Budget Repair and "The Waiver"

In autism circles in Wisconsin, it's often (and not-quite-accurately) referred to as "The Autism Waiver."

It's a section within a the Children's Long-Term Supports (CLTS) Waiver, allowing Wisconsin to use Medicaid dollars for intensive autism treatment.

My daughter received two years of intensive autism therapy through the autism section of the CLTS waiver and now has funding available through a different section of the waiver for things like respite, home modifications (like a plexiglass layer on our picture window so she doesn't bang her head through it), and more. The postive impact on her progress and on our lives has been astonishing.

"The Waiver" is subject to be changed/slashed without notice or hearing if the Walker budget-repair bill passes -- and it just passed the Joint Finance Committee last night, along party lines.

I wrote yesterday about the process part of how the cuts could be made. Today I want to emphasize that the intensive autism therapies are absolutely a part of this, even if the bill doesn't mention them by name.

Here's what kind of changes the Walker appointees in the Wisconsin Department of Health services would be empowered to make to MA and MA Waivers, affecting the autism community AND the broader disability community AND people with low incomes.

-- cost sharing could go up to the full extent allowed by federal law, and if people couldn't pay, they could be denied services.
-- modify existing benefits (as much as they want, as far as I can see!)
-- change eligibility standards
-- revise how providers get reimbursed
-- and more!

Again, as I wrote yesterday -- after the bill passes, this can all happen without public hearing, without public notice.

This analysis comes from a summary of the bill released by the non-partisan Legislative Fiscal Bureau on Tuesday, on page 8 & 9.

The version that passed the Joint Finance Committee was amended to sunset the power to make these sweeping cuts by emergency rule: They'll only be able to work this way until January 2015. When Scott Walker's current term comes to an end. So any new administration would not be able to use the new emergency-rule process to undo the damage.

You should also be aware that the new Secretary of the Department of Health Services, Dennis Smith, is no friend of Medicaid. He has written in the past, during his tenure with the Heritage Foundation, advocating that states should DROP MEDICAID ENTIRELY. This is who will be in charge of the changes.

Time is short. The bill could pass within days, and the only issue that's making the news, that most people know about, is the union-busting part. Even if the unions are saved -- which I surely hope happens! -- the assault on Medical Assistance and the MA Waivers will go through untouched unless somebody starts noticing.

Make some noise, people! This is HUGE and it's happening RIGHT NOW!

P.S. The TinyURL for this post is http://tinyurl.com/4cnqmyx -- please tweet widely.

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Reiterating my new disclaimer (though it's always been true): I am expressing my own personal opinions, which are not to be construed as representative of any organizations or associations to which I may belong.