Frederica Freyberg:

I'm Frederica Freyberg. Tonight on “Here and Now,” in our first look, former Governor Tommy Thompson on the future of health care and his impressions of the new administration in Washington. After that, a closer look at state transportation funding. And in our look ahead, our political panelists talk President Trump and forecast Governor Walker’s budget due out next week. It’s “Here and Now” for February 3.

Announcer:

Funding for “Here and Now” is provided, in part, by Friends of Wisconsin Public Television.

Frederica Freyberg:

A first look tonight at the future of health care with former Governor Tommy Thompson. Thompson served as U.S. Secretary of Health and Human Services under George W. Bush and has been advising the current administration as it works to repeal, replace or repair the Affordable Care Act. Our interview took place earlier this week.

Frederica Freyberg:

Governor Thompson, thank you very much for being here.

Tommy Thompson:

It's an honor for me to be here. I’m so glad to see you again and be on a program moderated by you. Thank you and I wish you the best.

Frederica Freyberg:

Thank you. You served as an agency secretary in Washington and were in politics for a very long time. We wanted to ask you right of the chutes what you make of President Trump’s first two weeks in office?

Tommy Thompson:

I think they’ve been good. I means he’s had some stumbles, but the truth of the matter is he’s doing exactly what he said. You may disagree with what he’s doing, but the truth of the matter is he hasn’t deviated from what he told the American public that elected him what he was going to do. I happen to like people that kept their word and do things. I don’t agree with everything he’s done so far, but you know the fact that he’s done them and continues to do them, I give him credit. I give him high marks for his willingness and his intestinal fortitude to stick it out and do what he said.

Frederica Freyberg:

On some policy matters, you are on record as saying that you would like to repeal the Affordable Care Act or Obamacare?

Tommy Thompson:

Well, that’s a little bit over-broad statement, Frederica. What I want to do is I want to fix the health care system and make it more accessible to everybody, but also make it affordable and make more — willing to be more competitive and allow individuals to have more opportunities.

Frederica Freyberg:

Okay. So —

Tommy Thompson:

So you have to amend the Obamacare. Obamacare is the only major social policy that only had Democrat votes and as a result of that, there’s been a lot of problems because it was just one party that passed it.

Frederica Freyberg:

So are you saying that you would like to fix Obamacare?

Tommy Thompson:

Yes.

Frederica Freyberg:

And not ditch it.

Tommy Thompson:

I don’t think you can ditch it. You know, people say you’re going to do it. But everybody that says they're going to ditch says but there are a few parts I like.

Frederica Freyberg:

Right.

Tommy Thompson:

Such as allowing individual children to be with their parents on their parents’ insurance til 26. Make sure somebody is not cut off from insurance after they hit so many expenditures. Two provisions of Obamacare that everybody seems to like. So that part is going to stay. So what I'm talking about, Frederica, is you have an opportunity now with Republicans in control of the executive branch, the congressional branch, you have a chance to fix it and make it better and that’s what I want to see happen.

Frederica Freyberg:

You’d like to see that happen, but that doesn’t seem to be the course that is taking shape in Washington right now because they are moving ahead on some of these resolutions to basically replace Obamacare, repeal it and then they want to replace it, but they don’t really have anything bona fide in place yet. I mean, right? That’s what’s happening.

Tommy Thompson:

No, Frederica. It’s not. That’s what everybody thought was going to happen. But things have changed in the last week. They’re not talking about that right now. They’re talking about, yes, repealing and repairing Obamacare and making it better. They’re not talking about completely — the resolution you’re talking about was an executive order by the president giving — but in order to change it, you have to do it in the congressional body.

Frederica Freyberg:

Right.

Tommy Thompson:

And there’s lots of problems with that. And I've been pointing them out to the leadership in the executive branch, as Tom Price, and so on. You just can’t do that. You have to be — you have to be able to get the votes to do it. And so far they don’t have the votes for a particular plan. So what you’re saying, partially correct, but not totally correct. What I'm saying is let’s take a look at it. Let’s find where we’ve got the votes, but let’s improve and make better health care in America and that’s what we can do and that’s what America wants.

Frederica Freyberg:

And are the people you’re talking to in Washington listening?

Tommy Thompson:

Sure. Absolutely. Right now I'll give you three examples which they can’t seem to come to grips with. That’s why, what you said, they’re going to just repeal it and get rid of it. Number one, if you take away all the taxes you don’t have any money left over to rebuild it. I pointed that out. I said, “Do you think the Republicans are going to then, once they’ve taken away a trillion dollars in taxes, turn around and vote for it? I don’t think so. And I don’t think anybody does. Therefore, you better go slow on the tax repeals at this point in time until you know how much money you’re going to have to spend to repair it or rebuild it or replace it. Second thing is the baseline. The baseline, you know, that — on Medicaid, some states took an expanded match. Wisconsin didn’t. Now, how do you — how do you — how do you bring equity to that system?

Frederica Freyberg:

Good question.

Tommy Thompson:

How do you bring equity? Is Wisconsin going to get penalized because they didn’t take the federal money? I don’t think so, not with Speaker Ryan there. And the states like Republican states that put Trump in office, Pennsylvania, Ohio and Florida, are they going to want to take less now? No. So that’s a huge problem. And they haven’t been able to come to grips. How are they going to do it? These two — the taxes, how much taxes they repeal, and how they develop an equitable system on the baseline are two problems they have not been able to come to grips with because you have Republicans on both sides. The third thing is what is going to go into that? Are you going to be able to cross state lines and buy insurance? What about insurance exchanges? I talked to Speaker Ryan about that. Speaker Ryan is actually the godfather of insurance exchanges. People don’t realize that but he was one of the founders of insurance exchanges. But he wants unlimited exchanges so that whatever insurance company is going to put out there gets on the exchange, not a gold, platinum or bronze or silver. Whatever Frederica wants to buy, we’ll put it on there. And then the fourth thing is who regulates across state lines? Is it the state where the insurance company is or the state where you sell the insurance? These are problems that have to be developed. So moving fast is what everybody said they were going to do.

Frederica Freyberg:

Right.

Tommy Thompson:

But the problem is they haven’t thought through how they solve these big problems.

Frederica Freyberg:

Do you have an answer to the Medicaid problem?

Tommy Thompson:

I think I do.

Frederica Freyberg:

What is it?

Tommy Thompson:

Well, I think what you have to do is you have to make sure there’s equity. And I think the only way you’re going to have equity is to bring everybody up to the same baseline. Because Ohio and Pennsylvania and California, Florida and Michigan are not going to take less.

Frederica Freyberg:

Right.

Tommy Thompson:

And Wisconsin will get crucified if they take less. We’ll be penalized forever. So I think the only equitable system is you got to adjust where the baseline is for the highest and freeze it at that and put an inflationary index in. If you do that, then you treat equity. But that costs money. And therefore go back to my taxes.

Frederica Freyberg:

Right.

Tommy Thompson:

If you take care of all the taxes, there’s no way to backfill that. That’s why this thing is not going to move as rapidly as you indicated in your question. It’s got to have these answers solved in order to make it happen.

Frederica Freyberg:

Now, one thing that you’re quoted as saying is that just like people are required to have car insurance, they should be required to have health insurance. Still think that?

Tommy Thompson:

No. I didn’t — I said take into consideration. That statement was one that I just had at the noon luncheon. And that is not what I basically said. I said this is an example where there’s mandatory insurance. We have car insurance, so you could make the argument that you should have health insurance. But you got to be able to get people in the system. Because if you don’t have everybody buying health insurance, then the healthy are going to stay away and sick people are going to go in there, which will drive up the cost and nobody will want to sell it and nobody will want to be able to pay for it or will be able to pay for it. So you got to have a broad parameter. And that means in order to get people in there, I'm not big on mandates. I’m big on trying to make sure that the health care system is so affordable and accessible, that, Frederica, this is what you want in a policy for you and your family, your husband, your family. This is what I want. I may not need as much as you do. So I want to be able to do that. But I want to be able to go into the system and do that and not have the government tell me what I have to have but what I think I should have.

Frederica Freyberg:

How do you get at that affordability?

Tommy Thompson:

That's the problem? You can do it, I think, by allowing for a lot of information. You’re going to have to have insurance companies. You’re going to have the states and the federal government really be able to talk to you and explain to you what health insurance is all about and be able to try and give you a tutorial on what, Frederica, at your age level, your marriage status, children you have, what you need. And that’s going to be an educational thing. It may not be a gold, silver platinum. It may be a thing called a copper program, which we don’t have.

Frederica Freyberg:

Do you think the insurance agencies, though, are really going to want to tailor each kind of health insurance plan to the individual?

Tommy Thompson:

No. But the insurance exchanges can. You can set up on the insurance exchanges, Frederica, all of the things that are out there that company A is selling and be able to buy into that thing and you’re going to be able to pick and choose. It’s not there yet, but it certainly is conceivable and could be easily done. So insurance companies could have it. And have a — just like anything. You go into a grocery store.

Frederica Freyberg:

Ala carte.

Tommy Thompson:

Ala carte. You buy what you need and you put it on the insurance program and this is what I need for myself and my family and that’s how you do it.

Frederica Freyberg:

Now, you very much espouse prevention; is that right?

Tommy Thompson:

I'm big on that. I really sincerely believe, you know, that the problem we are in our society is 133 people over the age of 65 have got one or two or three chronic illnesses. 75% of the cost of health care is because of chronic illnesses. And that’s because of individual decisions. We still have too many people smoke. We too many individuals that are overweight. We have too many individuals that are not exercising. And we have too many people, you know, that don’t know about nutrition, so on and so forth. All of these things, exercise, eating properly, getting the proper amount of sleep, can do a tremendous amount to make you healthy. And that’s what I'm trying to say. Let’s build — let’s build a healthier society, which will hold down costs, make you healthier and put prevention front and center. 91% of health insurance dollars and health care costs go to fix you. Only 9% of the money goes to keep you well in the first place. Isn’t there something wrong with that scenario?

Frederica Freyberg:

Now, the ACA had built in a lot of preventive services that ended up under that law being free. What do you think of that?

Tommy Thompson:

Well, the problem is somebody’s got to pay. We’ve got to come to the realization in society there’s nothing free. Somebody pays for it.

Frederica Freyberg:

So do you think that ought to be in any of the array of the ala carte plans?

Tommy Thompson:

Absolutely. I think anything dealing with wellness and health and prevention has got to be in that array or you’re not doing your job. As I said, 91-92% goes to get you well in the first place after you get sick. I want a bigger share of that money to keep Frederica and Tommy Thompson and all the people who work around here healthier at the beginning. And we can do that.

Frederica Freyberg:

I want to switch gears to FoodShare and a plan that our Governor Walker wants to institute requiring able-bodied parents who are on FoodShare to either train or work 80 hours a month. Now, a critic of this that we had on our program last week said that if you dock parents of FoodShare, that food is literally going to come out of the mouths of their children. What do you say to that?

Tommy Thompson:

Well, they said the same thing about me when I put in W-2 and so on and so forth. I sat down with welfare mothers, and I had a tremendous exchange with them. And I said, “Why don’t you work?” If I work, I don’t get child care. If I work, I don’t get health insurance. I said, “What if I give you child care and health insurance?” Yeah, but I don’t have any training. So I said, “Give them training.” And then they said, “How am I going to get there?” I said, “I'll set up transportation for you.” I did this. And so I don’t want to be punitive and I don’t think Governor Walker does. What he wants to do is get people to work. And there’s nothing wrong with that. And I think if you do it right, roll it out and get buy-in from people that are doing it. You know, people want the same thing. They want a good home. They want a good education for their children. They want safe streets. You know, it’s not rocket science. It’s right there. So let’s do that. Let’s make it easier.

Frederica Freyberg:

We spoke with former Governor Tommy Thompson earlier this week.

Frederica Freyberg:

Now for our closer look at the state budget, which Governor Walker presents next Wednesday. How to make up for the state’s transportation shortfall continues to be a sticky budget issue. We hit the highway to learn more, as Andy Soth reports from a travel plaza in western Wisconsin.

Andy Soth:

With this location next to Crystal Cave, the TEAM Oil Travel Center in Spring Valley is built to handle thousands of tourists that visit each season.

Tony Huppert:

This building was built by people that do maintenance, not by people who sit behind a desk.

Andy Soth:

But on this frigid January morning, only a few regulars are here.

Tony Huppert:

There we go. There we go. That’s good.

Andy Soth:

The team behind TEASM Oil is really Tony Huppert and family.

Tony Huppert:

Every morning I come in and say good morning to April. She says good morning to me. Works out good. If we both say good morning, we’re having a good day. TEAM stands for Trudy, my wife, Eric, my son and I'm actually Anthony and my daughter-in-law is Michelle. So that’s where TEAM comes from. It was cold, too. Eric came up with it.

Andy Soth:

The 65-year-old is happy, having son Eric onboard.

Tony Huppert:

He runs the show. I just have to — I got the ideal job. So as far as retiring, here I can act like a boss. If I’m retired, I'm home with Trudy and she’s the boss.

Andy Soth:

That gives Huppert the time to sit at the round table with the regulars. With last night’s snowfall, weather conditions are on everyone’s mind.

Man:

When's the last time you pulled someone out of the ditch right out here?

Tony Huppert:

You.

Man:

That was a whiteout that morning.

Andy Soth:

The most recent automobile accident is another topic.

Tony Huppert:

Did you know about that accident out by Martel?

Other Man:

Phone rings. Daughter Karen, she works at the title company in River Falls. She says, “Good, I'm glad you answered the phone. There’s an accident out there.”

Tony Huppert:

It's not you.

Other Man:

Wasn’t me.

Andy Soth:

Of course, transportation is also a professional interest for Huppert and an issue he watches closely.

Tony Huppert:

In a rural area, because less state funding, the early areas are having to make a decision, as all communities, what do we do about roads? So Gilman Township, where this place is located in, just raised the levy 35%. TEAM Oil will pay $1300 a year more.

Andy Soth:

Huppert's also concerned about a bridge that’s out a few miles away. It’s created a detour for a popular local restaurant.

Tony Huppert:

You have to go an extra ten miles to get to this place. Plus I have people stopping here saying they just can’t find it. He employs 90 people on his payroll, pays in over a half a million dollars in total taxes and it’s going to start up again this spring and the bridge is still going to be out. That bridge should have been done six months ago.

Andy Soth:

And Huppert is not seeing much help or hope from Madison.

Tony Huppert:

As far as the transportation fund in Wisconsin, I don’t understand how there can be any hesitation on doing something.

Andy Soth:

Legislators have been reluctant to unfreeze the state’s gas tax. And tax revenues have declined as gas mileage has improved. That means the state’s designated transportation fund is seriously under-funded.

Tony Huppert:

So where is the money supposed to come from? There should be the designated transportation fund or it’s got to come out of the general fund. Well, then when it comes out of the general fund, you got everybody fighting for that. You got education fighting for it. We have to maintain the infrastructure of the state of Wisconsin. It isn’t because we like pretty roads.

Andy Soth:

Huppert is frustrated and his irritation at the inaction of politicians is growing.

Tony Huppert:

Somebody's got to get off their butt and start to realize this is not funny anymore and, you know, it really irritates me. Coming from a person with two heart attacks, my wife says don’t get irritated.

Frederica Freyberg:

That was Andy Soth reporting. And this program note. Governor Scott Walker’s state budget address will be carried live on Wisconsin Public Television at 4:00 p.m. next Wednesday afternoon, February 8. I’ll anchor that broadcast with Wisconsin Public Radio’s state capitol bureau chief Shawn Johnson.

Frederica Freyberg:

A look ahead to Governor Walker’s state budget is next, but not before getting our political panelists’ response to President Trump’s first couple of weeks on the job. Welcome to One Wisconsin Now’s Scot Ross and managing partner of Capitol Consultants, Bill McCoshen. Thanks for being here.

Bill McCoshen, Scot Ross:

Thanks.

Frederica Freyberg:

So how about Donald Trump’s first two weeks of shock and awe? What do you guys make of it?

Scot Ross:

I think, first of all, the Muslim ban is exactly the way the country didn’t need to start with the Trump years. It’s something that’s unconstitutional. It turns out it wasn’t even vetted by actual security, national security folks. And there are people who are really suffering because of what he’s been doing. And I think that that sort of typifies the way he’s been running things, which is reckless and without regard to the implications of what he is doing.

Bill McCoshen:

It's all about results. It’s exactly what voters wanted when they voted for Donald Trump, including in the state of Wisconsin first the first time since 1984. He’s off to an unbelievable pace in two weeks. Look at the things he’s been able to accomplish already. The TPP, which voters wanted for the U.S. to get out of, the acceleration of the Keystone pipeline which the Obama administration had rejected, the nomination of a conservative Supreme Court justice. These are all things he promised on the campaign trail, and he’s actually delivering. I think what’s surprising to the other side is they’re not used to politicians who actually deliver on what they promised and Donald Trump’s doing that.

Frederica Freyberg:

You were citing some of those things and I had almost forgotten them, they are coming at such a rapid pace. Is that part of the idea here?

Bill McCoshen:

It’s the business model. He’s really the first true businessman we’ve had in the White House in a very long time, maybe at his level ever. And he’s used to working 20 hours a day and seems like he goes to the private quarters and tweets once he’s done working in the office. But he’s getting stuff done. For him, this is all about results. He’s tired of the status quo. Voters were tired of the status quo. They want action in Washington and Donald Trump’s bringing it.

Scot Ross:

I don’t know. I don’t know that they wanted action like what he’s doing. For instance, like a four-year-old child in Iraq whose grandparents are citizens being denied the ability to come here for the heart surgery that’s going to save her life. I don’t think that’s what people were asking for. And I think what we’ve seen more than anything else is just how quickly Paul Ryan and Mitch McConnell are going to roll over and do whatever Donald Trump wants and that is scary because they are supposed to be a check.

Bill McCoshen:

Saving jobs at Carrier, saving jobs at Ford, making the focus on American jobs, that’s what people wanted. I think they’re excited about it. Rasmussen Polls show his job approval is at 53%. Maybe not as high as other presidents 12 days in to their presidency, but I’ll tell you what, results are going to take some time. He’s making bold actions early in the administration and I think it’s going to play out pretty well for him politically and policy-wise.

Frederica Freyberg:

Let me ask you about Obamacare. We had Tommy Thompson on who said that repealing Obamacare is so last week. So now they want to do surgery and repair it. What do you make of that?

Scot Ross:

I think that Paul Ryan has had more than 2500 days since the ACA passed the House of Representatives and he still doesn’t have a plan. He doesn’t have a plan to prevent 30 million people losing their health care. He doesn’t have a plan to ensure that preexisting conditions are no longer denying people health care or the fact that being a woman is a preexisting condition. I mean they have had time to do this. They have no answers. I think they’re delaying, delaying, delaying. What’s going to end up happening is they’re going to put it off so that the effects of the cuts don’t come until after the 2018 election but the cuts are coming.

Bill McCoshen:

Tommy Thompson’s my mentor. He’s a surrogate father to me. I wouldn’t question him because he’s certainly involved both with Paul Ryan, with the president himself and with Reince Priebus. But I would say this. ACA repeal was last week. It’s this week. It’s next week. It’s going to happen. The Republicans ran on this time and time again. The House Republicans actually passed it 67 times, the repeal of it, and the Senate rejected it. They’re going to do and they’re going to do it in 2017.

Frederica Freyberg:

As your mentor says, “It's complicated.” Let me ask about Act 10 going national.

Bill McCoshen:

Yeah.

Scot Ross:

Well, what have been the results here? We are near the bottom of job creation in the Midwest. Just last year we lost 2700 manufacturing jobs. We are divided as never before. Education has been able to be cut by nearly $2 billion and student loan debt has gone up so those are the results of Act 10.

Bill McCoshen:

Act 10 has proven to be successful. Wisconsin saved more than $5 billion since it’s been enacted. And I’ll tell you what. This is one where Donald Trump is probably a little bit different than what we did here in Wisconsin. You saw that he had union leaders in the White House, literally in the Oval Office on day two or day three of his administration. They left there saying nicer things about him than they said about the previous president, Barack Obama. So there is a difference between public sector employees and private sector union employees and I think Donald Trump is going to try and walk that line.

Frederica Freyberg:

Looking ahead to Scott Walker’s budget, it looks like he’s going to be talking about the earned income tax credit, giving more money to rural schools and then a little bit of Tommy Thompson's kind of welfare reform with FoodShare beneficiaries. So this seems like a budget that’s like something for everyone.

Bill McCoshen:

Yeah. In the third year you try and build a budget, especially if you’re going to run for reelection. What we used to say in the Thompson administration is you win reelection in the third year. You lose it in the fourth year. In other words, do the right things in the budget and the politics should take care of itself unless you make a big mistake in the fourth year. I think Governor Walker calls it a reform dividend. There is extra money this time around, which is new to Wisconsin for the last three budget cycles. So look for Governor Walker to spread that to K-12 schools, to higher education and to take care of some of the needy here in the state.

Scot Ross:

Let's take the earned income tax credit. We have raised taxes under Governor Walker $144 million on the working poor as a result of what he did with the earned income tax credit in his first budget. Now he’s going to give back $20 million. That I think makes him $124 million short. His rural schools initiative. He literally had his three events at three schools that have seen their aid drop by double digits under Scott Walker. So yes, he is trying to do his reelection budget and he’s very good at that because it is all he knows. But the fact is our budget is in a mess. We can’t pay for education. We can’t pay for higher education, and we certainly can’t pay for our roads.

Bill McCoshen:

We know that he inherited a mess from the previous administration and he fixed it.

Scot Ross:

Come on.

Bill McCoshen:

Made some tough decisions. Had to make very tough choices. Now as he calls it, we have a reform dividend and he’s going to start to give that back.

Scot Ross:

Jim Doyle was on the ballot last 11 years ago. It’s time to let go of that talking point.

Frederica Freyberg:

We need to leave it there. Thank you very much. Now for an update away from the state capitol. This week, UW-Madison Chancellor Rebecca Blank proposed free tuition for all first generation college students who transfer from one of the state’s two-year colleges. But the proposal, which Blank announced during a board of regents meeting Thursday, depends she says, on whether the UW system gets sufficient new investment from the state.

Frederica Freyberg:

And finally tonight, a look ahead to next week. The head of immigration assistance for Wisconsin Lutheran Social Services will be here for an update on the U.S. travel ban’s impact in Wisconsin. And look for our live coverage of Governor Walker’s budget address on Wednesday, February 8, at 4:00 p.m. I'm Frederica Freyberg. Have a great weekend.

Announcer:

Funding for “Here and Now” is provided, in part, by Friends of Wisconsin Public Television.