Healthcare, social services and mental health treatment providers across Wisconsin are bracing for potentially radical cuts in funding as political leaders in Madison and Washington, D.C., scramble to close budget gaps exacerbated by the Great Recession.
Wisconsin agencies servicing HIV/AIDS patients, caring for LGBT at-risk youth and homeless individuals and delivering mental health and addiction recovery services are poised to be some of the hardest hit.
Republican majorities in the U.S. Congress and the Wisconsin Assembly already proposed and partially passed budget bills that would dramatically reduce the number of Medicare and Medicaid patients, potentially shrink federal healthcare programs and, at the state level, drop hundreds of BadgerCare patients.
HIV/AIDS treatment and prevention programs would suffer an estimated $638,700 cut under Gov. Scott Walker’s budget, passed by the Legislature’s Joint Finance Committee in early February. It is the same bill that has resulted in massive protests statewide for stripping public unions of most of their collective bargaining rights.
At the same time they’re slashing state healthcare funding, Walker and other GOP governors are fighting implementation of the 2010 federal healthcare law, which is designed to provide near-universal healthcare coverage.
Politicians who have supported strong public health funding policy say they have not given up on protecting core services, despite the Republican push to slash public funds and repeal the national healthcare law. At a rally in Madison, U.S. Rep. Tammy Baldwin, D-Madison, said the fight is not over.
“We all know that we have to create budgets that are in balance,” she said. “Democrats understand that. But we have to do it in a smart way that promotes the health, education, and welfare of the people of the United States, and in Wisconsin.”
Leaders in HIV/AIDS services delivery and activism communities are uncharacteristically split on the cuts’ possible impact. They all admit there might be room for compromise with Walker, and they’re cautiously optimistic that proposed cuts can be maintained at the proposed 10 percent in across-the-board reductions.
“There is room for trimming in some administrative costs, and we are hopeful that we will be able to work with the Walker administration to hold the line on cuts and maintain core services,” said Michael Gifford, chief operations officer at AIDS Resource Center of Wisconsin.
Other HIV/AIDS advocates, including Heidi Nass from the UW Health Infectious Diseases Clinic, based at UW Hospitals and Clinics in Madison, said she and other activists in the provider community don’t understand why President Barack Obama and Democrats have not fought harder for the ground gained in the past few years regarding HIV/AIDS funding, considering how scarce resources are currently.
“The thing that is curious to me is the shortsightedness of not investing more in prevention, considering that it is less expensive to prevent disease rather than treat it after the fact,” she said. “We were already behind on this thing before, if you look at the incidence rates and prevention efforts. And with the proposed cuts, I have little hope we can get ahead of it.”
Nass said UW Health is evaluating how to service its caseload of about 800 patients with core medical services and limited case management, while continuing to push for more funding support from state and national leaders.
Karen Dotson, executive director of AIDS Network in Madison, said she is hopeful her 400 clients will see little reduction in core services. But she admits the true impact is not yet known beyond the overall 10 percent cut in funding.
“There are some concerns about how much the Medicare and Medicaid cuts will have on our budgets,” she said.
Like Gifford, Dotson expressed a hopeful tone as to how Walker’s administration will view serving the needs of the poor. Dotson noted that 33 percent of her agency’s budget comes from private donations and grants, not from public funds.
Wisconsin’s State Department of Human Services has yet to weigh in on exactly which cuts will be implemented if the governor’s budget becomes law.