Vos Pandemic Plan Sets Up Political Battle

On Tuesday — as Wisconsin set a record-high number of 107 deaths from COVID-19 — Gov. Tony Evers got on the phone with incoming Senate Majority Leader Devin LeMahieu and Assembly Speaker Robin Vos to discuss how to address the pandemic that is ravaging Wisconsin. Afterward, Vos unveiled a 23-page summary of his 50-point plan for dealing with the pandemic. Most aspects are notably different from the bills the governor unveiled in mid-November.

Some measures in the Assembly GOP plan and Evers’ plan continue practices begun in April, others invest in stopping the spread — increased testing for example.

But several aspects of the Vos plan would likely damage public health and spread the virus by pushing people together in schools and workplaces. To wit, it includes requiring nursing homes to accept visitors, forcing employees back into state agency offices that must then be open to the public, sanctioning gatherings in churches and compelling students and teachers to return to in-person classrooms.

And many of Vos’ 50 measures include a familiar theme from the past two years — shifting power away from the governor and agency experts and bestowing it on the Republican-controlled Legislature.

But it’s not political, Vos maintains.

“I’m having to make sure that the people of Wisconsin know that the fight against COVID is not partisan,” said Vos, in a news conference on Nov. 17 after Evers’ plan became public. “The goal is for us to find that common ground so it’s not just a political discussion where each side goes back to their corners. I want to find things we can actually agree on.” On Tuesday Vos labeled the Assembly Republicans’ ideas “a robust package to address the critical needs of our state.”

Vos’ GOP colleagues in the state Senate were noticeably quiet. LeMahieu (R-Oostberg) told the Milwaukee Journal Sentinel he liked some aspects — including limiting business liability (proposed by the business lobby Wisconsin Manufacturers & Commerce) but said he hadn’t studied the plan, having just received the summary at the meeting with Evers. Vos has not released any actual bills.

And while Evers and Vos agree that the Legislature should meet this month on a COVID plan, LeMahieu said most Republican senators see no need to convene. However, he indicated that the Joint Finance Committee (JFC) could meet to allocate part of the state’s budget surplus for increased COVID testing.

Assembly Democratic leader Gordon Hintz slammed the measures — which came after seven months of no legislative action on coronavirus.

Vos’ plan “is politically driven, undermines Governor Evers’ efforts to combat the virus, and ignores the reality our state is facing,” Hintz said in a statement.

The months since April, when the original compromise Wisconsin COVID bill became law, have been marked by Republicans suing the governor and the Department of Human Services challenging their power to mandate masks, limit capacity or otherwise address the pandemic.

Pandemic politics continue to play out. Rep. John Macco began the Assembly Ways and Means Committee meeting on Wednesday noting that because it is an Assembly committee, going forward in-person attendance would be mandatory for representatives — anyone joining virtually would be recorded as absent. Taking the opposite approach Wednesday morning, Evers announced his budget and State of the State addresses would be delivered virtually in the first months of 2021.

Wisconsin is currently averaging approximately 4,000 news cases per day and health officials expect to see a post-Thanksgiving spike, as symptoms can take up to two weeks to emerge.

Public health officials, local politicians, healthcare workers, hospital administrators and editorial pages have been weighing in, many begging Evers and legislative leaders to meet to hammer out a plan. The meetings are now happening — and staff is working together behind the scenes — but the vast differences in bills and legislative urgency show just how far apart the three leaders are on this. (For unknown reasons, Evers appears not to have included  Democratic legislative leaders.) But groups that have been pleading for action have a unified goal: Reducing the toll COVID-19 is taking on Wisconsinites.

“We need you, the state’s top elected officials, to come together immediately with unified actions to slow demand for care by mitigating the spread of COVID-19 and to increase the capacity for care by making significant investments in our workforce and care sites and further streamlining regulatory policies,” wrote Eric Borgerding, CEO of the Wisconsin Hospital Association (WHA), in an open letter to Evers and leaders of the Legislature last month.

Local leaders said the Vos plan fails that test.

“Rather than an answer to our months-long plea for state governments to take greater action to combat the spread of COVID-19, Speaker Vos’ proposal undermines our ability to protect our residents,” Dane County Executive Joe Parisi said Wednesday. “Speaker Vos’ proposal is not a plan — it’s a political document. I would ask the speaker, how is your plan going to prevent people from getting sick? How is it going to reduce the pressure of patients in our hospitals? The answer in short is it won’t.”

With a rather large caveat that Vos’ plan has 50 components and no draft has been made public, below are some key elements from the two plans. Neither Vos nor Evers’ office responded to queries on what they like in one another’s plans.

Contact tracing and testing

The Department of Health Services (DHS) has fallen far behind on estimates of the number of contact tracers needed. Public health experts, among others, have sought improvements in these areas. Adequate contract tracing can help public health agencies more closely monitor and curb the spread of the virus.

Evers: Includes $36 million for contact tracing — enough for 1,000 more tracers based on cost projections of $36,000 per tracer in an April report from Johns Hopkins University.

Requires insurers to cover testing and treatment; budgets slightly more than $300 million for testing and testing lab supplies.

Vos: An early sketch of his proposal called for doubling the number of contact tracers in the state, but the new plan does not directly address that point. However, it doubles state funding for COVID staff, directing that money to counties and requiring JFC approval.

Requires DHS to work with private vendors to expand the use of at-home rapid antigen tests for COVID-19.

Authorizes transfer of up to $100 million in appropriations for unspecified COVID-19 emergency expenditures. The price tag on Evers’ full plan is $541 million.

COVID-19 vaccine

Evers: Requires insurance plans to provide coverage of a vaccine when available, as well as coverage for testing and treatment for COVID-19.

Vos:  Requires vaccine coverage under government plans including SeniorCare, allows pharmacists and pharmacy students to administer the vaccine; forbid any employer, health official or others from mandating the vaccine; require DHS to submit a vaccine plan to JFC. The latter would give Republicans — including JFC members who have expressed skepticism regarding the impact of the pandemic —  control over any vaccine plan approval.

Dr. Patrick Remington, a University of Wisconsin preventive medicine professor, says it would be a serious mistake to put “a cumbersome lawmaking body” in charge of a vaccine plan. “Right now there are some of our best scientists and public health experts who are developing a fair and equitable vaccine allocation plan,” Remington says. “And the last thing I would want is elected officials who are subject to political pressure to be making these decisions.”

Power and local control

The pandemic has renewed contests for power between the Legislature and the governor. And it’s testing the power of local public health authorities. The differences between the Evers and Vos plans are sharpest when it comes to control — in the Capitol and in the counties.

The Republicans’ proposals continue what they began during the lame duck session two years ago and built on with lawsuits: taking control from the executive branch and giving it to the Legislature.  The Vos plan would wrest control over decisions that have always been the prerogative of the executive — including veto power over the state’s vaccination plan and direct control over agency employees and even several Evers appointees’ salaries.

Most measures will require approval by the Joint Finance Committee (JFC), which has 12 Republican members and just 4 Democrats. Republicans selected for the committee typically do not come from swing districts — so if they have to take unpopular votes, they are not likely to suffer any penalty. Giving JFC the final say means potentially vulnerable Republicans get to dodge those votes.

Marquette University political scientist Philip Rocco says that in their proposals,  Republican lawmakers “want the Joint Finance Committee to be the fulcrum of political power in the state of Wisconsin.”

The Assembly plan also gives the Republicans an effective veto over the governor and DHS on a wide range of public health matters, while the Legislative Audit Bureau would audit executive pandemic-related spending.

In addition to grabbing executive power, the GOP measures also wrest control from local government, particularly public health authorities and school districts — precisely the opposite of what the hospital association urged.

“Not only do Wisconsin Republicans not want to respond to the COVID-19 pandemic, they want to put into law limits on local governments in their ability to respond in the way that works for their community,” asserted Hintz.

Evers: The governor’s proposals make no changes in the structure of control other than giving the executive branch temporary authority to waive rules such as the one-week waiting period for people applying for unemployment compensation or to waive interest as well as penalties and payments on governmental loans. It makes no changes to the power of local government to address public health emergencies.

Vos: The GOP proposals replace local control with state mandates. For example, one proposal requires nursing homes and assisted living facilities to allow visitors. The Vos plan bars state and local health officials from issuing emergency orders, closing businesses or restricting capacity unless the orders apply to all businesses, and then for just two weeks, with an additional two weeks if the county board approves the extension. Local public health officials could not prohibit gatherings in churches.

The all-or-nothing stance to local closing orders disregards what epidemiologists have learned over decades of study. “I completely understand the desire to have a one size fits all approach,” says Remington. That, however, is “really not the best approach,” he continues. “I think we are much better suited to use evidence, to identify those settings that are the highest risk for transmission of the virus, and therefore worse for public health, and to have different policies for those places that have different potential impact on the public.”

Marquette professor Rocco, whose research includes polarization around health policy, sees Republicans engaged in “aggressive preemption of local authority” with the support of conservatives on the Supreme Court.

“It’s a real attempt at repositioning the entire public health regime that’s been constructed in the state over the last 100 years — away from the power of public health professionals, away from the sort of people who are at the local level and aware of unique local contexts and toward explicitly political branches of government and toward generalists rather than specialists.”

Rocco sees two different ways to interpret the Republican legislators’ underlying intent. “One potential explanation is that this is just about preventing Tony Evers from being an effective governor, and limiting his ability to control the spread of the virus,” he says. “Another potential explanation is that it is actually rooted in a much longer ideological battle about the appropriate role of the state, not just in public health, but in every domain of life. And whether or not the state has the capacity and duty to help mitigate risk — or whether or not people are just on their own.”

Schools and teachers

Evers and Vos: Both make it easier to re-hire and license retired teachers.

Evers: Waives report card and assessment requirements and streamlines re-licensing of retired teachers to fill vacancies.

Vos:  Relaxes regulations on public school open enrollment and the state’s private school voucher program for special needs students. It is not clear how either of these changes would relate to the pandemic.

Vos’ plan imposes state restrictions forbidding school districts from conducting classes online only — which several urban districts instituted this autumn to control the spread of the coronavirus. It imposes financial penalties on districts that don’t comply. It also requires two-thirds majority approval of the local school board to shift to virtual instruction, with a 14-day time limit; extensions for 14 days at a time require the same supermajority approval. And it penalizes school districts that use virtual instruction, requiring them to pay $371 to each parent of a student taking virtual classes.

Angelina Cruz, president of Racine Educators United objects to Republicans’ suggestions that virtual schooling requires less time and money than in-person instruction. “Teaching and learning is still happening, regardless of what it looks like in each district,” says Cruz. In the Racine Unified School District, where the teachers are represented by Cruz’s union, “we’re still feeding students. We’re providing computers and wifi to students and families that do not have ready access to those things. Teachers, educators, all staff are working around the clock to make all of this still happen despite a pandemic.”

The Racine teachers union filed a brief in the Wisconsin Supreme Court supporting local public health authorities and opposing a lawsuit by private school interests that seeks to overthrow a public health order closing schools.

Licensing, liability and business

Evers and Vos: Both plans make it easier for out-of-state health care workers to get licensed to work in Wisconsin during the pandemic.

Evers: Gives workers in the healthcare industry the ability to claim worker’s compensation if they contract COVID-19 on the job. Allows online notarization of estate planning documents through 2021, as well as some state services.

Vos: Makes businesses and schools immune against lawsuits resulting from COVID-related circumstances. Creates business grants to boost the hospitality industry.

State workforce

Evers and Vos: Both facilitate rehiring retired state employees for critical positions.

Evers: Gives the Department of Personnel Management flexibility in moving employees to vital positions that need additional capacity in the pandemic.

Vos: Mandates that executive branch employees return to work in-person, require that state buildings housing agencies be kept open and allow state employees to be moved among agencies to address workloads so long as their pay is not increased and a report on any movement is filed with the JFC. Allows the JFC to cut the salary of Evers’ Workforce Development secretary, deputy secretary and administrator of the unemployment insurance program by any amount.

Insurance

Evers: Requires telehealth services be covered at the same level as in-person appointments.Require insurers to cover testing and treatment, as well as the administration of any COVID-19 vaccination through the end of 2021.

Vos: Requires out-of-network coverage on par with in-network coverage if like services are provided for in the plan. Authorizes out-of-state health providers who get licensed in Wisconsin state to use telehealth.

Prescription drugs

Evers and Vos: Both make access to up to 90 days of any prescription more easily accessible without prior authorization.

Unemployment

Evers: Continues waiving the one-week waiting period for unemployment benefits to begin — a measure set to expire at the end of this month.

Vos: Directs state Department of Workforce Development (DWD) to draw down the backlog in unemployment compensation claims that has plagued the system since the start of the pandemic, prescribing longer call center hours and other changes; threatens salary cuts if objectives aren’t achieved.

Reprinted with permission of Wisconsin Examiner.