FREDERICA FREYBERG:

MORE THAN 200,000 PEOPLE IN WISCONSIN INSURED THROUGH THE AFFORDABLE CARE ACT MARKETPLACE PLANS. AN ADDITIONAL 800,000 IN THE STATE ARE COVERED THROUGH THE STATE MEDICAID PLAN KNOWN AS BADGERCARE PLUS. OUR NEXT GUEST AND HIS STAFF HELPED GUIDE PEOPLE INTO SUCH COVERAGE. BOBBY PETERSON IS THE EXECUTIVE DIRECTOR OF ABC FOR HEALTH, A PUBLIC INTEREST LAW FIRM IN MADISON. BOBBY, THANKS VERY MUCH FOR BEING HERE.

BOBBY PETERSON:

GLAD TO BE HERE.

FREDERICA FREYBERG:

WHAT IS YOUR OVERALL REACTION TO SCOTT WALKER’S PATIENT FREEDOM PLAN?

BOBBY PETERSON:

WELL I THINK IT’S GOOD THAT HE’S BRINGING IT UP FOR DEBATE. I THINK THAT GETTING IT OUT THERE, HAVING DISCUSSIONS ABOUT IT IS REALLY IMPORTANT. BUT THINGS GO DOWNHILL FROM THERE. WHEN HE USES THE TERM FREEDOM, IS RAISES A LOT OF QUESTIONS. I THINK IT’S — THERE’S A LOT OF PROBLEMS WITH USING THAT AS A CHARACTERIZATION. AND HE’S RIGHT ON HALF OF IT. WRONG ON HALF OF IT. YOU KNOW, IT’S NOT FREE BUT IT IS REALLY DUMB. I MEAN, IT’S JUST A BAD PLAN.

FREDERICA FREYBERG:

WHY ARE HIS AGE-BASED TAX CREDITS, UP TO $3,000 A YEAR FOR 50 TO 64-YEAR-OLDS NECESSARILY A BAD THING FOR LOW-INCOME PEOPLE?

BOBBY PETERSON:

WELL, BECAUSE IT DOESN’T TAKE INTO CONSIDERATION, YOU KNOW, INCOME IN THE CALCULATIONS. SO IT’S MORE OF A FLAT RATE THAT SOMEONE OF A HIGHER INCOME WILL GET A SIMILAR TAX CREDIT TO SOMEONE THAT’S REALLY LOW INCOME. IT’S REALLY A PROBLEM I THINK.

FREDERICA FREYBERG:

I KNOW THAT THE WALKER CAMPAIGN SUGGESTS BUT IT’S BY AGE, THAT’S THE WAY INSURANCE COMPANIES AND POLICIES WORK. AND THAT’S WHY HIS PLAN DOES THE CREDITS BY AGE AND NOT BY INCOME.

BOBBY PETERSON:

RIGHT. BUT, YOU KNOW, THE REALITY IS WE’RE A DIVERSE SOCIETY AND WE RANGE FROM VERY POOR TO VERY WEALTHY. THIS IS A PLAN THAT WORKS OUT PRETTY WELL, IF YOU’RE HEALTHY AND YOU’RE WEALTHY. BUT FOR LOW-INCOME, POOR FOLKS, NOT SO WELL.

FREDERICA FREYBERG:

SO DOING THE VERY SIMPLE MATH. $3,000 A YEAR IS $250 A MONTH. WHAT KIND OF POLICY CAN SOMEBODY BUY FOR THAT?

BOBBY PETERSON:

NOT MUCH. YOU KNOW, MAYBE CATASTROPHIC PLAN, WHICH YOU’RE GOING TO HAVE VERY HUGE DEDUCTIBLES AND CO-PAYMENTS. BUT I DON’T SEE THIS PLAN BEING OF MUCH VALUE TO MOST PEOPLE.

FREDERICA FREYBERG:

THE GOVERNOR MAINTAINS COVERAGE UNDER HIS PLAN FOR PEOPLE WITH EXISTING CONDITIONS. BUT IN THAT HE SAYS THAT THEY CAN NEVER HAVE HAD A GAP IN COVERAGE. HOW REALISTIC IS THAT?

BOBBY PETERSON:

WELL, I THINK TODAY WHEN PEOPLE, YOU KNOW, LOSE THEIR JOB AND LOSE COVERAGE AND TRYING TO GET IT BACK, THAT VARIABILITY HAPPENS. AND MAKING THAT A REQUIREMENT FOR PEOPLE BECOMES A DIFFICULT BURDEN.

FREDERICA FREYBERG:

WHAT ABOUT PEOPLE WHO ARE COMING INTO THE THING UNINSURED? WHERE DO THEY GO?

BOBBY PETERSON:

YEAH. THAT’S A GOOD QUESTION. I THINK THAT, YOU KNOW, ONE OF THE ISSUES IS THAT HE’S TALKING ABOUT RECREATING THE HIGH-RISK POOLS FOR PEOPLE WITH PRE-EXISTING CONDITIONS, WHICH REALLY IN SOME WAYS IS MORE HEALTH CARE SEGREGATION. SO IF YOU HAVE AN ILLNESS OR A DISABILITY AND YOU NEED COVERAGE, YOU MAY GO TO A HIGH-RISK POOL THEN, WHICH WE JUST GOT RID OF, BY THE WAY. IT’S NOT — IT’S MORE EXPENSIVE IN THAT WORLD.

FREDERICA FREYBERG:

NOW THE OTHER THING THAT HAPPENS IN THIS PLAN IS THAT THERE ARE BIG CHANGES IN MEDICAID. HE TURNS IT INTO A BLOCK GRANT PROGRAM FOR STATES AND THEN STATES HAVE AUTHORITY OVER IT. WHY IS THAT A BAD THING IN YOUR MIND?

BOBBY PETERSON:

WELL, BECAUSE YOU KNOW THERE’S SOME FEDERAL PROTECTIONS THAT ARE OUT THERE. IT’S AN ENTITLEMENT FOR PEOPLE THAT ARE LOW INCOME AND PEOPLE WITH DISABILITIES. THE SECURITY TO KNOW THAT YOU’RE GOING TO HAVE THAT TYPE OF COVERAGE THAT IS, YOU KNOW, PROVIDED THROUGH FEDERAL REQUIREMENTS. FOR EXAMPLE, CHILDREN WITH SPECIAL HEALTH CARE NEEDS. THERE’S AN IMPORTANT PROGRAM CALLED HEALTH CHECK IN WISCONSIN. IT’S COMPLICATED BUT IT PROVIDES A REALLY IMPORTANT LAYER OF COVERAGE THAT’S REQUIRED UNDER FEDERAL LAW. A LOT OF GOVERNORS DON’T LIKE IT BECAUSE IT’S COMPLICATED. THEY’D LIKE TO GET RID OF IT TO SIMPLIFY THE SYSTEM. IMPACT ON KIDS NOT SO GREAT.

FREDERICA FREYBERG:

SO IF STATES ARE FULLY IN CHARGE, WOULDN’T THAT POTENTIALLY PUT PEOPLE IN DIFFERENT STATES ON DIFFERENT FOOTING? YOU KNOW, MAYBE EVEN DEPENDING ON POLITICS?

BOBBY PETERSON:

WELL, YEAH. THEY ARE TO A CERTAIN DEGREE. BUT THERE IS LIKE A FEDERAL SORT OF BENCHMARK, SO TO SPEAK, OF COVERAGE THAT STATES HAVE TO PROVIDE. SO THERE’S FLEXIBILITY WITHIN IT RIGHT NOW FOR STATES TO OFFER VARIATION. STATES CAN APPLY FOR WAIVERS. WISCONSIN HAS GOTTEN WAIVERS AND THE FEDS OFFER SOME DEGREE OF FLEXIBILITY. THIS HANDS THE KEYS OVER TO THE STATES WITH A LOT OF FEDERAL MONEY BEHIND IT TO SAY, OKAY, LET’S CREATE YOUR OWN PLAN.

FREDERICA FREYBERG:

WHAT ABOUT BEING ABLE TO PURCHASE INSURANCE POLICIES, YOU KNOW, OUTSIDE OF STATE LINES, OR CROSSING STATE LINES. ON ITS FACE THAT WOULD SEEM LIKE THAT MIGHT BE A GOOD THING.

BOBBY PETERSON:

YEAH. ON ITS FACE IT DOES. SOME LARGE CORPORATIONS SELF-INSURE FOR THAT VERY REASON, TO ESCAPE STATE REGULATION OF INSURANCE. BUT IN WISCONSIN WE DEVELOPED VERY SPECIFIC BENEFITS FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS, FOR KIDS WITH AUTISM AND THOSE WERE HAMMERED THROUGH A LEGISLATIVE PROCESS AND A LOT OF THOSE WOULD BE GONE. THOSE MANDATED STATE BENEFITS WOULD LIKELY BE ELIMINATED THEN WITH, YOU KNOW, PURCHASING INSURANCE ACROSS STATE BOUNDARIES.

FREDERICA FREYBERG:

YOU SAY THAT THIS ISN’T ABOUT FREEDOM, AS THE PLAN’S TITLE WOULD SUGGEST. BUT IT DOES SOUND AS THOUGH THE INDIVIDUAL WOULD HAVE A BETTER ABILITY TO BUY OUT-OF-STATE OR CHOOSE AND BUY CHEAP PLAN, YOU KNOW, ALA CARTE KIND OF LIKE.

BOBBY PETERSON:

AND THAT’S WHY I THINK, YOU KNOW, A WISE MAN NAMED JON STEWART ONCE SAID, WHEN YOU USE TERMS LIKE FREEDOM IN A POLITICAL ARGUMENT OR A PROGRAM, LOOK AT IT VERY CAREFULLY. BECAUSE WHEN YOU SNIFF THIS ONE OUT, YOU SEE THERE’S A LOT OF PROBLEMS IN IT. IT’S REALLY NOT FREE. THERE’S A REAL CONSEQUENCE. AND THAT FREEDOM COMES AT A GREAT COST TO CHILDREN, TO THE VULNERABLE, TO LOW-INCOME FOLKS. IT IS. IT IS A PLAN FOR THE HEALTHY AND THE WEALTHY.

FREDERICA FREYBERG:

BOBBY PETERSON, THANKS.

BOBBY PETERSON:

YOU'RE WELCOME.