Since the beginning of 2025, WiAHC’s lobbyists have been aggressively advocating to increase the Medicaid reimbursement rate for home health agency-based nurses from $96.96 per visit to $117.86 per visit, which is 70 percent of the Medicare home health reimbursement rate. Such a rate increase would bring our state in line with the reimbursement rates in other Midwest states. With your help as WiAHC members, we are pleased to inform you that this increase was included in the Fiscal Year 2025-2027 state budget that Governor Tony Evers (D) signed into law on July 3!

More specifically, this budget law provides $294,300 in FY2025-2026 and $588,600 in FY2026-2027 to increase the Medicaid reimbursement rate for home visits performed by licensed practical nurses or registered nurses employed by home health agencies, effective January 1, 2026. Please note that per the funding levels provided above, it appears that this requested rate increase will be fully implemented in the second year of the biennial budget – in FY2026-2027.

In addition to WiAHC’s gratitude to Governor Evers and the Legislature’s budget-writing Joint Committee on Finance, our organization greatly appreciates the leadership of both Senator Rachael Cabral-Guevara (R-Appleton), a nurse practitioner, and Representative Clint Moses (R-Menomonie), a chiropractor. Both of these legislators formally submitted this rate increase request to the Joint Committee on Finance for consideration.

Early on July 1, Governor Tony Evers (D) announced an agreement on the state Fiscal Year 2025-2027 budget with legislative leadership. The budget bill compromise between Governor Evers and legislative leaders will boost funds for the Universities of Wisconsin, special education, and childcare providers in exchange for preserving approximately $1.4 billion in Republican tax cuts. The Legislature’s Joint Finance Committee approved this agreement on July 1 by a vote of 13-3. Subsequently, the state Senate passed the bill on July 2, and the state Assembly passed it in the early morning hours of July 3. As noted above, Governor Evers signed this bill on July 3.

The following are highlights of the $111.1 billion FY2025-2027 budget:

State Taxes

• A reduction of the Wisconsin individual income tax by over $600 million annually.
• Over 1.5 million of Wisconsin taxpayers will receive a tax cut, averaging $180.
• 82 percent of the tax cut will go to taxpayers with adjusted gross income below $200,000.

• Reducing income taxes for many Wisconsin retirees.
• Allowing those age 67 or older to exclude up to $24,000 (up to $48,000 for married-joint filers) of retirement income payments will reduce taxes on approximately 280,000 Wisconsin filers by an average of about $1,000 per filer.

Department of Public Instruction

• A $1.4 billion increase in funding for public K-12 schools in Wisconsin.
• This includes an increase in the special education reimbursement rate, to 42% in FY2025-2026 to 45% in FY2026-2027. According to Governor Evers, this is the highest reimbursement rate in three decades.

Department of Children and Families

• The Fiscal Year 2025-2027 budget includes more than $361 million in economic support for Wisconsin’s child care industry, including:
• $110 million in FY2025-2026 for direct payments to child care providers.

Department of Health Services

• Medicaid Cost-to-Continue: The budget agreement also fully funds the state’s Medicaid program – this is known as “Medicaid cost-to-continue.” This funding incorporates enough funding to pay for the increased costs of providing services and also takes into account changing Medicaid enrollment projections.
• In FY2025-2026, $1.529 billion is provided and in FY2026-2027, $2.279 billion is provided.

• Hospital Assessment: At present, Wisconsin hospitals pay 1.8% of their net patient revenue to the state Department of Health Services (DHS) – this is known as the “hospital assessment.” This budget agreement increases this percentage to 6%.
• 30% of these funds will be held in the Medical Assistance Trust Fund, which helps pay for the state’s Medicaid program.
• The rest of this funding will be used to make hospital provider payments, resulting in over $1.1 billion in funding to go to Wisconsin hospitals.
• Private Duty Nursing (PDN) Medicaid Rate Increase: Provide $4.7 million in FY2025-2026 and $9.59 million in FY2026-2027 to increase Medicaid reimbursement rates for private duty nursing services provided by RNs and LPNs (excluding PDN services provided by independent practice RNs and LPNs), effective January 1, 2026.
• NOTE: WiAHC member Maxim Healthcare Services advocated for this increase.
• Personal Care Medicaid Rate Increase: Provide $6.3 million in FY2025-2026 and $12.7 million in FY2026-2027.
• WisCaregiver Careers: Provide $2 million in FY2025-2026 to increase funding for this program, which aims to increase the number of certified nurse aides (CNAs) and certified direct care professionals (CDCPs) in the state.
• Free and Charitable Clinics: Increase funding for free and charitable clinics by $1.5 million between FY2025-2027.
• Federally Qualified Health Centers: Provides $800,000 annually to increase grants to such centers.

• Health Care Provider Training Grants: Provide $1 million in FY2025-2026 to increase funding for the allied health professional education training program.
• University of Wisconsin Hospital and Clinics: Increases the uncompensated care supplement by $10 million annually.
• Adult Level One Trauma Hospitals: Provides $35 million in grants annually to support these hospitals.
• Regional Referral Hospital Support Payment: Provides $15 million annually to a regional referral center providing tertiary-level care to residents of multiple counties.
• Grants to Health Center “Look-Alikes”: Provides $200,000 annually to such health centers that are designated as federally qualified health center look-alikes.
• These types of health centers are community-based health care facilities that meet federal health center program requirements, but do not receive health center program funding. These centers provide primary care in underserved areas.

• State Mental Health Institutes: Provides $15.8 million in FY2025-26 to these institutes to address a projected deficit from fiscal year 2024-25 in the civil patient treatment program.

Higher Education Aids Board

• Emergency Medical Services Training Costs: Provide $3.5 million in FY2025-2026 and $3.5 million in FY2026-2027 for Emergency Medical Services training reimbursements related to training and materials incurred in completing a course at a Wisconsin Technical College System institution.

Department of Safety and Professional Services

• Occupational Credentialing Customer Service Call Center Staff: Extend five call center contract employees for three more years – until September 30, 2028. Provide $253,100 in FY2025-26 and $337,300 in FY2026-27 to support the positions.

• Occupational Credentialing Board Support Staff: Provide $126,200 in FY2025-26 and $164,400 in FY2026-27 and one pharmacy practices consultant for inspections of primarily non-retail pharmacy locations.

Universities of Wisconsin (UW)

According to Governor Evers, this budget will include the largest increase in funding for the UW System in nearly two decades. In particular, it includes:

• An increase of over $239 million in operational funding for the UW System, including:
• $54 million to help retain and recruit faculty in high-demand fields.
• Over $94 million to increase wages for faculty and staff.

Department of Workforce Development

• Worker’s Compensation – Hospital Service Fee Schedule: Provide that a fee specified in a hospital service fee schedule, for the purpose of paying a worker’s compensation claim, be utilized only if: (a) the fee is for an item or service provided by an eligible hospital; (b) the fee is for an item or service for which the eligible hospital may receive hospital inpatient or outpatient reimbursement from the Medicaid program; and (c) the fee is paid within the applicable period (up to 90 days, with possible 30 day extensions).

For the last several years, WiAHC has been advocating to eliminate an outdated state regulation relating to professional advisory bodies for home health care agencies. WiAHC has been advocating for this change since professional advisory committees were removed from federal regulations in 2017, as home health agencies are already overseen by a governing body pursuant to federal regulations.  In addition, home health agencies are also overseen by governing bodies in Wisconsin regulations.  In 2017, the federal Centers for Medicare & Medicaid Services (CMS) also put in place federal regulations requiring home health agencies to implement ongoing quality assessment and performance improvement (QAPI) programs.  Essentially, CMS replaced professional advisory committees in federal regulations with the creation of the QAPI program.

In January 2023, WiAHC formally requested that DHS eliminate professional advisory bodies for home health care agencies in the agency’s biennial rules review – a process by which DHS makes technical changes and updates to existing state regulations. Our organization’s rationale is that this would bring Wisconsin’s regulations in line with federal regulations for the reasons addressed above.

Subsequently, the draft DHS biennial rules review document includes the elimination of professional advisory bodies for home health agencies. On July 7, the agency formally requested public comments on the economic impact of the draft biennial rules review. In anticipation of this announcement, WiAHC had requested appropriate feedback from home health agency member employees. (Thank you to those who provided feedback!)  WiAHC incorporated this feedback into our formal comment letter, which has been submitted to DHS. Further updates will be included in future editions of this newsletter.

On July 15, DHS released their analysis showing how the recently enacted federal budget reconciliation bill will likely impact Wisconsinites who benefit from Medicaid (e.g., BadgerCare Plus) programs. Overall, DHS agrees with the estimate provided by the Congressional Joint Economic Committee that 276,175 individuals in our state will lose health care insurance coverage under the Affordable Care Act and Medicaid over the next 10 years. More specifically, 63,000 Wisconsin adults without dependent children are estimated to be at high risk of losing Medicaid coverage due to the work requirements included in this new federal law.

For more details, please view the detailed analysis on the DHS website.

On June 25, 2025, Marquette University Law School Poll released its most recent poll, which surveyed 873 registered Wisconsin voters between June 13-19, 2025. This poll is the first Wisconsin state-specific Marquette poll since the spring election. This new poll covers political approval ratings, budget issues, and education policy. The following poll findings may be of interest:

Elected Officials

President Trump Job Approval

• 47% approve of the job President Trump (R) is doing.
• 52% disapprove.
• 1% don’t know.

Governor Tony Evers Job Approval

• 48% approve of the job Governor Tony Evers (D) is doing.
• 46% disapprove.
• 5% don’t know.

Wisconsin Legislature Job Approval

• 41% approve of the state legislature’s job performance.
• 50% disapprove.
• 10% don’t know.

Wisconsin Supreme Court Job Approval

• 49% approve of the state supreme court’s job performance.
• 38% disapprove.
• 13% don’t know.

U.S. Senator Ron Johnson Favorability

• 40% have a favorable opinion of U.S. Senator Ron Johnson (R)
• 44% have an unfavorable opinion of him.

U.S. Senator Tammy Baldwin Favorability

• 44% have a favorable opinion of U.S. Senator Tammy Baldwin (D)
• 47% have an unfavorable opinion of her.

Wisconsin State Budget

State Tax Cut

When informed that state government has a roughly $4 billion surplus, registered voters are asked how much of that should go towards a tax cut.

• 27% feel that the entire surplus should be used for a tax cut.
• 9% feel that 75% of the surplus should be used for a tax cut.
• 29% feel that half of it should be used for a tax cut.
• 19% think that approximately 25% of it should be used for a tax cut.
• 16% feel that none of the surplus should be used for a tax cut.
• 1% don’t have a position.

State and Local Policy

Extending Medicaid Coverage to New Mothers One Year After Giving Birth

• 66% support this.
• 33% oppose this.

Childhood Vaccine Benefits and Risks

When asked whether the benefits or the risks are greater for children receiving the measles, mumps, and rubella (MMR) vaccine, the survey found:

• 84% feel that the benefits outweigh the risks.
• 15% feel that the risks outweigh the benefits.

State Education

Satisfaction with Public Schools

• 63% are very satisfied or satisfied.
• 36% are very dissatisfied or dissatisfied.
• 1% don’t know or have mixed views.

Property Taxes vs. K-12 Funding

When asked whether reducing property taxes or increasing spending on K-12 spending on public schools is more important, the survey found the following:

• 57% prefer reducing property taxes.
• 43% prefer increasing spending on public schools.

On June 30, the state Department of Health Services (DHS) released a report addressing Wisconsinites who receive both Medicaid and Medicare benefits – otherwise known as “dual eligibles.” This nine-page report includes various findings and recommendations. The full report may be viewed on the DHS website.

Each July, the state Department of Health Services (DHS) is required by state law to adjust the maximum amounts that health care clinicians may charge patients for their medical records. This adjustment takes into account inflationary changes over the prior calendar year. This updated fee schedule may be viewed on the state legislature’s website.

In support of an effort to increase the Medicaid reimbursement rate for home health agency-based nurses from $96.96 per visit to $117.86 per visit, WiAHC sent out an action alert to all WiAHC members on May 29 and again on June 16 requesting that they contact their respective state representatives and state senators to ask them to support this budget request. Such a rate increase would bring Wisconsin in line with other Midwest states.

In a positive development, WiAHC’s lobbyists have previously secured the support of both Senator Rachael Cabral-Guevara (R-Appleton), a nurse practitioner, and Representative Clint Moses (R-Menomonie), a chiropractor, to formally submit this request to the Joint Committee on Finance for consideration to be possibly included in the FY2025-2027 Department of Health Services budget. 

The Legislature’s budget-writing Joint Committee on Finance has been holding meetings in May and June to approve state Fiscal Year 2025-2027 budgets for various state government agencies. Once the committee has done its work, their work will be consolidated into FY2025-2027 budget legislation, which the full Assembly and Senate will vote on. As the current fiscal year ends on June 30, the Legislature generally attempts to send a budget bill to the Governor for his consideration by the end of June. However, if there are delays with the legislative process or the Governor vetoes the budget legislation in full, state government will continue to operate on existing funding levels until the Governor signs a FY2025-2027 budget bill into law.

In late April, the Department of Health Services (DHS) issued a press release that analyzed the impact of potential federal Medicaid budget cuts on Wisconsin. This analysis is based on federal budget reconciliation legislation that the U.S. House of Representatives approved on May 22.  The following elements of this legislation, which has not yet been approved by the U.S. Senate (as this is written), will likely be of interest to WiAHC:

·        Per-Person Funding Limit– Currently, the federal government provides funding to states based on a percentage of Medicaid costs. This legislation proposes to instead provide a set amount of funding per Medicaid beneficiary. This could cost the State of Wisconsin up to $16.8 billion in federal funds over a decade.

·        Administrative Costs – This funding pays for information technology and for staff to review Medicaid claims and pay health care providers, among other things. This could cost the State of Wisconsin up to $93 million each year.

·        Work Requirement – Such a requirement would likely require able-bodied adults without children to provide proof that they are working in order to receive Medicaid benefits. DHS estimates that the agency would incur up to $6 million in administrative costs to comply with such a requirement. Any employment and training requirements that DHS may need to provide to help Medicaid beneficiaries meet these requirements could cost $60 million annually.