Walker’s Battle Against Birth Control
State audit that could shut down family planning clinics may be latest of his anti-contraception efforts.
Scott Walker has long favored proposals that would reduce women’s access to birth control. In 1998, 1999 and 2001, Rep. Walker was the lead author of the “conscience bill,” which allowed doctors and pharmacists to refuse to prescribe and dispense birth control. He also supported a “personhood” amendment to the constitution that would outlaw some forms of birth control.
In his first budget as governor, Walker unsuccessfully attempted to repeal Wisconsin’s Contraceptive Equity law that requires employers to cover birth control in the same way as other prescriptions and preventive care. That budget would have also ended all funding of family planning clinics which offer contraceptive care (and do not offer abortions or abortion referrals), amounting to $1.9 million per year or $3.8 million over the biennium. This, too, was rejected by the Republican-led legislature.
Last July, he tried to use a U.S. Supreme Court decision to justify not enforcing Wisconsin’s Contraceptive Equity law, only to later back off.
So there is reason to be suspicious of an audit by the Inspector General of the Wisconsin Department of Health Services, which has sent letters to family planning clinics demanding repayment of millions in alleged overcharges. The department’s decision would force these, and eventually all family planning clinics in Wisconsin, to close, as Beth Hartung, president of the Wisconsin Family Planning and Reproductive Health Association, told reporter Kate Golden and the Wisconsin Center for Investigative Reporting.
Alan White, the Inspector General, was elevated to this position back in 2011 by Gov. Walker, with the announced goal of cracking down on fraud in state programs such as food assistance for the poor. The funding for the health planning agencies seems to fall into a very different category.
That includes Planned Parenthood of Wisconsin, whose public policy director Nicole Safer says the fee structure in fact was established by the state back in 2009 and was similar to that used in other states in the Midwest.
Milwaukee Journal Sentinel reporter Guy Boulton, in a recent story on the situation, posed these questions: “How could the clinics overbill for contraceptives and other prescription drugs when the state sets the payment rate? And if the state did pay the clinics too much for the drugs, how could it go undetected for five years?”
“The Department of Health Services,” he continued, “isn’t saying. The department declined to comment on the audits or explain how it pays family planning clinics for birth-control bills and other prescription drugs.
Back in November, when Golden first broke this story, White did comment, denying his audit was political and offering this statement: “This administration, this agency has put a great deal of effort into improving program integrity, and take it very seriously. And protecting the taxpayers of Wisconsin is their predominant responsibility.”
But White offered no explanation of how or why it made sense to change the reimbursement rate that all family planning clinics have been uniformly paid for five years. Safar suspects the clinics are being targeted for political reasons: “It’s something we’ve always been waiting for because we know that Walker does not support access to birth control services.”
White’s office claims that Family Planning Health Services Inc. overbilled Medicaid by $2.3 million, and NEWCAP Inc. by $1.2 million, from 2010 to 2011. But Molly Fuller, president and chief executive of Family Planning Health Services, told Boulton her organization has “following the instructions we have been given (from the state) and we’ve been following them for five years.”
Jennifer Waloway, a nurse practitioner who oversees the six family planning clinics in northeastern Wisconsin run by NEWCAP, says her organization would go out of business if the state sticks to the reimbursement rate it now wants to enforce. The repayment of $1.2 million the state demands from NEWCAP is nearly equal to its annual revenue of $1.2 million. Family Planning’s annual budget is about $3.4 million, compared to the $2.3 million the state demands it repay.
NEWCAP last year served 3,500 people in six counties in northeastern Wisconsin while Family Planning served about 6,000 people a year in 11 counties in north central Wisconsin. Both operate in areas officially designated to have shortages of health care professionals. The Medicaid funding they receive pays for their provision of contraceptives and family planning services, testing for cervical cancer, sexually transmitted diseases, HIV and pregnancy and treatment of sexually transmitted diseases. The clinics do not offer abortion or make abortion referrals.
“It would be a huge loss for these communities if they shut down,” says Safer. “These patients would have nowhere else to go. These are low income people who have no insurance or have some form of Badger Care.” Most of northern Wisconsin’s low income women would no longer have access to family planning services.
And if the Walker administration enforces this reimbursement rate for all other family planning clinics in the state?: “It would mean, quite frankly, that we would all close,” Hartung told Golden. “We’re all operating the same way” and getting paid the same reimbursement rate, she noted.
Diane Welsh, a former chief legal counsel to the Department of Health Services, is representing NEWCAP and Family Planning. Welsh responded to the state on the agencies’ behalf and told Boulton, “In the end, I’m very confident they will prevail.”
But it’s now been three months since she wrote the state and four months since the state issued its demand for repayment, and White’s office has yet to respond to Welsh. Meanwhile the clinics he targeted live with uncertainty regarding the law. This scared NEWCAP off from expanding its safety-net services this year, Waloway told Golden.
In his runs for governor, Walker was endorsed by Wisconsin Pro-Life, which opposes all forms of birth control and has championed the personhood amendment that Walker favored, which would ban some forms of birth control. Matt Sande, the group’s director of legislative affairs, told Lifesitenews.com that he hopes the OIG (White’s office) will do more audits of family planning agencies. “Those audits were very limited – in scope, in detail, in time frame,” he said. “What really needs to be done is that the OIG needs to do a comprehensive, thorough, robust audit of all family planning recipients, especially including Planned Parenthood of Wisconsin.”
Two Democratic lawmakers, Rep. Chris Taylor of Madison and Sen. Dave Hansen of Green Bay, wrote White’s office on Oct. 27 saying “there appears to be no legal basis” for the claims and “no credible claim of fraud.”