Policymaker Newsletter

May 2025

Federal Issues

While Congress considers a Budget Reconciliation bill, WPHCA encourages lawmakers to provide robust funding for Community Health Centers (including base grant increases and funding to convert Look-Alikes to Federally Qualified Health Centers) and to protect Medicaid. Without Medicaid stability, Health Centers will not be able to continue serving as the primary care providers that rural and urban communities rely on.

On April 28, the Wisconsin Department of Health Services published an analysis modeling various Congressional approaches to Medicaid changes. The analysis found that proposals such as per person caps, mandatory work requirements, and reductions in the federal share of Medicaid funds would have drastic impacts for Wisconsin. Read the full analysis here: Modeling the Impact of Congressional Budget Cuts on Wisconsin Medicaid 

Did you know?  

• According to 2023 data, 55% of Wisconsin Community Health Center patients were covered by Medicaid the program accounts for 73% of patient revenue. 
• Nearly half (44%) of Medicaid enrollees in Wisconsin are children. 
• Most adults with Medicaid work (44% full time, 20% part time) and the vast majority of those who don’t are caring for family, ill or disabled, or going to school.  
• Medicaid is a major payer for behavioral health services, including both county-based services and outpatient care, like counseling and therapy.  
• Medicaid covered 1.32 million people in Wisconsin as of December 2024, one-fifth of the state population.  
• One-third of Wisconsin births are covered by Medicaid. 
• Children and non-elderly adults in small towns/rural areas are as likely as those in metro/urban areas to rely on Medicaid (see details). 

Check out recent news from Community Health Centers in Wisconsin

State Issues

On April 2, advocates from across Wisconsin convened for WPHCA’s biennial State Policy & Issues Forum and met with nearly 100 legislative offices at the State Capitol. Advocates raised awareness of the value of Medicaid and encouraged investments in Community Health Centers through the State Grant, along with health care workforce priorities. Special thank you to Sen. Jesse James for serving as this year’s guest speaker.  

As lawmakers craft the 2025-2027 budget, WPHCA encourages you to consider the interconnected relationship of Medicaid payments and health professions training/pathways. Without investments in training the health care workforce, organizations like Health Centers will continue to see wait lists for care, and limited access to services. Explore WPHCA’s state budget priories:  

• Invest in the Health Care Workforce
• Invest in the Community Health Center State Grant
• Medicaid 101 Fact Sheet

WPHCA also supports AB-173/SB-203, which regulates Pharmacy Benefit Managers (PBMs) by enacting transparency requirements, prohibits patient steering and certain auditing practices, bans insurer co-pay accumulators, and prohibits 340B discrimination in PBM contracts, among other provisions.  

WPHCA also applauds the Wisconsin Senate for passing SB-23, providing a full year of Medicaid post-partum coverage and encourages the Assembly to move the bill forward.

Learn More

• What is a Community Health Center?
• Statewide Health Center Data (2023)
• Mental Health Care & WI Community Health Centers Issue Brief

To connect on state policy issues or arrange a visit with your local Community Health Center, please contact WPHCA’s Associate Director of Government Relations, Richelle Andrae.