Medicaid Advisory Committee 2025 Annual Report (January 1–December 31, 2025)

Medicaid Advisory Committee background

The Wisconsin Department of Health Services (DHS) established the Medicaid Advisory Committee (MAC) in February 2021. MAC members discuss issues that impact Medicaid and make recommendations to improve it. The MAC meets federal requirements outlined by the Centers for Medicare & Medicaid Services (CMS) at 42 CFR 431.12.

The MAC’s goal is to advise Wisconsin Medicaid and the Medicaid director. The MAC gives input on how Wisconsin Medicaid designs and administers policies and programs. The goal is to make Wisconsin Medicaid better for everyone.

The MAC includes Medicaid members, caregivers, and providers who work with them, including: 

• Professionals
  • State or local consumer advocacy groups or other community-based organizations that serve Medicaid members
  • Clinical providers or administrators familiar with the health and social needs of Medicaid members (primary care, specialty care, and long-term care providers)
  • Representatives from Medicaid managed care organizations or health plan associations
  • Representatives from other state agencies that serve Medicaid members
  • Experts on relevant and timely topics, as needed
• Medicaid members and their caregivers, who also serve on the Medicaid Member Experience Council (MMEC)

Medicaid Member Experience Council background

DHS established the MMEC in July 2025. The MMEC meets the CMS 2024 Access rule (CMS-2442-F) requirement to have a Beneficiary Advisory Council. The MMEC represents members and their caregivers in decisions about Medicaid.

The MMEC welcomed six new ambassadors in 2025. MMEC ambassadors reflect the variety of experiences of Wisconsin’s Medicaid members. MMEC members are current and recent Medicaid members and caregivers (currently three members and three caregivers). MMEC members include representatives from:

• Each Wisconsin region (northeastern, northern, southeastern, southern, and western)
• The county with the highest number of members (Milwaukee County)
• The county where the most residents are members (Menominee County)—seat open
• Tribal Nations—seat open

The MMEC began meeting in July 2025. Early meetings focused on onboarding, group introductions, and brainstorming priorities for 2026. All MMEC ambassadors are also MAC members. The new MMEC ambassadors joined their first MAC meeting in September 2025.

MAC membership and roles

MAC membership changes

The MAC said goodbye to six members whose terms ended in 2025. The committee recruited new members to fill open seats, and nearly 200 professionals applied. The MAC selected new members through a competitive application and interview process. The new MAC members began their terms in 2026.

Since the departing members included the MAC chairperson, the MAC voted to appoint a new chairperson. The MAC also created a new vice chairperson position. They will each serve a one-year term.

2025 MAC highlights

Priorities

The MAC identified and tackled several priorities for 2025. Frequent discussion topics during meetings included:

• Understanding H.R. 1 (“The One Big Beautiful Bill Act”) and its impact on Wisconsin Medicaid
• 2025-2027 Biennial Wisconsin budget
• Improving Medicaid members’ understanding of Wisconsin Medicaid coverage and programs

The MAC and DHS staff worked together on two additional key projects:

• Updating the MAC’s charter
• Establishing the MMEC

Focus areas

In 2025, the MAC engaged in thoughtful group discussions and offered insightful feedback to Wisconsin Medicaid. The group created meeting agendas collaboratively and focused on MAC priorities. Several focus areas emerged.

Administrative and staffing updates

• Updating the MAC charter: The MAC updated its charter when the new MMEC ambassadors joined the group. The new charter describes the MAC’s role and purpose more clearly. The MAC approved the updates in December 2025.
• Appointing new MAC members: The MAC recruited and appointed four new members in 2025 to fill open seats. Their terms started January 1, 2026.
• Appointing a new chairperson and vice chairperson (new role): The new chairperson and vice-chairperson started January 1, 2026. They work closely with DHS staff to set agendas, run meetings, and support the MAC.

Programmatic updates

• Reviewing State Plan Amendments (SPAs): DHS staff prepare quarterly summaries of SPAs to share at MAC meetings. MAC members requested that DHS staff share these updates ahead of meetings for MAC members and the public to review in advance. DHS staff began sharing updates ahead of meetings, briefing the MAC on 25 SPAs in total. MAC members asked questions and offered feedback on SPAs. The MAC supported all SPAs the Medicaid team submitted.
• Staying updated on waivers: DHS staff gave updates on federal waivers. Updates included the required annual forum on BadgerCare Plus and other timely updates about waiver changes.

Medicaid and FoodShare changes in H.R. 1 (“The One Big Beautiful Bill Act”)

• Reviewing materials: DHS staff provided background materials on the federal changes for Medicaid. The MAC reviewed the materials at the September MAC meeting.
• Discussing work requirements: The MAC shared suggestions about how to support Medicaid members with federal changes. Helping members navigate work requirements is a top priority. Suggestions included:
  • Messaging to address public confusion: Wisconsin Medicaid should provide quick, consistent messaging about changes. MAC members want to be communication partners. They shared ideas for how to reach populations with additional health and social needs.
  • Easing the transition: Wisconsin Medicaid should (when possible) broaden and clarify work requirements exceptions.
  • Streamlining work reporting: Wisconsin Medicaid should provide templates to help community groups support members with their work documentation.

Member education

In December, Wisconsin Medicaid communications staff gathered feedback from the MAC.

• Updating member communications and DHS website: The MAC shared feedback about navigating important webpages. DHS updated the website based on MAC feedback.
• Helping members understand their Medicaid coverage: In March, MAC members shared that some Medicaid members don’t know they have Medicaid. The MAC discussed the need to educate Medicaid members about their coverage. They also emphasized helping non-members understand the value of Medicaid. In December, Wisconsin Medicaid communications staff shared updated materials based on this feedback. The MAC provided more feedback to make it clear that all Medicaid programs are part of Wisconsin Medicaid.

Medicaid and Tribal Nations

• Getting updates from Tribal representatives: Wisconsin Tribal Health Directors and DHS will continue discussing how payments may affect Tribal Nations. Tribal Nations have a special federal relationship and unique issues. The MAC continues to keep this top of mind.

Mental wellness

• Hearing from the Interagency Council of Mental Health: The Interagency Council on Mental Health attended the June MAC meeting. This is a group of experts from Wisconsin state agencies. In 2025, they met with the MAC and other mental health experts from across the state. The Council presented their work on a statewide action plan.
  
  The Council asked the MAC, “What does it mean to you to have a strong foundation for mental wellness?” The MAC shared insights including:
  • Mental wellness is not protected like health care.
  • Navigating systems can be difficult, especially for children. 
  • For children, mental health care relies on Medicaid. For some kids, the Children’s Long Term Support (CLTS) Program is the first and quickest way to get the care they need.

Welcoming public comments

There is time for public comments at each MAC meeting. In 2025, the MAC heard 12 public comments. Comment topics ranged from drug coverage to work requirements. The MAC and DHS staff worked individually with public commenters to answer questions and solve issues.

2025 meeting dates

The MAC held their 2025 quarterly meetings:

• March 11
• June 3
• September 9
• December 9

More information

Resources

Find more information about the MAC and MMEC:

• Medicaid Advisory Committee webpage:
  • See upcoming meeting dates
  • See past meeting dates and minutes
  • See current membership
• Medicaid Advisory Committee Participant Guide (PDF)
• Medicaid Member Experience Council webpage:
  • See upcoming meeting dates
  • See past meeting dates and minutes
  • See current ambassadors
• Medicaid Member Experience Council Participant Guide (PDF)

Contact

For any questions or support, contact DHSMAC@dhs.wisconsin.gov.