A Promise Unfulfilled: The Paradox of Postpartum Care in Wisconsin

Speaker Vos, who rose to prominence championing anti-abortion legislation – famously signing four such bills in 2019 – now finds himself at odds with many in the anti-abortion movement. The core of the disagreement centers on a seemingly logical extension of “pro-life” principles: ensuring the health and well-being of mothers after childbirth. Many Republicans now recognize that providing healthcare access for a year following delivery can reduce maternal mortality and improve infant health outcomes, potentially decreasing the likelihood of future unwanted pregnancies.

Currently, 48 other states have already implemented the 12-month postpartum Medicaid extension, recognizing the critical health needs of new mothers. Wisconsin, along with Arkansas, remains an outlier. The Wisconsin Senate overwhelmingly passed the bill earlier this year, with 30 Republicans co-sponsoring the measure in the Assembly, guaranteeing its passage were it to come to a vote. However, Vos, wielding significant control over the Assembly’s agenda, has effectively buried the legislation within the Regulatory Licensing Reform committee, a body known for its infrequent meetings.

The situation has created a palpable tension within the Republican party. Representative Patrick Snyder, the bill’s author and a staunch opponent of abortion, expressed his frustration earlier this year, stating, “If we can’t get something like this done, then I don’t know what I’m doing in the Legislature.” His sentiment reflects a growing unease among lawmakers who feel their constituents’ needs are being ignored for political reasons.

Vos has consistently voiced concerns about expanding “welfare” programs in Wisconsin, arguing that Medicaid should be reserved for those with the greatest need. He has also declined to discuss the issue directly, deferring questions to a spokesperson who has not responded to repeated inquiries. This silence has fueled speculation about the motivations behind his opposition.

Did You Know? The first year postpartum is a particularly vulnerable time for mothers, with a significant risk of complications related to physical and mental health, including postpartum depression, hypertension, and blood clots.

The Role of Funding and Conservative Influence

Vos’s stance is reportedly influenced by conservative groups like the Foundation for Government Accountability, a Florida-based think tank that advocates for reduced government spending and stricter welfare requirements. The foundation, which has received over $11 million from billionaire Richard Uihlein, founder of Uline shipping supplies, has openly opposed Medicaid expansion in the past. Uihlein and his wife, Liz, have also been significant donors to Vos’s political campaigns, contributing over $6 million to Wisconsin’s Republican Assembly Campaign Committee since 2020 and an additional $500,000 directly to Vos in February 2024.

Concerns have been raised that extending Medicaid coverage could encompass health issues unrelated to pregnancy, a point highlighted during a debate in Arkansas, where a similar bill failed after questions arose about potential coverage for procedures like knee replacements. However, in Wisconsin, this argument has not gained traction, with medical experts emphasizing the critical need for comprehensive postpartum care.

Former state representative Donna Rozar, a Republican who sponsored the legislation in 2023, described her numerous “frustrating” conversations with Vos, emphasizing his unwavering opposition to any expansion of Medicaid. “He was just so opposed to entitlement programs and any additional expenditures of Medicaid dollars that he just stuck to that principle. Vehemently,” she recalled.

The bipartisan support for the bill is remarkable, even garnering endorsements from both Pro-Life Wisconsin and the lobbying arm of Planned Parenthood, demonstrating a rare alignment on an issue often fraught with political division. Matt Sande, a lobbyist for Pro-Life Wisconsin, stated, “It’s something that we can do and something that’s achievable given the bipartisan support for it. It’s not going to break the bank.” The Legislative Fiscal Bureau estimates the annual cost of the extension at $9.4 million, a small fraction of the state’s $4.6 billion budget surplus.

Despite attempts by Democratic Representative Robyn Vining to force a vote through a legislative maneuver during the state budget debate, Republicans ultimately tabled the amendment, effectively killing the effort. Vining accused her Republican colleagues of “taking marching orders from the speaker instead of representing their constituents.”

What does this impasse say about the priorities of Wisconsin’s political leadership? And how will this decision impact the health and well-being of new mothers across the state?

Frequently Asked Questions About Wisconsin’s Postpartum Medicaid Debate

• What is the current Medicaid coverage for new mothers in Wisconsin? Currently, new mothers in Wisconsin with incomes up to 306% of the poverty line receive Medicaid coverage for 60 days postpartum.
• Why is extending postpartum Medicaid coverage considered important? Extending coverage to 12 months can significantly improve maternal health outcomes, reduce complications, and provide crucial support during a vulnerable period.
• What is Speaker Vos’s stated reason for opposing the Medicaid extension? Speaker Vos has expressed concerns about expanding “welfare” programs and reserving Medicaid for those with the greatest need.
• How does Wisconsin’s policy compare to other states? Wisconsin, along with Arkansas, is one of only two states that has not yet extended postpartum Medicaid coverage to 12 months.
• What is the estimated cost of extending Medicaid coverage in Wisconsin? The Legislative Fiscal Bureau estimates the annual cost at $9.4 million, a small portion of the state’s budget surplus.