Wisconsin lawmakers are back in session and have a large budget surplus to work with. Advocates for the state's older residents hope any spending plan prioritizes certain needs for this population, and those who care for them.

The Legislature is being asked to reconsider the idea of a Caregiver Tax Credit. Helen Marks Dicks, state issues advocacy director for AARP Wisconsin, said it's been debated in previous sessions, but the problem hasn't gone away.

She noted that there are nearly 600,000 unpaid family caregivers in Wisconsin who are feeling a lot of pressure right now.

"They are spending about $7,000 out of their own pockets," said Dicks, "and that doesn't count lost wages, lost retirement or other things."

That figure represents average annual spending for each caregiver.

The plan calls for a tax credit for some family members to reimburse up to 50% of certain expenses, with a limit of $500 per care recipient.

The proposal has bipartisan support but has struggled to make it out of committee.

Dicks said she feels the current budget surplus of $6 billion might spur more fruitful negotiations.

Senior advocates also are calling for a state-run retirement savings option, as well as additional commitments to improve high-speed internet access.

Dicks said now is the time to make life a little easier for the state's aging population, and address some of the growing obstacles that older residents face.

"This is an opportunity," said Dicks, "when we have, hopefully, both the money and the goodwill - to tackle this problem, and to put the solutions in place before it gets to be more of a crisis."

Wisconsin is no stranger to a divided government. But Dicks says there appears to be a sense of compromise in the air.

Democratic Gov. Tony Evers is expected to unveil his biennial budget proposal in mid-February. Following that, the Republican-led Joint Finance Committee throws in its suggestions before sending it to the full Legislature.

Evers will then have a chance to sign it, reject it, or apply changes with his partial veto power.

Congressional Republicans are taking a hard look at Medicaid as they pursue spending cuts and a new report shows how the public health program is preventing care access from further eroding in rural North Dakota and elsewhere.

A House GOP proposal floats a nearly $2.5 trillion Medicaid reduction. Findings from Georgetown University's Center for Children and Families showed people in rural areas are more likely than metro populations to receive health coverage through Medicaid.

Katy Kozhimannil, professor of health and policy management at the University of Minnesota School of Public Health, said the program is a key contributor to pregnancy care in these settings.

"Offering obstetric care is a financial challenge for hospitals as revenues may not cover the costs of providing that care," Kozhimannil pointed out. "Medicaid covers nearly half of all births nationally and plays a substantially larger role in paying for births in rural areas."

The report said in 2022, 52% of rural hospitals no longer had maternity wards, compared with 36% of urban hospitals. There is concern the gap would widen with Medicaid cuts and North Dakota almost leads the nation for lack of rural OB/GYN services. Some House Republicans insist the programs need reform to avoid a fiscal collapse. But skeptics said drastic changes are a way to offset a planned extension of federal tax cuts.

The report also pointed out residents in rural areas have worse health outcomes.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said it demonstrates why Medicaid is so important, adding it serves as a lifeline to a range of populations living in these communities.

"It is serving children. It is serving seniors in nursing homes, people with disabilities," Alker outlined.

Alker noted Medicaid helps recipients get ahead of health challenges through preventive care, as
opposed to letting conditions worsen.

"People wind up sicker and then they're in the emergency room and children can't get their asthma inhalers and they miss school," Alker explained.

CLARIFICATION: An earlier version of this story noted the Children's Health Insurance Program as a component of Medicaid, before outlining Minnesota data. That version did not make clear that while under the same umbrella, there are differences. An update emphasizes Medicaid and CHIP when noting Minnesota data. (8:45 a.m. MST, Jan. 16, 2025)

In their pursuit of slashing government spending, Congressional Republicans are taking a hard look at Medicaid. But a new report shows how this public health program is preventing care access from further eroding in rural Minnesota and elsewhere.

The incoming Trump administration promises major budget cuts, and a House GOP proposal floats a nearly $2.5 trillion Medicaid reduction. But findings from Georgetown University's Center for Children and Families show people in rural areas are more likely than metro populations to receive health coverage through Medicaid.

Katy Kozhimannil, associate professor in the University of Minnesota School of Public Health, said its providers rely on it, too.

"Medicaid is an absolutely essential source of revenue for those hospitals to keep operating and to provide different types of services and additional training and support for clinicians," she said.

A key Medicaid component is the Children's Health Insurance Program. At 7%, the Georgetown report says Minnesota is among the states with the largest difference in the share of kids covered by Medicaid and CHIP when comparing smaller towns to urban centers. Some House Republicans insist these programs need reform to avoid a fiscal collapse. But skeptics say drastic changes are a way to offset a planned extension of federal tax cuts.

Joan Alker, executive director and co-founder of the Center for Children and Families at Georgetown University, called these budget proposals "horrifying," while suggesting the public might be caught off guard because the program wasn't really discussed on the campaign trail last fall.

"There was complete silence about it, despite the fact that it is the largest source of public coverage by far in the United States," she said. "It's also a very popular program with the voters of all political stripes."

Report authors stress the timing of the proposed cuts is especially bad as rural areas continue to grapple with hospital closures. 120 facilities have either closed or ceased offering inpatient services over the past decade. Many rural hospitals opt to shutter less lucrative units such as maternity wards. And the experts say Medicaid covers a majority of pregnancy care in smaller communities where these units still operate.

One topic expected to make a big splash during Wyoming's general legislative session is property taxes at many levels.

First on the agenda for the Freedom Caucus, Wyoming's House majority faction, is a 25% property tax cut on homes up to $2 million in value, passed by both chambers in 2024. Gov. Mark Gordon vetoed it, calling the fix "temporary and very expensive," as the state would have to pay the backfill.

Hank Hoversland, executive director of the Wyoming Taxpayers Association, said another piece at play is a state constitutional amendment voters passed in November.

"That provides the legislature a vehicle to make a separate class for property taxation purposes, that is, residential real property," Hoversland explained. "Then, it also allows there to be a subclass for owner-occupied, single-family residences."

Though the amendment passed, Hoversland pointed out legislators need to take action this session in order to give the change legs.

At the industry level, Wyoming law includes a property tax exemption for "property used to eliminate, control or prevent air, water or land pollution." Senate File 61, sponsored by Sen. Cale Case, R-Lander, would clarify carbon dioxide shouldn't count as pollution so the state can tax incoming carbon capture projects.

Hoversland stressed energy companies pay a large portion of taxes in the state.

"Just this past tax year, minerals paid about 46% of property taxes, while the all-other category -- including industrial, commercial, residential and ag -- paid 54% total," Hoversland outlined.

Earlier this month, the state also certified the first Wyoming citizen's ballot initiative in 30 years, slated to appear on ballots in 2026. It proposes cutting residential property taxes by 50% for homeowners who have lived in Wyoming for at least one year.


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