WI Budget Has Shaky Hospital Deal

Among other things that Big-Spender Vos approved in the budget:

 ...The deal would also increase the hospital assessment rate to help maintain the state’s Medicaid costs. The Wisconsin Hospital Assessment is a levy from certain hospitals that the Wisconsin Department of Health Services (DHS) uses to fund hospital access payments, hospital supplemental payments and reinvestment in the Wisconsin Medicaid program. 

Wisconsin hospitals currently pay an assessment rate of about 1.8% of their net patient revenue to the DHS. That would rise to 6% under the deal with 30% of the funds being retained in the Medical Assistance Trust Fund, which supports Wisconsin’s Medicaid program. The rest of the funds will be used to invest in hospital provider payments and is estimated to provide over $1.1 billion in additional investments in Wisconsin hospitals. 

The changes use federal funding to increase hospital reimbursement while decreasing the amount of general program revenue for the Medicaid program....

Umnnhhhh.....perceptive (and not-Publick Screwel grads) readers will notice that 30% of 6% happens to be 1.8%--meaning that the hospitals' contribution to DHS will not change. 

So the deal will hand "investments" to Wisconsin hospitals of about $1.1 billion. 

Good deal?  Maybe not.

 ...A proposed rule by the Centers for Medicare & Medicaid Services, echoed in the Republican House reconciliation bill as well as a more drastic Senate bill, would significantly curtail the federal dollars many states draw in matching funds from what are known as provider taxes. Although it’s unclear how much states could lose, the revenue up for grabs is big....

While the Vos-Evers deal acknowledges that CMS (the old CMMS) could tighten the rules, they do not think it will happen THIS year.  They're betting that the BBB's provisions will not go into effect until '26, which means they're betting against Trump's drive to reduce Fed spending.

That may turn out to be a bad bet.