Progressive Thinking

Surprise medical billing incidents occur often, and cause major problems for many of us who live within ordinary means. Sen. Smith hopes to establish a meaningful solution.

MADISON - Last week, Governor Tony Evers assigned homework for the Legislature to accomplish in the new year. Governor Evers urged bipartisan cooperation to tackle some of the most pressing issues in our state and create solutions Wisconsinites support to close the dark store loophole, lower insulin costs, protect our water, address homelessness and more.

In his letter, Governor Evers also highlighted an issue that happens far too often, but gets very little attention: surprise medical billing. With only a few more session days left for legislators to debate and vote on legislation, we must prioritize the issues impacting Wisconsinites across the state together to make our state better for all.

Surprise medical billing incidents occur more than you’d think. If you or someone you know hasn’t dealt with surprise medical bills, imagine this: you’re a patient scheduled for a necessary procedure. You know your doctor and the clinic or hospital is in your network, so you don’t think twice about it. Everything goes smoothly, you recover nicely and all is well. But then you get a bill months later, which may be thousands of dollars that you didn’t expect.

It doesn’t make sense because you have insurance and visited the same doctor and clinic you’ve been to in the past. After calling to get answers, you’re told the anesthesiologist was out-of-network and their insurance doesn’t cover that portion of the procedure.

Surprise medical billing causes major problems for people like us who live within ordinary means. Suddenly a family is facing extreme financial stress while considering how to pay for expensive unplanned medical bills.

In fact, something similar happened to me many years ago. When my children were young, I made a skate rink for them in front of our house. One day, I slipped while spraying the last layer of ice. One leg bent unnaturally and caused excruciating pain. After crawling to the house and hoping to recover on my own, I visited my doctor. The doctor insisted I needed an MRI to find out what happened to my knee. Since the machine at my usual clinic was unavailable, I was referred to another clinic for the exam.

Months later, after I had the MRI, I received a shocking bill and learned I would have to pay out-of-pocket because I was sent to another clinic.

I know, personally, the impact of surprise billing and how devastating it can be. When you’re facing an already stressful health emergency, you shouldn’t be expected to worry if a physician is covered by your insurance or any other hidden costs are involved in your care. All a person wants when sick or in pain is to get the help they need and feel better again – paying an expensive medical bill makes it extremely difficult for an individual to recover quickly and comfortably.

Surprise medical billing affects many of us. Policymakers on the state and federal level have been working in search of solutions to prevent these practices. Throughout this session, I’ve worked with Representative Debra Kolste (D – Janesville) and Senator Luther Olsen (R – Ripon) to find a solution for Wisconsinites to relieve the stress and financial burden associated with surprise billing.

We’ve consulted with many stakeholders, including non-partisan policy experts, advocacy groups and graduate students at the UW School of Law and the UW School of Medicine and Public Health to establish a meaningful solution to protect patients from surprise bills. We need to be sure we get this right.

Today, Governor Evers delivers the State of the State address when he will announce the top priorities for 2020 and the remainder of this session. While I listen to his speech, I’ll reflect on all of the constructive policy work we’ve carried out this session and keep considering ways I can work with my colleagues to push substantial healthcare policy proposals forward.

Sen. Smith writes about measures we can take for fair maps in Wisconsin, including the passage of Senate Bill 288/Assembly Bill 303 and the constitutional amendment he recently introduced.

MADISON, WI - Every new year is an opportunity to reflect on what we can do better moving forward. When the New Year is the first of a new decade we think even bigger. What can we do in this new decade to become the sibling, parent, neighbor, colleague or citizen we’re expected to be?

While being a parent may arguably be the most important role many of us take on, being a good citizen is a close second. You may already say you never miss voting during an election, and that’s a good thing. But can we do better?

As we prepare for the next decade, we must commit ourselves to be the best citizen we can be. There are many opportunities to be a better citizen: participate in the census, call your elected officials and demand nonpartisan redistricting reform. Every day in my role, I work to ensure each vote counts – it’s a responsibility I take seriously, and I hope you do too.

Every ten years, citizens are required to complete the U.S. Census by providing information about themselves for officials to identify demographic shifts in our country. Data collected in a census year is then used to draw legislative districts.

Redrawing political lines can be very controversial. Currently, Wisconsin statutes allow legislators to draw their own lines, which can be easily manipulated for political advantage, known as gerrymandering. Consequently, if Wisconsin has uncompetitive maps, legislators are far less likely to make decisions reflecting the will of their constituents.

In 2011, Republican leaders paid a private law firm to draw the lines, according to their specifications. The attorneys forced legislators to sign a document agreeing they wouldn’t disclose how the redistricting occurred.

Advocates challenged this undemocratic process all the way to the U.S. Supreme Court. Millions of our tax dollars were paid to the law firm that drew the lines and to defend their actions in court. The Supreme Court took no action other than to suggest each state should handle this problem in their own way.

Before this happened, most citizens didn’t pay much attention to legislative redistricting. Now, it’s clear we need a better system to protect our vote.

With the start of a new decade, the Legislature can change the way legislative districts are determined. All we need to do is pass a bill. In October, Senator Dave Hansen (D-Green Bay) and Representative Robyn Vining (D-Wauwatosa) introduced legislation to create a fair process for nonpartisan redistricting reform.

This legislation makes the Legislative Reference Bureau (LRB) responsible for re-drawing Wisconsin’s legislative districts. The LRB is the full-time, nonpartisan agency made up of lawyers we already rely on to turn your ideas into law. With no outside political pressure or affiliations, this is the agency perfectly suited to handle this important task. As legislators, we should approve fair maps, not draw favorable maps for our own protection.

Since Senate Bill 288 and Assembly Bill 303 were introduced, the Republican Committee Chairs haven’t held a public hearing. Public hearings allow legislators an opportunity to learn more about an issue and listen to Wisconsinites. In 2009, as the Chair of the Assembly Committee on Campaigns and Elections, I held a public hearing on similar legislation to establish a process for nonpartisan redistricting reform.

This session, it’s important, if not more than in 2009, that legislators in the Majority hold a public hearing to create fair maps. That’s why legislators sent a letter today to the Senate Committee Chair requesting a public hearing. Make sure you know where your legislator stands and advocate for a public hearing.

Last week we also took steps to prevent gerrymandering in future redistricting efforts. I introduced legislation with Representative Hesselbein to create a constitutional amendment for nonpartisan redistricting reform, modeled after SB 288/AB 303.

We can’t move these proposals forward without the support from more legislators. I’ve said it before and I’ll say it again: contact your elected officials and urge their pledge of support for nonpartisan redistricting reform. While you have your own personal intentions for 2020, let’s all commit to be better citizens to make every vote count and restore trust in government.

Sen. Smith writes about issues to prioritize going forward, including Medicaid expansion and gun safety reform. In 2019, we saw a glimpse of what compromise looks like and he's hopeful we can all come to the table to finish what we started.

BRUNSWICK, WI - During this time of year, we’re surrounded by reminders to set goals for the next twelve months and fulfill our New Year’s resolutions. As the weeks pass by, we typically find ourselves falling back into our old habits and routines. Once we slip up, it may seem like our resolutions are hopeless and we push off our goals to next year.

While preparing to head back to Madison, I thought about small, yet realistic intentions to continually motivate me in this New Year. Step by step, I’m hopeful these intentions will guide me to put differences aside and finish what we started in 2019.

To begin, I’m determined to stay away from holding grudges and I’ll encourage others to do the same.

Of course, we won’t suddenly lock arms and sing “Kumbaya.” After all, I wouldn’t expect anyone to turn their back on their own personal values or beliefs. The basic principle of our political system brings two separate parties with at least two ideas to the table to solve any problem. That’s the standard most citizens expect and hope for from their elected officials.

I intend to follow through on this expectation while advocating for policies to support all Wisconsinites. In the last year, I heard from constituents over and over about the necessity and urgency of expanding Medicaid to improve healthcare affordability for Wisconsinites. Medicaid expansion will also save our state more than $300 million to later re-invest back into essential health programs. With 62% of Wisconsinites supporting this proposal, Medicaid expansion must be a top priority.

I’ll continue advocating for commonsense gun safety measures. Last year, my Democratic colleagues introduced legislation to implement universal background checks and extreme risk protection orders to remove firearms from individuals who may be suffering from a mental illness and present a danger to themselves or others. These lifesaving proposals, supported by more than 80% of Wisconsinites, still haven’t moved forward, even though Governor Evers called a special session to debate and vote on the bills.

I intend to find common ground so we can have a civil discussion to find solutions we can agree on. Considering the overwhelming support from Wisconsin residents on these ideas, I hope my colleagues can come to the table and do the right thing.

The effort to gather together isn’t futile – there’s hope for more compromise in 2020. Last year, there were signs that legislators could find themselves in agreement, in principle, on some major issues. I was pleased and surprised to see legislation introduced by Republicans mirroring bills that had previously been introduced by Democrats. The most prominent examples that jumped out included contraception accessibility and medical marijuana legalization.

Earlier in the year, Republicans introduced Senate Bill 286, which would allow pharmacists to sell contraceptives to customers over the age of 18 without a doctor’s prescription. I was impressed to hear one Republican author identify the hurdles that existed for women to access contraceptives as a primary reason for introducing this legislation. This may be one area we can finally break through and have a civil conversation about women’s health and access to birth control.

Recently, two Republican legislators introduced a version of a bill to legalize medical marijuana. Though it was quickly criticized by their own leaders, it gave many hope that the conversation could be resurrected and not take a partisan stance like it’s been in the past. I applaud this effort and others that give us a glimpse at what might be.

In 2020, I will keep fighting for the issues that matter most to Wisconsinites. My Republican colleagues have begun to show they’re capable of recognizing the challenges Wisconsinites face. Now we need them to act on Medicaid expansion and gun safety reform. Let’s all hope that 2020 brings us closer to the type of shared governance that most of us wish for and expect so we can finish what we started.

This week’s column describes how the discussions in western Wisconsin help Sen. Smith craft new legislation to help all of the state. This is the second of three columns detailing reflections from 2019 and what the Senator is looking forward to in 2020.

BRUNSWICK, WI - The past year pushed me to learn and grow as a leader. As I spent time with my family over the holiday season, I reflected on the value of collaboration, a lesson learned in 2019. I thought about all the conversations I had with others, and how accomplishments were possible from the time spent learning from others.

We’ve collaborated with Democrats, Republicans, local leaders, industry experts and others to introduce 24 new bills. However, I don’t use this number as a measuring stick for our progress through the year, it is a reflection of the discussions I’ve had with folks throughout the district.

Every conversation sparks a new idea. The best ideas come from advocates understanding a certain issue or professionals who have expertise in a specific field.

I appreciate hearing from constituents who contact my office directly, but I also want to meet people where they’re at, whether that’s coming home from work or heading to a community event. In the last year, I routinely parked my pickup truck along roads throughout the district and invited folks to “Stop ‘N Talk” about the issues they’re facing or things they’d like to see changed.

After Governor Tony Evers introduced his 2019-21 budget, I held 8 budget town halls from Black River Falls to Ellsworth and Alma to Eau Claire to discuss Wisconsin’s priorities. Folks consistently said they wanted to properly fund our public schools, fix our roads and expand Medicaid, which would provide healthcare coverage to more than 3,000 individuals in counties throughout the 31st Senate District.

As the year progressed, I prioritized meeting with constituents of diverse backgrounds, including farmers, teachers, students, town leaders, county board members, tribal members and many more. These meetings resulted in new ideas, innovative investments and inspired much of the legislation I introduced.

This fall, I had the chance to speak with local farmers on a milk hauler route ride along. The challenges farmers face are just as diverse as the solutions needed to help. These conversations with local farmers provided me with valuable insight for offering new bills to support small family farms, farm succession planning or help with sustainable agricultural practices.

Throughout the year, I visited local school districts, meeting teachers, reading children’s books with elementary students and participating in a high school civics classes. These visits remind me of the valuable role our schools have in preparing children for Wisconsin’s future workforce and ensuring our schools and teachers are well supported. As a result of these visits, I introduced legislation to make it easier for rural school districts to hire trained, qualified teachers by allowing retired teachers come back to the classroom.

In 2019, I also introduced two bills to address Wisconsin’s healthcare workforce shortage. Earlier in the year, I toured Gundersen Tri-County Hospital in Whitehall and learned about the consequences of the nursing shortage and how it affects the quality of care in rural communities.

Over the summer, I joined commuters on City of Eau Claire bus routes to listen to the issues that matter most. This experience motivated me to introduce legislation to recreate the Chippewa Valley Regional Transit Authority.

As Wisconsinites prepared for hunting season, I introduced legislation with my Democratic colleagues to allocate funding for CWD research, testing and carcass disposal sites.

During the gun hunting season, I toured CWD testing kiosks with Senator Schachtner and met hunters and scientists concerned about the growing spread of CWD. These conversations reinforced the need for these preventative measures to stop the spread of CWD and preserve Wisconsin’s hunting heritage.

I’m looking forward to meeting more advocates and introducing new bills to support Wisconsinites in 2020. However, we won’t be able to address the most critical issues or have meaningful accomplishments without non-partisan redistricting reform. Next week, I’ll be writing about my 2020 priorities and the need for fair maps.

The Senator from western Wisconsin shares lessons learned in 2019 and his hope for cooperative shared government. He’ll be writing about 2019 reflections and his hopes for 2020 for the next three weeks.

BRUNSWICK, WI - This time of year offers an important opportunity to reflect and be grateful for the experiences we’ve earned. It’s been an honor serving as your state senator this year. As I returned from my last Madison trip of 2019, I had so much to think about, including the lessons learned, accomplishments made and what to look forward to in 2020.

For the next three weeks, I’ll be writing about my 2019 reflections and what drives me to serve the 31st Senate District. This past year created so many opportunities to learn from advocates, constituents and my legislative colleagues.

When this year began, I knew this would be a year of learning for myself and the entire legislature. After all, this was the first year Wisconsin had shared government since the 2007-2008 session, when Republicans controlled the Assembly, Democrats controlled the Senate and there was a Democratic governor.

I cringe when people call shared government divided government. Democracy is supposed to be messy, it’s supposed to be deliberate. Putting aside our ambitions and doing our part in the democratic process isn’t about division, it’s about finding unity.

In 2018, before officially taking office, I attended a legislative forum with area leaders. During the forum, I explained the reality of the situation: to get a committee hearing scheduled or a bill passed, I’d need support from Republicans, like the senator I was sitting next to. The Republican senator quickly replied, letting me know my help would be needed to prevent their bills from being vetoed. This optimistic conversation gave me hope of a cooperative environment within the Capitol.

However, my initial expectations fell far short of what happened this year. Stripping the Governor and Attorney General of power during the Lame Duck Session set a bad precedent and an uncooperative tone. The state senate only met 9 times in 2019, without bringing up important policy proposals, including Medicaid expansion or closing the dark store loophole. Less Senate floor sessions isn’t a bad thing if committees are thoroughly vetting policy and producing quality legislation. But this hasn’t been the case.

This year, I became the Ranking Democratic member of the Senate Committee on Agriculture, Financial Institutions and Revenue, a responsibility I take very seriously.

During the final Committee hearing of the year, we were scheduled to debate and vote on three bills relating to labeling dairy and meat products. These bills stem from farmers’ concerns for consumers not understanding the labeling for plant-based foods and imitation animal products. I understand we aren’t saving lives or farms with such legislation, but it’s something we can agree on that may help famers know we care about protecting Wisconsin’s proud agricultural legacy.

Under these bills, a grocer could be imprisoned if they sell products that are labeled as milk, cheese or meat if they aren’t produced by a mammal or come from an animal. Before we voted on these bills, I introduced amendments to remove the bill’s imprisonment penalty. Typically, in committee, we discuss and vote on the amendments and pass the bills with or without the amendments. Instead of following this procedure, the Republican Committee Chair ruled he wouldn’t even consider a vote on the amendments.

Even a member from his own party spoke against this process. Additionally, Senator Risser, the longest serving legislator in the nation, stated “I can safely say that if it has happened, it is a rare occurrence. The Chairman’s failure to allow deliberation of amendments perverts the very nature of committee meetings, to scrutinize legislation before it is sent to the full Senate for final review.”

This entire session, I’ve tried to say we have shared government to acknowledge the need for bipartisanship, but it feels more like divided government. Despite setbacks in 2019, I will renew my optimism for the good government concept of cooperation in 2020.

I’ve met advocates who have inspired my hope and lifelong endeavor to continue learning. My office has become my classroom where I learn from people of all backgrounds and identities. In next week’s column, I’ll share how conversations with others and lessons learned resulted in accomplishments over the last year.