advanced by anti-abortion activists who seek to make abortion illegal and stigmatize women and doctors. President Trump parroted blatant falsities about abortion care during his State of the Union address, using inflammatory language to score needed political points. Yesterday we saw Rep. Robin Vos and Assembly Republicans follow suit by staging a press conference in Madison to make their own inflammatory claims that are flat out false and offensive to women who face pregnancy complications. It’s important to remember that the people spreading this misinformation have one motive in mind -- to ban safe, legal abortion in this country.”
 
“While I don’t appreciate the artifice that was behind yesterday’s media stunt, I welcome this opportunity to talk reproductive rights and abortion laws in Wisconsin. Here in Wisconsin we have an archaic 1849 law on the books that criminalizes abortions. The U.S. Supreme Court is now controlled by an anti-abortion majority following the appointment of Justice Kavanaugh and the future of Roe v. Wade is uncertain. If Roe is overturned, then our 1800’s law kicks in, abortion becomes illegal in Wisconsin and doctors in Wisconsin could face jail time.”
 
“The Wisconsin Alliance for Women’s Health strongly supports a woman’s right to make her own health decisions. We will continue to work to ensure all women have access to healthcare and access to medically accurate information. We all deserve the rights, freedoms, and opportunities to control our lives at the most basic level: our bodies, our families, and our futures--and that requires the right and ability to have an abortion. It is disrespectful and dangerous that a body of mainly white male legislators without healthcare backgrounds believes they are entitled to dictate a woman’s personal healthcare decisions to score political points. Anti-abortion zealots will do anything to push their agenda to ban safe, legal abortion in this country — including making things up and making outlandish accusations that are not based in fact or medical science. These claims are horrifying and offensive.”
 
Facts:

• In 1849, Wisconsin made it a felony to have or provide an abortion. While that law became unenforceable after Roe v. Wade, Wisconsin never took its criminal abortion ban off the books. This law does not have exceptions for rape, incest, or the health of the mother.
• In 1973, the Roe v. Wade case declared the US Constitution protects the right to have an abortion.
• In 2016, in Whole Woman’s Health v. Hellerstedt, the Supreme Court added that while states can regulate abortion, those regulations have to benefit patient health more than they burden their access.
• Only 3 out of 131 Wisconsin state legislators have healthcare backgrounds and there are 95 men and 36 women in the State Legislature.

Last summer, the Pew Charitable Trust released a comprehensive report that analyzed Wisconsin’s existing substance use disorder (SUD) treatment systems and public policy landscape. The report includes 25 policy recommendations, several of which pertain to providing SUD treatment to pregnant and postpartum women.

Most importantly, the report acknowledges the barriers to pregnant women seeking treatment in Wisconsin that are posed by Wisconsin’s Act 292, which was passed into law in over 20 years ago and is commonly referred to as the “Cocaine Mom” law. This law gives the state almost unprecedented power over pregnant women who use or have admitted to past use of any amount of alcohol or a controlled substance. There is widespread agreement among medical professionals and advocates that the law deprives pregnant women of basic rights and ultimately undermines maternal, fetal, and child health.

Before getting into the specifics of the Pew report, some details about the specific provisions of Act are needed to provide context for why the law serves as a barrier to pregnant women accessing the medical care they need. An excerpt from and article written by WAWH Executive Director, Sara Finger, outlines the most relevant provision:

Under this law, pregnant women who are thought to use alcohol or drugs may be subjected to forced treatment without any proof that it is safe or even helpful for the pregnant woman or her future child. It gets worse. If the woman refuses the forced treatment, a court can then hold her in contempt and incarcerate her in a county jail, where she is likely to be denied access to pretty much everything recommended for pregnant women including healthy foods, and access to prenatal and other health care. The state can also begin proceedings to terminate her parental rights before she even gives birth. And while the state appoints a lawyer to represent fetuses at all stages of such proceedings, the woman has no right to counsel at important preliminary hearings where her rights are at stake.

In 2017, a federal district court initially struck down Act 292 on constitutional grounds, but the case was eventually dismissed by a federal appellate court because the plaintiff eventually left the state.

While the Pew report does not explicitly call for the full repeal of Act 292, it does state that clinicians and patients “report that this policy serves as a barrier to SUD treatment for pregnant women by potentially discouraging individuals from seeking SUD treatment for fear of repercussions” and that “[t]his barrier potentially puts pregnant women and their child at greater risk of harm than they would be if this policy did not exist.”

Pew does generally suggest that the Legislature make changes to state law to make it easier for pregnant women to “seek and receive evidence-based treatment,” which can certainly be interpreted to mean making changes to Act 292. The report says that state agencies work to address misunderstandings about Act 292 among clinicians, social service agencies, and law enforcement. Finally, Pew recommends that the Department of Health Services issue guidelines for health care providers that receive any type of public funding to align with best practices regarding the education, screening, and treatment of childbearing age women regarding SUD’s. 

In addition to recommendations regarding prevention and treatment for pregnant women, the report suggests several policy changes to improve SUD care for postpartum women, including:

• Earlier delivery of postpartum SUD care, ideally before the first regularly scheduled postpartum visit
• Integrating traditional postpartum care and SUD treatment programs, which could be accomplished through co-locating family planning, breastfeeding, psychiatric services, and home visiting programs.
• The Department of Health Services and Legislature should consider incentivizing such policies.

It is encouraging to see these critical issues regarding the intersection of the opioid crisis and women’s health finally being brought to the forefront by respected, nonpartisan organizations like Pew. WAWH is hopeful that this is indicative of a larger shift in the Wisconsin policy landscape regarding substance use disorders that will begin to prioritize patient health, medical evidence, and individual autonomy over the urge to promote the punitive policies that have helped land Wisconsin in its current predicament with opioid addiction.
If you’re interested in learning more about the background of Pew’s Substance Use Disorder Treatment Policy Recommendations for the State of Wisconsin, you can view the full report here.

Prior to the passage of the ACA, insurance companies were allowed to discriminate against women due to our unique health needs. Insurers could deny coverage to women if they had been pregnant, had fought and survived cancer, or even if they had suffered domestic violence. In many cases, health plans didn’t even cover maternity care.

If the ACA is overturned, then women could be denied coverage based on their medical history, their age, and their occupation, among other factors. As a result, women could be charged more, or priced out of the insurance market altogether. Insurance companies could also try to reinstate gender rating, a common pre-ACA practice in which insurance companies charged women higher premiums than they did men, even though other parts of the ACA protect women from discrimination in the health care system.
 
The gravity of what the loss of coverage for women and girls would look like, should ACA be repealed, makes it paramount that we speak out against our state legislature supporting anything that could lead to reduced coverage. That's why this week, we weighed in on a GOP authored bill - Assembly Bill 1 - that claims to addresses coverage of preexisting medical conditions in our state.
 
It's important to note that under the direction of former Governor Scott Walker, Wisconsin joined this multi-state lawsuit to overturn the ACA. In December, a Texas District Court judge held that the ACA is unconstitutional in Texas v. Azar. As this case makes its way through the appeals process, the ACA remains the law of the land.

Despite Wisconsin’s voters speaking out loud and clear in November by electing state-wide officials who campaigned on a promise to withdraw Wisconsin from the ACA lawsuit, the Republican-led Legislature rejected the outcome of the November elections and voted to force the state to remain as plaintiffs in Texas v. Azar, threatening coverage for many Wisconsinites.

And with recent actions and actions taken over the past eight years to sabotage the ACA while the GOP has held a super majority in our state, now the Republican controlled legislature is attempting to show interest in protecting coverage for Wisconsinites.
 
Unfortunately, their proposal, AB1, does not guarantee insurance for people with preexisting conditions in the same capacity as the ACA, nor does it address other very important issues of coverage -- including essential health benefit mandates such as maternal care. AB 1 does not address lifetime coverage limits, preventative care, consumer protections, or bar discrimination based on gender. During the Assembly Committee on Health’s January 15, 2019 hearing, the bill authors testimony made it clear that they were not interested in expanding the scope of AB1 to include expanded coverage. Without the broader protections and subsidies of the ACA, AB1 does not protect enough people—and could actually lead to harmful unintended consequences, including higher costs.
 
Northern District of Texas Judge Reed O'Connor's December ruling didn't just put protections for preexisting conditions at risk, it attempts to throw out the entire law, including the subsidies that help Wisconsinites afford coverage. AB1 would not close the gap in coverage that will open up should ACA be repealed through the courts.
 
Our state legislative leaders are in a unique position to work to ensure that Wisconsinites continue to be covered and protected in an affordable and comprehensive manner. Rather than enact this inferior talking-point bill, the Assembly should instead focus on withdrawing Wisconsin from the lawsuit and join the numerous attorney generals seeking to uphold the ACA's framework. Such action would allow the Assembly to proudly take ownership for protecting coverage for Wisconsinites and would have the full support of the Wisconsin Alliance for Women’s Health.  AB1 is no substitute for the ACA.

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All health insurance plans should cover all basic health services for women, including birth control, abortion, pre-natal care, childbirth and post-partum care. Yet, merely a day after voters made clear that health care is a top priority, the Department of Health and Human Services released a Proposed Rule designed to take abortion coverage away from individuals who get their insurance through the ACA marketplace.

The Proposed Rule is designed to eliminate coverage of abortion altogether.

• The Proposed Rule would drastically expand the burdensome and arbitrary accounting requirements imposed on qualified health plans that cover medically necessary abortion. This would impose significant barriers on insurance companies and on consumers who need a comprehensive health plan that covers abortion.
• These proposed barriers are likely to cause insurance companies to stop providing insurance coverage of abortion. Indeed, insurance issuers have said that barriers like the ones being proposed would be onerous and act as a strong disincentive to covering abortion.
  
• The impact of the Proposed Rule could reach well beyond the marketplace, causing insurance companies to drop abortion coverage in other markets as well.
• The Proposed Rule is the latest attempt by the Trump-Pence Administration to eliminate private insurance coverage of abortion altogether.