Analysis Politics

Wisconsin Governor Candidates Battle Over Obamacare, Economy, and Sexual Health

Nina Liss-Schultz

As the race for governor heats up ahead of the November election, incumbent Gov. Scott Walker has consistently aligned himself with the Republican Party and against the clear front-runner among Democratic primary candidates, Mary Burke, on issues like Medicaid, the Affordable Care Act, and the economy.

When Mary Burke announced her candidacy for governor of Wisconsin in October 2013, she accused her incumbent opponent, Scott Walker, of pandering to the Republican Party instead of helping the state’s residents. “Our state capital has become so focused on politics and winning the next political fight, it’s pulling our state apart and our economy down,” she said.

Now, as the race for governor heats up ahead of the November election, Burke, who has made herself the clear front-runner among Democratic primary candidates, has stuck with that sentiment and used it to leverage her own message, highlighting how she differs from her opponent. Similarly, Walker, whose name has been thrown in as a possible GOP contender for the 2016 presidential race, has consistently aligned himself with the Republican Party and against Burke on issues like Medicaid, the Affordable Care Act, and the economy, which are becoming central to each candidate’s election strategy.

Economy

Only a month after assuming office in 2011, Walker, who served in the Wisconsin assembly for almost a decade starting in 1993 and then as the Milwaukee County executive until 2010, proposed a budget bill that was perhaps simultaneously his most controversial and influential piece of legislation. The budget that would come to define his term as governor and influence legislatures across the country, including in Ohio, Missouri, and Oregon, not only cut millions of dollars from education funding, but also effectively obliterated public employees’ collective bargaining rights.

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When Walker made it to the governor’s mansion in 2011, Wisconsin, a rust-belt state hard-hit by the Great Recession, faced on enormous budget deficit, estimated by him as $137 million and projected to grow to $3.6 billion during his term.

Gov. Walker’s budget fix, known as Act 10, axed collective bargaining by limiting government employee negotiations only to wages and not other benefits, doubled the health-care premiums paid by state employees, and required some unions to renegotiate contracts each year.

“I’m just trying to balance my budget,” Walker told the New York Times in 2011. “I don’t have anything to negotiate with. We don’t have anything to give. Like practically every other state in the country, we’re broke. And it’s time to pay up.”

Tens of thousands of Wisconsinites protested the bill and its passage at the state capitol, and Democratic and labor leaders gathered over 900,000 signatures for a recall election, making Walker just the third governor in U.S. history to face recall. After Gov. Walker introduced the legislation in 2011, 14 Democratic senators fled to Illinois from Wisconsin, to protest the bill and avoid a vote on it. The Madison teachers’ union and one representing Milwaukee public schools sued the state over Act 10.

The bill was eventually passed, and Walker survived the recall election, making him the only governor ever to do so. Last month, the Supreme Court of Wisconsin ruled against teachers unions and upheld Act 10.

Burke, who “supports the rights of workers to collectively bargain,” has pushed to make a name for herself—in opposition to her opponent—as an experienced financial manager able to balance budgets. Though Burke has only held one elected position—on the city of Madison school board—she is well-known in the state as the executive of the Trek Bicycle Corporation, originally founded by her father. In 2005, she was appointed by Gov. Jim Doyle (D) as state secretary of commerce, a position she held for two years.

Gov. Walker has criticized Burke’s economic track record, with varying success. This year, the federal government asked the Walker administration to repay several million dollars in grant money, which the federal government says were improperly awarded under Burke’s leadership as the secretary of commerce. Three grants awarded by Burke, including one $12.3 million grant given to Abbott Laboratories, have come under federal scrutiny because they did not meet the requirements of the grants developed by the Department of Housing and Development (HUD). For example, according to an investigation by WisPolitics.com, HUD found that a grant issued to Juneau County in 2006 didn’t meet federal standards because though the grant helped create jobs, it did not directly benefit low-income individuals.

According to the Milwaukee-Wisconsin Journal Sentinel, Alleigh Marre, a Walker campaign spokesperson, has said that the grants are just one example of Burke’s failures as secretary of commerce. “Seven years later Wisconsin taxpayers are still on the hook for millions of dollars as a result of Burke’s bad and careless decisions,” Marre said. A Burke spokesperson countered that she “makes no apologies” for granting the money, and that the grants created jobs.

In February, Burke said during a talk-show interview that she would support raising the minimum wage to $10.10, a plan that Walker called “political grandstanding,” according to the Wisconsin State Journal. Walker has opposed increasing the minimum wage from $7.25 an hour, saying the change would hurt business.

In Wisconsin in 2013, 5.3 percent of the employed population, or 91,000 people, were paid either minimum wage or less, according to the U.S. Bureau of Labor Statistics. That’s higher than the national average of 4.3 percent.

Abortion Access and Reproductive Care

Though Burke doesn’t explicitly mention abortion or reproductive care, she alludes to the “war on women” on her website: “The last three years have seen an unprecedented assault on the freedom of women to make their own health care choices. And Scott Walker has led the charge.”

Indeed, Walker, who has said he opposes abortion without exceptions, has support a number of anti-choice and anti-health care laws during his term as governor. “I don’t know if you can get more conservative than Scott Walker on abortion,” says Jenni Dye, the research director of One Wisconsin Now, an organization that works to get progressive candidates elected in the state.

In 2013, the Wisconsin legislature enacted several controversial abortion restrictions, including a targeted regulation of abortion providers (TRAP) law that requires providers to have admitting privileges with hospitals within 30 miles of a clinic. A district court blocked enforcement of the law, SB 206, following a lawsuit filed against the state by Planned Parenthood. The trial over the litigation ended this June, and a decision is expected soon.

In addition to the TRAP provision, SB 206 included an ultrasound mandate, requiring that the physician perform an ultrasound, provide an oral explanation to the patient describing the embryo or fetus depending on the stage of pregnancy, show the patient an image of the ultrasound, and provide “a means for the pregnant woman to visualize any fetal heartbeat.”

Dye says that Walker’s legacy on reproductive access extends beyond his anti-choice legislation, extending to reproductive care and sexual health more generally.

In 2011, for example, shortly after Walker took office, the Wisconsin legislature largely repealed the 2009 Healthy Youth Act, which set state standards for fact-based and progressive sex education in schools, putting in its place standards mandating abstinence-only education and removing information about contraceptives from the law.

Most recently, the Walker administration announced that it would not be enforcing a state law mandating contraceptive coverage in certain company insurance plans, a direct response to the Supreme Court’s Hobby Lobby ruling and one which health advocates and consumer protection advocates called “absurd.”

Medicaid

In early 2013, Walker announced that Wisconsin would be rejecting federally-funded Medicaid expansion under the Affordable Care Act, making it one of 24 states to do so. But unlike most other states, Walker has gone forward with his own reforms of the state’s Medicaid program, called BadgerCare. The governor lifted a cap on the number of low-income childless adults eligible for BadgerCare, but at the same time changed the eligibility requirements for the program—now, only residents below 100 percent of the federal poverty level, $11,490 for a single adult, qualify for Medicaid. Before the change the cutoff for Medicaid eligibility was 200 percent of the federal poverty line, a number higher than the federal Medicaid cutoff.

The policy pushed an estimated 63,000 Wisconsinites from Medicaid coverage to the private insurance marketplace set up by the federal government, a change that Walker’s administration said was good for people’s health. “Governor Walker is focused on moving people from government dependence into the independence of making their own health care decisions,” Jocelyn Webster, a spokesperson for Walker, said in an email to the Milwaukee-Wisconsin Journal Sentinel. “Governor Walker’s plan allows adults not living in poverty to access affordable health care through the private market,” Webster added.

The Walker administration also chose not to set up its own, state-run insurance marketplace, instead relying on the federal government’s exchange website, Healthcare.gov.

Kevin Kane, the lead organizer for Citizen Action Wisconsin, a social justice advocacy organization in the state, says that Walker’s reforms to Medicaid have hurt, not helped, low-income Wisconsinites. “Roughly 38,000 of the people kicked off of BadgerCare by Walker have not signed up for private insurance,” which is how they were expected to receive insurance after the eligibility change.

A recent state report confirms that coverage gaps exist among low-income Wisconsin residents. People pushed out of their Medicaid coverage due to the eligibility change had until June 1 to sign up for private insurance offered through the exchange. The state Department of Health Services found that more than 60 percent of the people became ineligible for BadgerCare following the eligibility changes have not purchased new insurance.

While it’s difficult to measure and explain why those 60 percent didn’t get new coverage, Kane says that private insurance is still cost prohibitive for many people over the poverty level. “The administration is going to say that they got employer or spousal coverage,” he told Rewire, but “the problem is that the private insurance is not affordable, and these people can’t spend money on it.”

Moreover, a White House Council of Economic Advisers report released early July found that by 2016, an additional 120,000 people would have health coverage if Wisconsin had opted into federal expansion.

Though citizen-initiated ballot measures aren’t allowed in Wisconsin, Kane says that a third of the state’s population will be voting on what’s called advisory referendums—non-binding questions on the ballot to which voters can say yes or no. This November, voters in the state will be asked whether their legislators should accept the federal money to expand Medicaid. According to Kane, while only a third of the population lives in counties that have put the question to the ballot, that number is likely to increase by the end of the month.

On her website, Burke says that she plans to overturn Walker’s refusal of federal dollars to expand BadgerCare. “Rejecting hundreds of millions of our own federal tax dollars means our money goes to cover health care in other states, and leaves us paying more as a state to cover fewer hard-working Wisconsinites,” she says.

Though Burke has almost no voting record to point to, both Dye and Kane say that the Democrat has successfully fashioned herself as an alternative to Walker—enough to convince Wisconsinites to vote for her in November.

Analysis Abortion

Legislators Have Introduced 445 Provisions to Restrict Abortion So Far This Year

Elizabeth Nash & Rachel Benson Gold

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. Of these, 35 percent (445 provisions) sought to restrict access to abortion services. By midyear, 17 states had passed 46 new abortion restrictions.

Including these new restrictions, states have adopted 334 abortion restrictions since 2010, constituting 30 percent of all abortion restrictions enacted by states since the U.S. Supreme Court decision in Roe v. Wade in 1973. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

Mid year state restrictions

 

Signs of Progress

The first half of the year ended on a high note, with the U.S. Supreme Court handing down the most significant abortion decision in a generation. The Court’s ruling in Whole Woman’s Health v. Hellerstedt struck down abortion restrictions in Texas requiring abortion facilities in the state to convert to the equivalent of ambulatory surgical centers and mandating that abortion providers have admitting privileges at a local hospital; these two restrictions had greatly diminished access to services throughout the state (see Lessons from Texas: Widespread Consequences of Assaults on Abortion Access). Five other states (Michigan, Missouri, Pennsylvania, Tennessee, and Virginia) have similar facility requirements, and the Texas decision makes it less likely that these laws would be able to withstand judicial scrutiny (see Targeted Regulation of Abortion Providers). Nineteen other states have abortion facility requirements that are less onerous than the ones in Texas; the fate of these laws in the wake of the Court’s decision remains unclear. 

Ten states in addition to Texas had adopted hospital admitting privileges requirements. The day after handing down the Texas decision, the Court declined to review lower court decisions that have kept such requirements in Mississippi and Wisconsin from going into effect, and Alabama Gov. Robert Bentley (R) announced that he would not enforce the state’s law. As a result of separate litigation, enforcement of admitting privileges requirements in Kansas, Louisiana, and Oklahoma is currently blocked. That leaves admitting privileges in effect in Missouri, North Dakota, Tennessee and Utah; as with facility requirements, the Texas decision will clearly make it harder for these laws to survive if challenged.

More broadly, the Court’s decision clarified the legal standard for evaluating abortion restrictions. In its 1992 decision in Planned Parenthood of Southeastern Pennsylvania v. Casey, the Court had said that abortion restrictions could not impose an undue burden on a woman seeking to terminate her pregnancy. In Whole Woman’s Health, the Court stressed the importance of using evidence to evaluate the extent to which an abortion restriction imposes a burden on women, and made clear that a restriction’s burdens cannot outweigh its benefits, an analysis that will give the Texas decision a reach well beyond the specific restrictions at issue in the case.

As important as the Whole Woman’s Health decision is and will be going forward, it is far from the only good news so far this year. Legislators in 19 states introduced a bevy of measures aimed at expanding insurance coverage for contraceptive services. In 13 of these states, the proposed measures seek to bolster the existing federal contraceptive coverage requirement by, for example, requiring coverage of all U.S. Food and Drug Administration approved methods and banning the use of techniques such as medical management and prior authorization, through which insurers may limit coverage. But some proposals go further and plow new ground by mandating coverage of sterilization (generally for both men and women), allowing a woman to obtain an extended supply of her contraceptive method (generally up to 12 months), and/or requiring that insurance cover over-the-counter contraceptive methods. By July 1, both Maryland and Vermont had enacted comprehensive measures, and similar legislation was pending before Illinois Gov. Bruce Rauner (R). And, in early July, Hawaii Gov. David Ige (D) signed a measure into law allowing women to obtain a year’s supply of their contraceptive method.

071midyearstatecoveragetable

But the Assault Continues

Even as these positive developments unfolded, the long-standing assault on sexual and reproductive health and rights continued apace. Much of this attention focused on the release a year ago of a string of deceptively edited videos designed to discredit Planned Parenthood. The campaign these videos spawned initially focused on defunding Planned Parenthood and has grown into an effort to defund family planning providers more broadly, especially those who have any connection to abortion services. Since last July, 24 states have moved to restrict eligibility for funding in several ways:

  • Seventeen states have moved to limit family planning providers’ eligibility for reimbursement under Medicaid, the program that accounts for about three-fourths of all public dollars spent on family planning. In some cases, states have tried to exclude Planned Parenthood entirely from such funding. These attacks have come via both administrative and legislative means. For instance, the Florida legislature included a defunding provision in an omnibus abortion bill passed in March. As the controversy grew, the Centers for Medicare and Medicaid Services, the federal agency that administers Medicaid, sent a letter to state officials reiterating that federal law prohibits them from discriminating against family planning providers because they either offer abortion services or are affiliated with an abortion provider (see CMS Provides New Clarity For Family Planning Under Medicaid). Most of these state attempts have been blocked through legal challenges. However, a funding ban went into effect in Mississippi on July 1, and similar measures are awaiting implementation in three other states.
  • Fourteen states have moved to restrict family planning funds controlled by the state, with laws enacted in four states. The law in Kansas limits funding to publicly run programs, while the law in Louisiana bars funding to providers who are associated with abortion services. A law enacted in Wisconsin directs the state to apply for federal Title X funding and specifies that if this funding is obtained, it may not be distributed to family planning providers affiliated with abortion services. (In 2015, New Hampshire moved to deny Title X funds to Planned Parenthood affiliates; the state reversed the decision in 2016.) Finally, the budget adopted in Michigan reenacts a provision that bars the allocation of family planning funds to organizations associated with abortion. Notably, however, Virginia Gov. Terry McAuliffe (D) vetoed a similar measure.
  • Ten states have attempted to bar family planning providers’ eligibility for related funding, including monies for sexually transmitted infection testing and treatment, prevention of interpersonal violence, and prevention of breast and cervical cancer. In three of these states, the bans are the result of legislative action; in Utah, the ban resulted from action by the governor. Such a ban is in effect in North Carolina; the Louisiana measure is set to go into effect in August. Implementation of bans in Ohio and Utah has been blocked as a result of legal action.

071midyearstateeligibilitytable

The first half of 2016 was also noteworthy for a raft of attempts to ban some or all abortions. These measures fell into four distinct categories:

  • By the end of June, four states enacted legislation to ban the most common method used to perform abortions during the second trimester. The Mississippi and West Virginia laws are in effect; the other two have been challenged in court. (Similar provisions enacted last year in Kansas and Oklahoma are also blocked pending legal action.)
  • South Carolina and North Dakota both enacted measures banning abortion at or beyond 20 weeks post-fertilization, which is equivalent to 22 weeks after the woman’s last menstrual period. This brings to 16 the number of states with these laws in effect (see State Policies on Later Abortions).
  • Indiana and Louisiana adopted provisions banning abortions under specific circumstances. The Louisiana law banned abortions at or after 20 weeks post-fertilization in cases of diagnosed genetic anomaly; the law is slated to go into effect on August 1. Indiana adopted a groundbreaking measure to ban abortion for purposes of race or sex selection, in cases of a genetic anomaly, or because of the fetus’ “color, national origin, or ancestry”; enforcement of the measure is blocked pending the outcome of a legal challenge.
  • Oklahoma Gov. Mary Fallin (R) vetoed a sweeping measure that would have banned all abortions except those necessary to protect the woman’s life.

071midyearstateabortionstable

In addition, 14 states (Alaska, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, South Carolina, South Dakota, Tennessee and Utah) enacted other types of abortion restrictions during the first half of the year, including measures to impose or extend waiting periods, restrict access to medication abortion, and establish regulations on abortion clinics.

Zohra Ansari-Thomas, Olivia Cappello, and Lizamarie Mohammed all contributed to this analysis.

News Abortion

Pennsylvania’s TRAP Law Could Be the Next to Go Down

Teddy Wilson

The Democrats' bill would repeal language from a measure that targets abortion clinics, forcing them to meet the standards of ambulatory surgical facilities.

A Pennsylvania lawmaker on Wednesday introduced a bill that would repeal a state law requiring abortion clinics to meet the standards of ambulatory surgical facilities (ASF). The bill comes in response to the U.S. Supreme Court’s ruling striking down a similar provision in Texas’ anti-choice omnibus law known as HB 2.

A similar so-called targeted regulation of abortion providers (TRAP) law was passed in Pennsylvania in 2011 with bipartisan majorities in both the house and state senate, and was signed into law by former Gov. Tom Corbett (R).

SB 1350, sponsored by Sen. Daylin Leach (D-Montgomery) would repeal language from Act 122 that requires abortion clinics to meet ASF regulations. The text of the bill has not yet been posted on the state’s legislative website.

The bill is co-sponsored by state Sens. Art Haywood (D-Philadelphia), Larry Farnese (D-Philadelphia), and Judy Schwank (D-Berks).

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Leach said in a statement that there has been a “nationwide attack on patients and their doctors,” but that the Supreme Court’s ruling upholds the constitutionally protected right to terminate a pregnancy.

“Abortion is a legal, Constitutionally-protected right that should be available to all women,” Leach said. “Every member of the Pennsylvania General Assembly swore an oath to support, obey and defend the Constitution of the United States, so we must act swiftly to repeal this unconstitutional requirement.”

TRAP laws, which single out abortion clinics and providers and subject them to regulations that are more stringent than those applied to medical clinics, have been passed in several states in recent years.

However, the Supreme Court’s ruling in Whole Woman’s Health v. Hellerstedt that struck down two of the provisions in HB 2 has already had ramifications on similar laws passed in other states with GOP-held legislatures.

The Supreme Court blocked similar anti-choice laws in Wisconsin and Mississippi, and Alabama’s attorney general announced he would drop an appeal to a legal challenge of a similar law.