Bradley Burmeister, MD
On May 1st, over 20 Emergency physicians were among the more than 300 physicians from across Wisconsin to participate in Doctor Day in Madison.
The two main policy issues for this year focused on Medicaid reimbursement and the personal conviction waiver for immunizations.
As you know, Wisconsin continues to be at or near the bottom for Medicaid reimbursement. In fact, for most Emergency Department levels of service, Wisconsin is dead last for reimbursement often at rates far below overhead costs. Adequate and fair Medicaid reimbursement is important in order for patient to have access to both primary and specialty physicians.
In general, legislators provided feedback that they understand the Medicaid issue is regarding access. Many had a very strong understanding, and realize the issue is not just about the bottom line for physicians.
This year’s particular “ask” regarding Medicaid was focused on institutional versus non-institutional payments. The Governor’s budget includes Medicaid expansion and with expansion, over $300 million dollars would become available. The budget, however, allocates all of these funds as institutional payments to hospitals and health systems, and not toward physicians or other non-physician providers.
The second issue was around support of proposed legislation to end the personal conviction waiver for school-mandated vaccines. Wisconsin is one of only 18 states that continue to permit a personal conviction to waive the requirement to have vaccines for school-aged children. In many states, parents can seek a medical waiver or a religious waiver. But only a few states, including Wisconsin, allow parents to essentially check a box exempting their children from the vaccine requirement. Since 1997, Wisconsin has seen a significant increase in parents obtaining a vaccination waiver. While medical and religious waivers, which represent less than 1% of all waivers, have not increased over time, the personal conviction has seen a steady and dramatic increase and represents the vast majority of total waivers.
Legislation has been introduced that seeks to end the personal conviction exemption but continues to permit medical and religious waivers. As you know, the science is clear on immunizations, and we must maximize our “herd immunity” for the betterment of the whole community.
To summarize, Doctor Day 2019 was a tremendous success. To continue our advocacy efforts, several of us from WACEP leadership are now in Washington DC to participate in ACEP’s Leadership and Advocacy Conference. There, we will meet with legislators and staff from Wisconsin, and will engage in advocacy at the national level. Stay tuned for additional updates, and in the meantime, save the date for Doctor Day 2020, scheduled for January 29, 2020 in Madison. We hope to see you there!