>> The following program is a PBS Wisconsin original production.

>> As the federal funding package moves on to the Senate, Wisconsin's delegation staunchly opposes the measure, but for very different reasons.

[MUSIC] tonight on "Here& Now" Wisconsin veterans say their VA benefits.

A state analysis shows who will lose out on federal health care and food assistance.

[MUSIC] Hospital nurses strike in Madison as the health care workforce struggles to keep pace, and a moderate Republican returns to the statehouse to find common ground.

It's "Here& Now".

For May 30th.

>> Funding for "Here& Now" is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.

>> A handful of Republican U.S.

Senators are saying they won't pass a big budget bill that spends more than it saves.

Leading the charge is Wisconsin Senator Ron Johnson, who has vowed to oppose the measure in his chamber unless more is done to rein in spending on assistance programs.

Senator Tammy Baldwin agrees.

The measure adds too much to the federal deficit, but places the blame on tax cuts.

>> You got to do the work.

We're not doing the work.

We're exempting most spending.

Taking a at a couple of programs.

Afraid of the political blowback?

The lies being told about Medicaid, for example?

Oh, we can't touch that.

And that's why we're $37 trillion in debt.

There's no amount of pressure that President Trump can apply to me that exceeds the pressure I feel the promises I made to stop mortgaging our kids future.

>> I believe that the impact that the bill would have as passed by the House would be devastating on the most vulnerable communities, and mightily to the deficit and debt.

And again, why?

So that they can pay for more tax cuts for the very wealthy and big corporations.

>> Senator Johnson is expected to join us next week.

The Department of Veterans Affairs is in crisis.

Those are the words of a retired physician of 27 years at the VA hospital in Madison.

Trump administration DOGE cuts to VA health care are having real life consequences to the some 9 million patients and their care teams and providers across the country.

This week, Senator Baldwin held a roundtable in Madison with veterans, patients and employees to hear about it.

>> The mass firings that we have seen have had real, real impact.

>> Appointments are being canceled because there is not a provider there to see them.

>> I went out there and I was deployed.

I don't know how many times, but I did it and I just called and they reglued my feet together and I put my boots back on and I went back out there.

I just enjoyed my job so much because we had the sense that our Congress, our Senate and our president and those offices would take care of us because we were taking care of what they were asking us to do.

>> That's right.

I have been getting calls where many highly service connected.

Many with, you know, fragile mental health are afraid that their benefits will be taken.

And I have had more than one say.

Well, then I'll just kill myself.

It's horrifying.

>> The retired physician at the VA in Madison, we mentioned was also at that roundtable, bringing his inside knowledge.

Doctor Michael Sieber says the cuts have led to disastrous problems for veterans health care.

He joins us now.

Doctor, thanks for being here.

>> So we know that the VA secretary wants to cut the agency's workforce by about 83,000 employees, but vows not to take any frontline health care workers.

What's your knowledge about who's been let go or who's leaving?

Because of the kind of uncertainty of it all?

>> Well, it's very hard to get exact data, but it's clear that even with the cuts that have been made so far, services have been worsened for veterans.

So it's only going to get worse as time goes by.

>> You said that there's a certain secrecy about what's happening.

>> How so?

There is a secrecy.

There are DOGE people that are senior advisors now working at the Veterans Administration.

The leadership in the 170 different medical centers around the country have had had to sign non-disclosure agreements.

The people on the ground, the people working in the VA hospital don't know what's going to happen.

They're very fearful about the cuts.

There are a group of people who are quite dedicated to taking care of veterans.

>> What are some other examples of the real world consequences in inside these hospitals?

>> At the Middleton VA hospital where I work, they have a shortage of custodial staff so that individual persons, including secretaries and cardiovascular surgeons, are cleaning their own rooms, emptying their own wastebaskets.

The veterans are cleaning the Or and surgeries are delayed.

While they're doing that cleaning.

>> So what are your former colleagues there telling you about conditions like that inside for both health care, but also morale?

>> Well, morale is terrible.

The fear about what's going to happen, not knowing what it's going to be.

The fact that there was a mandate that everybody working from home had to come to the hospital.

People are jammed, jam packed in, you know, this happened with the suicide prevention hotline and there was no confidentiality.

People were working out of closets or, you know, six at a table.

So there are a lot of things that have happened that make it more difficult to deliver good medical care.

>> I was going to ask, how should families what what should they know about what all this means for patient care?

>> Well, it's not good.

I mean, there are things that are happening that make it harder to deliver good patient care.

The pattern of loss of people at the VA is primarily letting go.

People who are support staff, so that the physicians, they're not letting them go.

The nurses are not letting them go.

Although 1700 nurses have already taken early deferred retirement.

200 doctors we know have taken early deferred retirement.

There was a case where in one VA hospital, the x rays were piling up.

There was no radiologist to read them for an extended period of time.

And that's a very detrimental and dangerous situation for patients.

>> So what is the mindset of the veterans?

The VA cares for?

>> Well, I think, you know, they're of two minds.

There are group of veterans, a significant group who voted for President Trump and think he's doing the right thing in most cases.

But many have reservations in that group.

And there is a group, of course, who are extremely upset about what's happening.

Their whole goal is to privatize all medical health care for veterans.

The new budget for 26 has 4% increase in the budget for the VA, but it's largely earmarked to go for care in the community with private providers.

You know, the average private provider visit is like 10 to 12 minutes.

You know, wouldn't probably be accurate or helpful for a patient who has suicidality or PTSD or homelessness.

>> Because that's the kind of care that that the VA kind of has a mission toward.

>> The mission is to take care of veterans.

We've got a system that tries to help them, but we're losing psychologists.

We're losing psychiatrists.

So it's becoming more difficult to take care of those people.

>> Thank you for your insight, doctor Michael Sieber.

>> It's my pleasure.

Thank you.

>> As we discussed earlier, cuts and changes to social safety net programs figure prominently in political discourse right now in Wisconsin.

By the numbers nearly 1.3 million children and adults are enrolled in Medicaid, and 700,000 receive food share.

For a closer look at how congressional changes to these programs could look in Wisconsin, we turn to Bill Hanna Medicaid, director at the Wisconsin Department of Health Services.

And thanks for being here.

>> Thank you.

Happy to be here.

House did on Medicaid and nutritional assistance.

Cuts could go deeper under the Senate provisions.

As it stands before Senate action, some analyzes show nearly 230,000 people in Wisconsin could lose Affordable Care Act.

And Medicaid coverage.

Is that what your analysis is showing?

>> We're focused our analysis on Medicaid.

That's where we have the specific data.

Wisconsin's part of the National ACA plan.

And really we rely on national experts on the ACA data.

But for Medicaid specifically, we estimate that 63,000 adults without children under the age of 18 would be at risk of losing their Medicaid coverage.

I think it's important to note that the coverage won't just impact those individuals.

It really impacts all of us because those individuals will still need to see their doctors or go to the hospital.

They'll just be uninsured.

And those additional costs get passed on to all healthcare consumers.

>> What is it in the bill that prompts people to lose that coverage?

>> Yeah, the House bill creates a lot of additional red tape for this population to maintain their eligibility.

First, it requires them to complete their Medicaid application or renewals every six months instead of once a year, as it is today.

And it requires them to submit documentation to prove that they are meeting work requirements.

>> So what costs to provisions of the bill add for the state of Wisconsin now fashioning its own budget?

>> Yeah, we take eligibility enrollment very seriously here in Wisconsin.

We run a very efficient program.

We have one of the lowest eligibility error rates in the in the country.

But this will require additional costs.

We are really doubling the amount of work in a year to do eligibility for the 195,000 adults that this would subject to, meaning the state and county eligibility workers will need to hire more workers, and we will need to make changes to our system in order to verify and collect that work requirement information.

We estimate it will cost us about five and a half million dollars each year to implement these changes.

In Wisconsin.

>> On Foodshare, the House bill would mean about 90,000 people would lose that assistance.

According to your office.

How does the bill result in those people losing those benefits?

>> Yeah, they're already work requirements in Foodshare today, but the bill drastically changes.

Who is required to meet the food requirements.

Today?

It's adults between 18 and 54 who do not have dependent children.

What the bill does is expands that to adults between 18 and 65 and includes adults with children if their children are not under age seven.

So you've really increased the number of adults that need to meet work requirements in order to maintain their food share benefits.

And we estimate that about 90,000 individuals would likely lose their foodshare benefits because of this expanded requirement.

>> So the bill would also start penalizing the state for snap error rates, costing Wisconsin $207 million annually.

What are those errors?

>> Yeah, errors are just that.

They're errors, right?

It's not fraud.

Determining Medicare or Food share eligibility.

It's complex.

And occasionally there are mistakes.

If you think about doing your taxes and occasionally there is a mistake, there's a lot that changes in people's lives.

Think about this population.

They're often doing gig work, meaning their income can change.

There's a lot of deductions that go into calculating it, so it's complex in getting it to the dollar.

Accurate.

We already have one of the lowest error rates in the country.

In fact error rate went down last year were well below the national average.

The national average is 11.7.

Wisconsin is at 4.4.

But the bill continues to sort of narrow that tolerance for any even $1 error in calculating payments.

It also is an incredible cost shift, not just for the error rate, because what it does for the first time is requires states to contribute towards food share benefits, which at a minimum will cost us $69 million a year in Wisconsin.

It also changes the amount of the administrative costs that the federal government will pay.

Today.

They pay 50% of those costs, split 5050 with the state going forward, they would only cover 25% of the cost.

So that's an additional $51 million for us to just run the program that we run today.

That is a well run program, and the bill gives us no additional tools to control costs or any other flexibilities to try to.

Really control costs in the in the food share program.

>> Well, we appreciate your information.

Bill Hanna.

Thanks very much.

>> Thank you.

>> On the picket line, hundreds of nurses at Meriter Hospital in Madison went out on strike Tuesday.

Negotiations resumed Thursday and Friday.

Even in the midst of picketing.

>> Union union.

Mighty, mighty union.

>> In the hospital's first ever strike, the nurses called for a wage hike higher than the 3.68% offered better security and better patient to staff ratios.

Meriter says throughout the strike, the hospital has remained fully operational and is running smoothly with the hiring of travel nurses.

SEIU represents nearly 1000 nurses at the hospital.

The union filed an unfair labor practices complaint against Meriter over threats to strip striking nurses of benefits.

>> There's a lot of people rallying around health care workers, especially after Covid, and we are finally standing up for ourselves and fighting for what we need and deserve.

>> We just want what's best.

We love what we do, and we're here trying to advocate for what's best for our patients.

[MUSIC] addressing violence against health care workers are two points addressed in the Wisconsin Hospital Association's 2025 Workforce Report.

However, in a turn from recent years, the health care workforce is making gains slowly.

>> We've actually upgraded our workforce condition in Wisconsin from critical but stable to serious but stable.

We've made some real good gains in some professions, like certified nursing assistant, where we're actually seeing vacancy rates go down.

We're also seeing improved retention, less turnover, really helps, not just in numbers but in expertise in our annual workforce report.

The last several years, we've talked about violence against health care workers, new data just out from the Bureau of Labor Statistics shows that despite great effort and partnerships between hospital leaders, their workforce, state policymakers, law enforcement that the incidents of intentional injury against healthcare workers by another person is actually higher.

And so we need to continue every effort we can to report and take action on any incident that occurs.

Wisconsin actually was the first in the nation to create an enhanced penalty.

A class H felony, for violence against healthcare workers, and threats of violence.

We have to grow the workforce faster, but with the demographic changes going on, it's unlikely that our workforce will grow fast enough.

So we're asking for good health care policy that supports faster growth.

Costs are rising, salaries are rising, supply costs are rising, and reimbursement, especially from Medicaid and Medicare, what we call government payers, is not keeping pace.

So to support and sustain our workforce, we need better reimbursement.

>> At the state Capitol.

With all the talk of political gridlock, it's hard to remember a time when Wisconsin politics were less partisan.

But one Assembly Republican is trying to recapture that feeling.

Representative Dean Crawford originally served from 1991 to 2014, but was recruited to run again when the last round of redistricting made his old seat much more competitive.

Kaufert won last fall by just 365 votes.

Here and now, senior political reporter Zach Schultz sat down with Crawford this week to talk about what's changed and what he hopes to accomplish.

>> Well, representative, thanks for meeting with us.

What's it like to be back in the state Capitol?

>> Well, it's exciting.

On one hand, you know, I still tell people when they ask me that question, I still get those good fuzzy feelings driving down East Washington Street.

You come into the Capitol, and the Capitol comes into view as you're driving, and there's still an electric feeling.

And then I know at that point I kind of went, you know, I did the right thing by coming back because it's still exciting to walk into this building.

>> Is it fair, though, to say that you wouldn't be here today if the maps hadn't been redrawn to make it a district where Republicans needed you to run in order to win it?

>> Yeah.

I mean, this wasn't in my wife and my plan to do this.

I was happy being semi-retired, owning, running a business.

>> Well, how did you did you get recruited?

How did that process happen?

>> Some people talked to me.

Some of the leaders talked to me and asked if I would have any interest.

Numerous there's only one guy who can win this.

This seat.

And it just got me thinking.

And it is important who's in charge here?

You know, the majority party has a lot more power, and I and, you know, the second best job I had being mayor was being chair of finance committee, because that taught me all about government.

And I loved government.

I hate politics.

My entire years in the legislature, we were we were responsible for our own fundraising.

It was all local.

The most we spent was 39,000 bucks, I think was the highest that I ever spent in my campaign.

And, you know, now it's millions of dollars.

The Democrats and their friends spent $3.8 million against me.

Our side, I think, spent 1.3 million job pays 57,000 a year.

It is crazy.

But $3.8 million against you every day.

Getting your head pounded in every day.

Both parties.

And, you know, Republicans and Democrats, because I watched ads from both parties all over the state.

Lies, fabrications.

It's just not good.

And there's nothing you can do about it.

I mean, at night, I mean, I'm not afraid to say my wife and I would go, what the hell did we do this for?

Because you'd come home at night after watching the TV.

You know, having, you know, ten ads during a TV show that were just blatant lies.

And there's nothing you can do about it.

It's no fun.

It's no fun for you.

It's no fun for your family.

And then the hardest part is when you come, you get here and then people say, are you going to be bipartisan?

Can can we work together?

Well, you just spent three months, four months telling people in my district what a bad person I was.

>> Compare and contrast how the budget was done back in the 2000.

Governor Doyle, Democrat versus today.

Governor Evers, a Democrat with no Republican legislative majorities.

>> Yeah, that's a great question, especially in this environment that we're in.

And, you know, we were able to do things together even back then when Jim Doyle was governor.

The Republicans had the legislature and I was the chair, joint finance.

There was a lot more communication between the governor's office and between the finance committee and the legislative leaders.

You know, I respect Governor Evers, and I met with him after I came back here because Governor Evers knows that I was one one of the more moderate members of the Republican caucus.

And you got to be when the district that I represent is 45% Republican, 55% Democrat.

And so I represent the district.

And that communication just doesn't seem to be there.

And I told the governor, I said, governor, you got to reach out.

You got to extend that olive branch.

You're the governor.

>> So you are the chair of corrections.

Is that something you requested?

Is there?

Do you have a mission in your in your second wind here?

Corrections is going to have some pretty heavy stuff this time, so I requested it.

And now, as it turns out, the governor's in his budget.

You know, it's a very complex problem.

And he has a solution that's going to cost a lot of money.

But, you know, at the end of the day, closing green Bay, I'm touring it on Thursday morning.

I toured Waupan last week, and green Bay needs to come down.

So we need to figure out here's another issue that Republicans and Democrats.

This shouldn't be political, but we should be able to figure out a way how to make sure our inmates are safe and our correctional officers are safe.

So I'm dedicated to doing that.

>> Is it is it fun to have a purpose where you can see something that may be a little easier to get consensus on?

>> Yeah.

And that's that's what I'm best at.

You know, I mean, is getting people together.

I know that I'm going to only be here 2 or 4 years, probably four.

I'm going to try for four, but I won't.

I don't have an agenda.

I don't have to appease anybody.

I can do what Dean Crawford thinks is right, whether it's Republican or Democrat.

And I've been known to lead my leave my party.

But I will be with him 95% of the time.

But I also will chastise him when I think they're doing something wrong.

I will try to convince them to massage it.

I've already had some successes where I've said in caucus, I've said, you know, your bill is okay, but this needs to change.

And you know, they respect me enough to make that change and say, hey, we're okay with that.

It makes it better.

And so I do have a purpose for a couple of years or four years.

And that's to try to make this place better, try to make this place run better.

And see if we can't change the political climate.

I don't know if we're going to be able to, because there's too darn much money involved in politics.

But I'm going to sure try.

>> For more on this and other issues facing Wisconsin, visit our website at PBS Wisconsin.

Org and then click on the news tab.

That's our program for tonight.

I'm Frederica Freyberg.

Have a good weekend.

[MUSIC] >> Funding for "Here& Now" is provided by the Focus Fund for Journalism and