Announcer:
The following program is a PBS Wisconsin original production.

Mark Born:
A strong Republican majority here, passing a good budget for the state of Wisconsin and looking forward to the governor signing it.

Zac Schultz:
After months of stop and go negotiations

Man:
Clerk will open the roll.

Zac Schultz:
the legislature swiftly passes the state budget and Governor Evers signs it soon after.
Good evening. I’m Zac Schultz, filling in for Frederica Freyberg. Tonight on “Here & Now,” Governor Tony Evers joins us to discuss the final passage of the state’s biennial budget. Then, after 30 years on the Wisconsin Supreme Court, retiring Justice Ann Walsh Bradley reflects on her career. And we look at what happens when you can’t afford your prescription medication in our series “Rx Uncovered.” It’s “Here & Now” for July 11th.

Announcer:
Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.

Zac Schultz:
Wisconsin has a new state budget signed in the dead of night last week by Governor Tony Evers. It’s the first budget to have bipartisan support since 2007. Joining us now is Governor Evers. And thanks for your time, sir.

Tony Evers:
Thanks Zac.

Zac Schultz:
So this has additional funding for special education, child care providers and the UW system in exchange for tax cuts. It sounds like it’s an actual compromise budget.

Tony Evers:
Yeah, I would say it was and I’m glad it was that way myself. Over the last year or so, a couple of years, I get out and talk to people all the time. That’s what I spend most of my time doing. And all across the state, I heard that a lot. You know, the idea that it’d be great that, you know, everybody knows we’re a purple state, that we actually do work on compromise. And so we were able to do that. We had some wins and some things that didn’t. But I guess that’s kind of the way the politics work if you’re, if you’re a purple state like Wisconsin.

Zac Schultz:
Now let’s go back to the last budget where you used your veto pen to create an ongoing $325 per pupil increase in public education. But that increase isn’t funded in this budget. And property taxes — taxpayers will pay for it if the school districts decide to levy that amount that they can. Was that a priority for you to try and get Republicans to fund that, or were there just too many other places for the money?

Tony Evers:
Yes and yes. Yes and no. We wanted both, obviously, but at the, at the end of the day, we, you know, we put together a package that was — I want to say it’s $1.4 billion in spendable money. And also as you likely remember, part of the problem in the past was the amount of money that school districts had to backfill into special education. And so now that is less of an issue for them. And so we put, we have the largest increase ever in, in, in that arena. And so I think it was a good start. Is it solving all the problems? No. And that’s the nature of working with the legislature. And you know, we’re a purple state. And so we’re not going to get everything but it was a good start. We had good starts in several areas. But education, we were — we made some huge increases in, in in the money for special education. That helps out in a couple different areas. Is it solving every problem? No, but it was a step forward, yes.

Zac Schultz:
Now negotiations with Republicans stopped and started a few times throughout this process and at one point it looked like they were going to go their own way as they’ve done the last few budgets. What were you doing? Were you reaching out to them? Were you waiting for them to figure out them and come back to the table?

Tony Evers:
That — it was a latter. Clearly the two houses weren’t on the same page. And after a while that became less of an issue. And so they came back and we ended up solving it. And, you know, we had some really significant wins also. I, you know, I know the importance of having, you know, both sides having some wins, having, you know, some things didn’t work. But for example, our ability to get more money for our hospitals in the state of Wisconsin, that was huge. That was a win. That was a complete win. And because, as you likely remember, we had two hospitals in Eau Claire close in one, you know, one year. And this keeps our hospitals all across the state in a much better place.

Zac Schultz:
Now, one reason Republicans did need to compromise. You talked about the difference in the houses is the Senate couldn’t afford to lose any votes in the Republican Party, and that’s because Democrats picked up seats in the last election. So how much does redistricting play into what happened in this budget?

Tony Evers:
Absolutely. This budget would not have looked anywhere near as positive if it, if it wasn’t for that. Having good maps that are reflective of actually what happens on the ground, that was huge. And so we’ll — and we’ll, we’ll continue to do a good job as far as taking, not taking advantage of it, but actually reflecting that. But you know, from my side too, from the Democratic side, just because we are, we have better maps doesn’t mean that we can run roughshod over the other side either. It just won’t work. We’re, we’re as purple as they come in our state as compared to other states, and we recognize that.

Zac Schultz:
Let’s talk about Donald Trump’s BBB – big, beautiful bill. What will be the impact of that bill in Wisconsin?

Tony Evers:
Yeah, I don’t think it’s going to be good. You know, clearly, issues that they feel strongly about is not necessarily good for Wisconsin. Passing this bill kind of makes them all legal. I think in the past there was some concern that on my part and others that what was, what was happening in the new administration was very difficult and frankly, not — shouldn’t have been able to do that because the Congress has not weighed in. Well, they’ve weighed in now. And so all those things that, that we were against, that were happening, happened. And so, yes, I think it’s going to be — it’s going to be a really difficult time for us. And, you know, whether it’s schools, whether it’s just about anything, you know. I’m sure we’ll have thousands of people in Wisconsin that no longer have the health care they had before.

Zac Schultz:
One area that’s still up is your corrections plan. As far as the prisons, you vetoed the deadline to close the Green Bay facility. Can you use the experience negotiating the bill, the budget, to figure out how to negotiate that plan?

Tony Evers:
Yeah, absolutely. We should and we have to. I mean, we – Green Bay is going to close. I get that. Whether it’s in 2029 or whenever, it is closing. But in order to allow that to happen, there’s all sorts of steps. We put together a plan several months ago. I think it was a rational plan. And, you know, there are some people that want to do different things. But the bottom line is we have to start. It’s like a dance. We have to do this first and then this first and this first. I’m willing to talk to any, any Republican, any Democrat on this issue. We just have to get it done. Do I think we will? Yes. We have to.

Zac Schultz:
It’s tradition for the governor to wait until after the budget is signed to announce whether they’ll run for another term. What is the timeline for your decision, and do you have any announcements you’d like to make today?

Tony Evers:
I’m not going to make any today, but I’ll tell you, it’ll happen shortly. I would say a week or so.

Zac Schultz:
All right, Governor Tony Evers, thanks for your time today.

Tony Evers:
Thanks Zac. Appreciate it.

Zac Schultz:
The Wisconsin Supreme Court has completed its term by releasing decisions in a number of high-profile cases, including a 4-3 decision to overturn Wisconsin’s 1849 abortion ban. The end of the term also means the end of the career of Chief Justice Ann Walsh Bradley, who decided to retire after 30 years on the High Court. I sat down with the Chief Justice recently to discuss her career and the future of the court. Madam Chief Justice, thanks for your time.

Ann Walsh Bradley:
Pleasure to be here Zac.

Zac Schultz:
Let’s go back to the start. Can you imagine what yourself in 1995 would think of where you are today, all these years later?

Ann Walsh Bradley:
Well, it’s been a journey and the journey, of course, has been traveled by me but surrounded by family and friends and colleagues. To answer your question, I don’t think I would have seen myself as I am today 30 years ago. That’s right.

Zac Schultz:
So Shirley Abrahamson was the first woman appointed to the Wisconsin Supreme Court.

Ann Walsh Bradley:
That’s correct.

Zac Schultz:
But you were the first elected. How far have we come in that it’s been mostly women on the court today, and most people in the modern era think it’s natural for women to sit on the bench.

Ann Walsh Bradley:
Well, it’s been — we’ve come a long ways. You know, that’s a — perhaps a worn-out phrase, but it holds some truth to it. When I got on the circuit court in Marathon County, there were only ten women judges in the entire state, and I was one of three north of Madison and Milwaukee. When I became an attorney and went to Wausau, I remember that very first day being welcomed by my supervisor with this. He said, “I want you to know I have no problem with a woman trying to do a man’s job.” So it has been a journey from the first days of being an attorney and then being a circuit court judge and till now. We have six of the seven members on our court are serving as women. So that’s a, that’s a long ways.

Zac Schultz:
So it was just a couple of years ago, the night that Janet Protasiewicz was elected to be a member of the court. I happened to interview you.

Ann Walsh Bradley:
Yes.

Zac Schultz:
And I said, “You’re up next. Have you thought about whether you want to run?” And you told me, “I’m going to run and I’m going to win.”

Ann Walsh Bradley:
Yes.

Zac Schultz:
Take us from that moment to your decision that this was going to be the end of your time on the bench.

Ann Walsh Bradley:
It was a difficult decision. A decision that took me many months. I had engaged services of someone who was going to be helping me run the campaign. But ultimately, as I reflected, I made lists of — as most people or many people would do — of yes, I want to run or no, I should not run. And the — it was just time to pass the torch. I’ve been on the court for 30 years. I’m told I have participated in 28,000 cases. 2,400 oral arguments, 600 or so opinions. And it was time to pass the torch to begin a new chapter of my life. I don’t look at this as retirement because I have a number of things I want to do and accomplish, but it’s a new chapter.

Zac Schultz:
When you first ran for the court, there wasn’t nearly the public attention, certainly not the money or even the partisan involvement. You ran as a nonpartisan and criticized one of your opponents for accepting endorsements from, from conservative politicians. How, how do you view the elections that occur today? Even your successor had to court the Democratic Party, received millions in fundraising and yet has to try and claim judicial independence when she takes the robes. How has that altered how the justices see themselves and how the public sees the court?

Ann Walsh Bradley:
In 1995, when I ran that first race, I had as my co-chairs, Tony Earl, who was the former Democratic governor, and Sue Ann Thompson, who was the then first lady – her husband, Tommy Thompson – serving as my co-chairs. I had strong bipartisan support, and I’ve had strong bipartisan support in all of my campaigns. But it’s harder to get. This is labeled as a nonpartisan race. It’s in April, right? That’s when we have the nonpartisan elections. And I am concerned about the influx of partisanship in judicial races. That’s of great concern to me because I think that it has a couple of effects. Number one, it has an effect on the public trust and confidence in an independent judiciary. And being independent not only in substance but also in impression is important for the public trust and confidence of the people. So I think the influx of political parties and the great amount of money is of concern.

Zac Schultz:
The legal landscape surrounding the court has changed as well. The amount of groups that exist only to file lawsuits with the best hand-picked cases and plaintiffs involved in order to find a crack in precedent to overturn something.

Ann Walsh Bradley:
Yes.

Zac Schultz:
How, how does that change how you react from the bench when you know that this was, you know, hand-selected just in order to try and reach the opposite conclusion?

Ann Walsh Bradley:
Your question brings to mind something my husband once said to me, because I mentioned, you know, being involved in 28,000 cases and all the oral arguments. He said, “Well, hasn’t it all been decided already?” You know, there are so many cases, but the answer is no. I get thrilled by the presence of good arguments and good attorneys because they really help the court develop the law. And when new arguments are brought, then we take a look at the issue in the way it’s framed, citing different cases and different issues.

Zac Schultz:
Do you support change in the Constitution to eliminate elections or alter elections, or you talked about what other states do? There’s a lot of options out there. Do you have a proposal that you would support?

Ann Walsh Bradley:
I don’t currently have any proposal that I support, but I do support looking at all sorts of different options as I know, groups and legislators are doing right now because we have a challenge before us. And the challenge is to make the selection of justices and the campaigns -if we continue with campaigns – better. Not for the sake of making a campaign better, but for the sake of the 5.8 million people who call Wisconsin home. They deserve a judiciary that they have trust and confidence in.

Zac Schultz:
How might that have changed you becoming a member of the Supreme Court? Because back in 1995, you may not have been either selected to become on a list or appointed to this process. You had to push your way onto it.

Ann Walsh Bradley:
That’s right. And about three weeks ago, I was on an international webinar regarding election of justices around the world. Now, there are not many countries that elect their state Supreme Court justices, or however they divide, whether it’s a province or an area. United States is one of the few. And I made the comment then to this webinar attendees that I probably wouldn’t be on the Supreme Court if it were not through election. I was not one of the favored people. I mean, I didn’t have inside track information or path, right? It was good old-fashioned retail campaigning around the state and I won. So I am not quick to say, “Let’s get rid of elections.” Not at all. I am quick to say, “Let’s see how they can become better.” And if we can’t make them what they should be, then let’s look at other options.

Zac Schultz:
Chief Justice Ann Walsh Bradley, thank you for your time.

Ann Walsh Bradley:
Thanks, Zac.

Zac Schultz:
For decades, the cost of prescription medication has been ever increasing. At the same time, health coverage for medication has been decreasing, forcing patients to make harder decisions about their health. Over the next few weeks, we bring you “Rx Uncovered,” a series from “Here & Now” producer Marisa Wojcik that dives into the complex systems driving these trends and the stories of patients facing life or death choices. Our first story is about a young man with asthma who suddenly had to choose between affording his rent or his medicine.

Bil Schmidtknecht:
Well, we got told, you know, just simply that he would never wake up.

Marisa Wojcik:
Bil and Shanon Schmidtknecht had just heard the worst news of their life.

Bil Schmidtknecht:
That all I remember is collapsing on him and the nurses sliding chairs behind us.

Marisa Wojcik:
Their oldest son, Cole, suffered an asthma attack. His roommate rushed him to the ER and his heart stopped beating two minutes before they arrived.

Bil Schmidtknecht:
When he arrived at the hospital, he was lifeless. He had no pulse. They had to resuscitate him.

Marisa Wojcik:
But the prognosis wasn’t good.

Shanon Schmidtknecht:
They were no longer seeing the brain activity. They were no longer seeing any hope that there would be any type of recovery, that essentially what we saw laying in the hospital of our son was all that he would ever be.

Marisa Wojcik:
The 22-year-old laying in that hospital just days earlier was happy and healthy. Bil and Shannon were mystified.

Shanon Schmidtknecht:
You just want to grab on to him. Like, I just couldn’t — you’re like, this cannot be happening.

Marisa Wojcik:
In the days that followed, Bil and Shanon watched their son fulfill an organ donation before watching him take his final breath.

Shanon Schmidtknecht:
Cole had had asthma his whole life. He was on a great medication that stabilized his asthma for the past decade or more. So we were, like, this cannot be.

Marisa Wojcik:
Still in shock, they didn’t understand how this could have happened and why Cole didn’t have his medication.

Shanon Schmidtknecht:
I will never forget that day.

Marisa Wojcik:
Their quest for answers began as grieving parents. More than a year later, they retell Cole’s story, hoping for change.

Bil Schmidtknecht:
We always felt there was something that was unanswered.

Marisa Wojcik:
The little they did know was from Cole’s best friend and roommate, who said Cole did go to the pharmacy days earlier but couldn’t get his asthma medication refilled.

Shanon Schmidtknecht:
His roommate had said, “I don’t know. We tried to get it a few days ago and he couldn’t afford it. It was like $500.” And we were like, “No, no, no, no. There has to be like…

Bil Schmidtknecht:
…something.

Shanon Schmidtknecht:
Something happened.

Marisa Wojcik:
Both Cole and his father managed the same chronic asthma their whole lives. They used the same prescription inhaler and they worked for the same company, meaning they had the same health coverage.

Bil Schmidtknecht:
Probably a few weeks later, texted her, said, “Hey, can you swing by the pharmacy and grab my steroid medicine too?”

Shanon Schmidtknecht:
I just remember walking in and she had it written down on a piece of paper: ‘no longer covered by insurance.’ She worked her magic and made a phone call. Even stayed after they were open and, you know, did what she had to do to get something for me to take home so that he had something.

Marisa Wojcik:
This was the first glimpse into what may have happened in the days leading up to Cole’s death. Health coverage from the employer had changed, and with it, the out-of-pocket cost.

Shanon Schmidtknecht:
They were told specifically as employees that it would be a seamless transition. Pharmacy benefits would be seamless. Prescription coverage would be seamless.

Bil Schmidtknecht:
The unique thing, though, is we stayed with the same pharmacy benefit manager.

Marisa Wojcik:
What did change without their knowledge was their prescription benefits formulary. The list of preferred drugs covered by the health plan. These lists are compiled of name brand and generic medications, categorized into tiers. Tier one is the most preferred by the plan and has the lowest co-pays. The higher the tier, the more the patient pays out of pocket.

Shanon Schmidtknecht:
I will never forget that. Leaving that pharmacy and being like, “Oh my God. This is what happened to Cole.”

Marisa Wojcik:
The preventative asthma medication that Cole relied upon was moved to a higher tier that he suddenly could not afford.

Bil Schmidtknecht:
We always assumed that he kind of ran some life choices and said “rent or this” and thought he could do without it. Five days after that, he texted me that he was having a hard time breathing.

Marisa Wojcik:
The parallel details around Bil and Cole’s condition, medication and health plan helped the Schmidtknecht understand how Cole’s pharmacy visit differed from Bil’s.

Shanon Schmidtknecht:
The difference is he didn’t have this pharmacist or any caring, independent pharmacist or whomever to stop for five seconds.

Marisa Wojcik:
Bil’s pharmacist made sure he got the lifesaving medication he needed.

Shanon Schmidtknecht:
She was like, “So we got to figure this out. You’re not leaving here with nothing for him, for Bil.”

Marisa Wojcik:
While no one can know for sure what happened to Cole at the pharmacy that day, many, including Bil’s pharmacist, are convinced.

Bil Schmidtknecht:
Honestly, she believes this is what contributed to Cole’s death was the fact that he didn’t get his medicine walking out of the pharmacy. You know, she, she can’t make that judgment for sure, but she felt that way.

Dwayne Page:
As you could tell, he was the love of our life. One day, him and I were laying in the yard looking up at the sky. He looked at me and said, “Grandpa, when you get to Heaven, would you save me a seat by you?”

Marisa Wojcik:
In March, Senate President Mary Felzkowski reintroduced legislation that she and the Schmidtknecht believe could have helped Cole get his medication.

Mary Felzkowski:
At some point, somebody has to say enough is enough and put some guardrails around this.

Marisa Wojcik:
The bill contains a number of measures aimed at protecting independent pharmacies and adding regulations against pharmacy benefit managers, or PBMs.

Todd Novak:
PBMs are essentially a middleman hired by insurance companies to manage patient prescription drug benefit programs.

Mary Felzkowski:
And they’re actually adversely driving up the cost of drugs and controlling whether or not you get the medication that’s been prescribed to you.

Marisa Wojcik:
Newly dubbed “Cole’s Act,” this is the third time the multi-pronged legislation has been authored.

Mary Felzkowski:
I watched what happened with the first PBM bill. It got really stripped down in the Assembly. We’re not going to allow that to happen this time around. We are going to pass meaningful legislation.

Marisa Wojcik:
One part of the bill deals specifically with drug formularies, saying a plan cannot change a drug’s tier except at the time of coverage renewal. Historically, employer and insurance groups have opposed this legislation, fearing it will increase costs.

Rachel Ver Velde:
Marketplace events occur throughout, throughout the year that impact the price of prescription drugs. By implementing a frozen formulary, payers and plans will be limited in their ability to take advantage of new reduced prices.

Mary Felzkowski:
We’re going to work very hard on showing them, through data from other states that have allowed that, have the same legislation, where it’s actually lowered the cost of health care.

Bil Schmidtknecht:
I can’t believe it’s been almost a year that he’s gone.

Shanon Schmidtknecht:
Yeah.

Marisa Wojcik:
Exactly one year after Cole’s passing, his parents filed a negligence lawsuit against the pharmacy benefit manager and the chain pharmacy where Cole went to try and pick up his inhaler. The complaint says no notification went out that the formulary had changed, and the pharmacist should have offered a generic alternative. It lists a number of points of failure, many of which violate Wisconsin law. In a motion to dismiss, the PBM argues that because Cole’s health plan is what’s called self-funded, these types of employer-sponsored benefits are not technically health insurance. They’re largely not subject to state law, and exclusively a federal concern.

Mary Felzkowski:
We can’t keep waiting for Washington. My constituents can’t afford to keep waiting for Washington on a number of things. And I believe in states’ rights. And it’s time that the states need to step up. You know, we have the fifth highest health care costs in the nation. And our quality does not reflect that.

Marisa Wojcik:
Congressional committees and federal agencies have been sounding some alarm on practices rampant across the industry. In January, the Federal Trade Commission released its latest report investigating the top three PBM companies for inflating drug prices, saying UnitedHealth Group’s Optum Rx, CVS’s Caremark and Cigna’s Express Scripts increased prices hundreds or thousands of times over, putting $7.3 billion back into their pockets from 2017 to 2022. Amid a complex system, Cole’s parents believe more should have been done.

Reporter:
How will this bill have saved Cole?

Mary Felzkowski:
I’m going to defer to Cole’s dad for that.

Bil Schmidtknecht:
The reality is — any portion of a bill that would prevent the slowdown at the pharmacy counter. There’s so many “had he done this” or “had he went to this type of pharmacy.” The ultimate thing, no matter what happens, it was totally preventable. I mean, like, it was preventable. Please don’t let another parent stand where we are today.

Shanon Schmidtknecht:
We’ve just taken a totally different look at so many things in life. It’s all because this cannot happen. This cannot happen to another family.

Marisa Wojcik:
Reporting from Poynette, I’m Marisa Wojcik for “Here & Now.”

Zac Schultz:
For more on this and other issues facing Wisconsin, visit our website at PBSWisconsin.org and then click on the news tab. That is our program for tonight. I’m Zac Schultz. Frederica Freyberg will be back next week. Have a great weekend.

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Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.