John Murray: The wins, near-misses, and why 2026 is a consequential election year for Wisconsin chiropractic

In this episode of Back to Basics, WCA President Dr. Chris Resch sits down with WCA Executive Director and CEO John Murray. 

John is a Wisconsin native who spent a portion of his professional career in
Washington, D.C., working in the world of politics and public policy before
returning home to Wisconsin.

Today, he leads the WCA as the Executive Director and works closely with
chiropractors across the state and the nation to help support, strengthen,
and advance the chiropractic profession.

In today’s episode, we’ll talk about John’s journey to the WCA, what led
him back to Wisconsin, and some of the current issues and developments
happening within the political landscape of chiropractic in the state of
Wisconsin.

Transcript

SPEAKER_01 0:16

Welcome to Back to Basics, the official podcast of the Wisconsin Chiropractic Association. I'm Dr. Chris Rush, president of the Wisconsin Chiropractic Association, and your host for today's episode. Today's guest is John Murray, Executive Director of the Wisconsin Chiropractic Association. John is a Wisconsin native who spent a portion of his career in Washington, D.C. working in the world of politics and public policy before returning home to Wisconsin. Today he leads the WCA as the executive director and works closely with chiropractors across the state and the nation to help support, strengthen, and advance the chiropractic profession. In today's episode, we'll talk about John's journey to the WCA, what led him back to Wisconsin, and some of the current issues and developments happening within the political landscape of chiropractic in the state of Wisconsin. John is extremely well spoken, so rather than me trying to tell the story, let's get right into it. I hope you enjoy my conversation with WCA Executive Director, John Murray. All right, Executive Director of the Wisconsin Chiropractic Association, John Murray. How are you doing today? I'm doing great. How are you, Chris? Awesome. Thank you very much for joining me on the Back to Basics podcast. This is long overdue. We've uh I think we're in year three of our podcast uh with the WCA. You were one of the first that I asked, and I'm glad you finally agreed. Well, thanks for having me. And you've had some great guests on so far. So Yeah, we have had some great guests. So I would encourage anyone that wants to hear some historical views of chiropractic in the state of Wisconsin. We've had a lot of great chiropractors that have been practicing for quite some time, and we've had some newer doctors too. So a lot of great insight for students and let's just say seasoned practitioners like myself. So let's talk about you a little bit, John. So a lot of people aren't aware of your full background. You know, you became the executive director a number of years ago, and you had quite a political journey up to that point. So why don't you take us through that?

SPEAKER_00 2:10

So as I was thinking about this, uh, Chris, uh probably the starting point is uh, you know, born in Green Bay, uh actually born in Milwaukee, raised in Green Bay, Wisconsin, and um had the opportunity to go to the University of Wisconsin. And we've actually talked about this. You and I overlapped there, uh, never ran into each other, but went to school roughly at the same time.

SPEAKER_01 2:28

So um literally lived on the same street and never knew.

SPEAKER_00 2:32

Yeah, never, but you know, when there's 40, 60,000 students there. Uh, but yeah, it really is, you know, had a great, great opportunity to get a great education and experience. It's a wonderful university, and it just opened my eyes to so many things. Um, graduated with a bachelor's in political science and economics. But even before I graduated, uh, I started working up at the State Capitol as a messenger, a page, if you will. And um, that was a great experience to kind of get acclimated to the culture of State Capital, learn a lot about you know the politics and kind of how things work, and then made the decision to uh apply for a staff position and got a staff position uh after I graduated. Uh actually working for a freshman state representative from the uh Hudson area, representative Sheila Harrisdorf, who then went on to become uh ag secretary under under Walker. And so she was my first job and uh learned learned a lot, uh had a variety of staff jobs up at the state capitol, you know, learned the roll-ups, learn how to do everything from constituent work, uh, you know, writing, uh drafting legislation, communications, uh, just the full range of kind of skills that I think not only set me up for success later on uh in in jobs, but just to be able to just learn those basic skills of communication verbally and just the nuances of interpersonal communication was really important. And then so I had kind of that I call that my first tour of duty, uh, and then had the opportunity to go out to Washington, DC, work for Congressman Paul Ryan, actually worked on his campaign and had the opportunity to go work out in Capitol Hill, which is anybody knows is an awesome experience. And um, just be prepared to not live very well because it's a very expensive city, even though you make pretty good money, uh, it's just a very expensive city. But got great experience, you know, working uh as a congressional staffer. Uh, then uh my wife and I moved up to Annapolis, uh, Maryland, and I had the opportunity to work for the governor of uh of Maryland, Governor uh Robert Ehrlich. Uh really opened my eyes to kind of the culture of a different state, very different East Coast states versus uh the Midwest, but still a very good experience. And then um kind of got the call from home that we'd like you to come back. And uh I ended up working on Dale Schultz's congressional race when he ran a number of years ago against Ron Kine. He did not win, but he uh ran for state senate majority leader because he was still a state senator. And he asked me if I would consider moving back uh to Wisconsin to be his chief of staff in the state senate, which I did and brought had my wife come back with me. And uh that was kind of my second tour of duty, and then worked for a number of years for him. Uh, worked for uh Speaker Mike Hipsch, uh, worked for Governor Walker in his administration, and then um had the opportunity to get interviewed by a uh great organization, the Wisconsin Chiropractic Association. And ironically, my 13th year will be next week. Uh, and uh Dr. Gene Yellow and Shearing always sends me a text message reminding me saying, Congratulations on making it another year as executive director. So there's a lot in, you know, there's a basically the past however many years of my professional life uh crammed in. Uh, took a little stop, I would say, along the way to be a local elected official in Sun Prairie. And I want to mention that because I think that was really great experience in terms of just, you know, I had always been the advisor to other policymakers. It was my chance to kind of be, you know, the the politician, the policymaker. And it was really eye-opening uh in terms of, you know, now you're making these decisions and listening to other people. But it was just great experience, great organizational management experience that I think really prepared me to come to work for the WCA. Uh, so I was on the city council for three terms, and then I was the mayor for two for two uh years or for two terms, and then um basically made the decision to step away from that to focus full-time on being the WCA executive director, as well as raise my young family. So um that's a lot, that's a lot in a uh in a nutshell, but uh I think that's kind of what's brought me here.

SPEAKER_01 6:28

So back to the uh Washington, DC days. So you weren't just out there for a couple of months, you were out there for a number of years, right?

SPEAKER_00 6:35

Were yeah, six six years in total. Uh I I always say the the the the the best thing that happened to me in Washington, DC was I met my wife. Uh and um, but yeah, really, you know, had had you know, kind of got the the experience, uh uh worked for the National Republican Congressional Committee for a while. Um, and so I got I got the full, you know, other than never worked in like a presidential administration because it was it was during Bush, um, you know, got got kind of a full range and uh really enjoyed you know living in up in Annapolis. Uh it's where my wife and I got married, and so there's kind of a little connection there. But uh yeah, uh I think it's really important that you get that perspective. I'm not saying that people that you know stay in their home state that they don't have that perspective, but uh I will tell you that the world looks very different from Washington, DC, you know, and then when you come back and then you know you see that perspective, and it's really all about perspective and experience. And I was very glad I had that experience. Gotcha.

SPEAKER_01 7:31

And I know that politics is something that you kind of nerd out on. So uh I get to observe that, and uh you do a great amount of lobbying efforts for the WCA. So you still get your your fill of politics. So that's great. But we'll get we'll touch on that a little bit later.

SPEAKER_00 7:46

Yeah.

SPEAKER_01 7:47

Before I get into the WCA, let's just say someone wants to get into politics. Um, what would your recommendation be regarding career in politics?

SPEAKER_00 7:55

So, so I it's kind of interesting. I've been having that conversation with uh one of my sons who's a political science major at the University of Madison. And um I'm kind of trying to let him kind of you know have his own journey. And but uh I said just you know, kind of think about what you're looking for. Uh, not that you need to make those decisions now, but uh I would say don't let the hyper partisanship of politics that is seeping through deter you from from getting involved in politics. You, you know, I and whether you get involved, uh, you know, I I got involved in interesting politics not just because I was a page, but you know, Ronald Reagan. You know, Ronald Reagan was that, you know, that leader that I'm like, that's really interesting. And he, you know, think what you want about Ronald Reagan. He has his detractors and he has his fans, but you know, that was a formative influence on me, not just from a that's the type of president that attracted me as an 18-year-old. That was who I voted for for my first time. Um, so so what I tell my son and I would tell other people, think about what's influencing you. And that's okay because what's influenced you right now, you know, may not be what influences you five or 20 years from now, but um, kind of follow your passion. Go work for a think tank or a lobbying firm or a legislator or whatever that really uh fits with your passion. And because now that's the time to do it, you know, when you're young and you can do it before you got a mortgage to pay. And so that's what I would tell them. You know, think about what interests you doesn't matter what is the environment, you know, uh, you know, healthcare, you know, whatever, uh, outdoor, you know, hunting issues, and find some opportunity to get some more experience in that area and dip your finger in, you know, into your toe into that pond and see if that works. And then if it is, then see if you can, you know, move on. And then at some point, then you need to start making decisions because you can't stay a generalist, you know, it's probably similar in chiropractic where you know you you kind of need to have some specialty a little bit, and um, and so that's what happens if you stay. Uh, there's kind of a joke that in Washington, if you stay five, you stay 20. Uh, I stayed six, so I guess I was right on the cusp. But same thing in in the state capital. Generally, people that get involved, if they stay two to four years, they make a career of it because they have found their niche and they figured out what they want to do, you know, or they just find it's not for them. And so that's what I tell people kind of get some experiences, go be a page, maybe go sit and do a summer internship with a legislator, or go work for a think tank or an advocacy group and just kind of see if it's something that interests you. And then from there, you can make, you know, you you can make some other decisions.

SPEAKER_01 10:31

Gotcha. So relating this to today and the Wisconsin Chiropractor Association, and my role as president, your role as executive director, and 35 years that I've been in practice, uh, last 13 uh working close with you with uh the WCA, you know, WCA has always had some presence at the Capitol in Madison, some years more so than others. Uh the last six, I would say we've had a pretty strong presence there with our Medicaid initiatives, which we'll get into. But when you think of the WCA, do you think of the WCA as more of a political organization or more of a membership trade association?

SPEAKER_00 11:06

Well, it's it's both. Uh you know, we we are a business. Uh we we provide services to our members that they that they want and hopefully appreciate as practice and chiropractor in the state of Wisconsin. And uh that that's really first and foremost that no nobody has to belong to the WCA that that they choose to belong, and we have to run a competitive business uh that has products and services that attract them and they see value in. Um, at the same time, we are a political organization. We have to be a political organization. And it's um kind of interesting because the conversations I've had, you know, in my years with with um members uh in terms of those that say, well, you know, why do we have to be involved? Why do we have to give money? Why do I why do we have to do that and and kind of play in that side of it? You know, why why don't the uh our policy positions and the strength of our policy arguments carry the day? And it's a great question. It's a legitimate question. Uh and I say, yes, we go up and make the best case. And you and I, as you said, have done that for the last six years on Medicaid, made a compelling, I think a compelling case uh on Medicaid. But so I always tell them, we're doing that already. We are up at the Capitol making the most compelling policy case possible to protect access to chiropractic and expand access. Okay, I think we do that. We do that very well, right? I think we do it better than you know many groups that have much more resources than we do. But I tell them, you know, part of it is that um you have to have a seat at the table. And you get that seat at the table not just by being up at the Capitol and having a lobbying presence. You have to build a relationship with those policymakers when they're running for election or they're running for re-election. And that involves going to campaign events and that involves supporting them financially. I always say, I didn't I didn't invent the system, I just work within it, and you have to have a presence on the political side uh to be able to have a seat at the table, build pro-chiropractic allies when they're running for election or re-election, and then you draw on that relationship to be able to have that policy. It doesn't get you any guarantees, but it builds a relationship that you can draw on when you need to make that compelling case about whatever that issue is. So we're we're both. And I think we straddle the we straddle that line uh very well. Uh it comes also comes down to resources, and we can talk about that later in terms of but membership dollars, you know, mean advocacy of the capital, they mean lobbying, they mean legal, they just mean you know, more more bandwidth that we can have at the capital that requires resources on the political side. They look at you know that where those dollars are, and we have to continue to have those dollars. So it takes it takes resources to have a strong trade association and be an effective political organization, and that's what I fight for every day.

SPEAKER_01 13:47

I want to get into the resources a little bit later. Yeah, along with a number of other things. We have a lot to talk about. At the WCA, we have a number of different committees. We have membership committee, we have education committee, we have an insurance advocacy committee, uh, we have a policy steering committee, which would also function as our government affairs committee. We have great members that have a lot of great ideas on policy and policy change. So if you're not on our policy steering committee and you have a great idea, what's the best way to bring that to our attention?

SPEAKER_00 14:17

Well, I think there's a variety of ways that you can have input. Uh this past convention, you know, I you talk to people, I talk to people. Uh, I think, you know, that's just uh I love that face-to-face because they have great ideas and membership and and you know, bones and ideas. So I would say talk to people, you know. Uh if you got Dr. Rush there and you got John Murray, then you got board members at a convention or a class, that's appropriate. I mean, obviously don't do it in the middle of the class, but you should, you know, talk to people. Um, I would say board members, uh, I think a lot of members don't realize or they don't really uh look at them as a resource. They should reach out to their board members. There's two board members for every district. Uh, we have some vacancies if people are interested in running for board. Uh put a little plug there. But I would say uh look on the website and find out who your board members contact them and have a conversation because you know, if there's interest at the district level, uh that's an indicator that that might be something we want to look at. So start with your board members. Uh I'd say contact me, contact you as the president, uh, and um, you know, make your case for that. Uh, we may invite you. We've done this with uh members on a number of issues, uh, you know, um uh marijuana, uh legalization of marijuana. If you remember, we had uh one of the doctors come on to our policy steering committee and kind of have a great conversation. So you have an idea and you've put some work into it and you want to bring that conversation to the policy steering committee, get in touch with us and we will look at it. It's got to fit with our you know our strategic objectives and it's certainly our mission, but we will give it a fair hearing and that means inviting you to a policy steering committee meeting and to talk about that. And so I encourage people that have ideas for you know how policy ideas that make the WC a strong organization on your scope of practice or just protecting your scope of practice, bring it forward and we'll take a look at it. Uh but we're gonna what we're gonna ask you though, and we've had this conversation, is you know, do a little legwork, you know, but put a little, you know, we're not asking you to write a dissertation, we're not asking you to write a four-page policy paper paper, but you need to bring bring some meat on the bones. Uh I love people that have ideas, but uh people that have kind of ideas that are kind of just more sentiments or more just sometimes you need to put a little more meat on that bone uh to bring it forward. So um just I would tell people, just make sure that you have something. What are other states doing, you know, what's done in the past, uh, but bring enough that we can actually take a look at it and react to it and we'll give it a fair hearing. And we've we've advanced ideas that have been brought forward.

SPEAKER_01 16:48

Well, I want to get a little bit more granular here now, and uh I'm gonna test your memory here a little bit, John. So believe it or not, it was six years ago this month that we had a policy steering committee meeting, and the topic was Medicaid. And we agreed as a committee that we wanted to really go after expansion in Medicaid uh through the state budget process. And we've been successful in the last three state budgets on expanding what chiropractors can do with Medicaid. Uh, one of those uh initiatives is still, I would say, pending. Uh, we've done all the work that we can. And you and I have been on the I I look back at our emails, and uh I don't know how many hundreds of emails you and I have had back and forth, and not even mentioning the phone calls that we've had on this topic to do the work here, but why don't you bring uh our listeners up to speed on what's been done with Medicaid in Wisconsin and the efforts that were made by the WCA?

SPEAKER_00 17:47

So I think that that's a great starting point to just let give people the backdrop that these things do not happen quickly and they require a tremendous amount of work, planning, you know, discussion. Uh, you know, I I'm not a provider, I don't have access to the data that say you do as a provider. Uh, you know, the giving away the farm. You you also can look at how PTs get paid because of the way your clinic is integrated. Um, but that that's an advantage. That's that's a bonus. And so, you know, I'll I'll thank you. I want to give you some credit because you know, you took the initiative, you what I was calling, your Ray Saturday, where you would sit down and crunch the numbers and look at the numbers between, you know, what PTs are getting getting paid. And you could look at, you know, it's called the Ford Health Portal, as you know. So um, it starts with just doing your homework, having having your ducks in a row, knowing what your arguments are, and knowing what the data uh is. And so uh I think probably the the other piece of it is that we had to make a political decision. And you know, I'm I'm uh I make you know references all the time, and I know you laugh at it, but uh, I I never want to tilt at windmills, you know, Don Quixote. And in terms of what it means is going up to the state capitol, you have limited bandwidth. You really do, and you can't go and chase everything. And there's times when you're like, you know what, we may fight the fight, we're not gonna win, but we still got to fight the fight. This is one where I think we knew we had a we had a kind of a fighter's chance of getting something done because of the political dynamics. Looking at Medicaid, as really so chiropractic, it doesn't bring in the insurers per se, it doesn't bring in the hospitals, it doesn't really bring in other provider groups because they don't really see us eating their lunch. And I think we knew that our biggest challenge was going to be to make a coherent policy and clinical case and also um a um convincing Republicans who control the legislature that they should invest the money in Medicaid, that that was a good investment. And so we kind of made a political decision that this was winnable, this was actually something we could get done that actually would provide expanded access to care for Medicaid patients and increase reimbursements, which I think was kind of the trifecta of things at a state association. Would it be nice to go for some type of huge insurance of quality? Does that sound great? But the odds of that happening really very challenging. And in the end, would it really put money into the pockets of chiropractors given how things work? So I think it was really important that we made a decision about where to put our resources into something that had a chance of getting done and actually would pay dividends for those chiropractors that that provide care to to um to Medicaid patients. Um I'll hit the three budgets real quickly because you know I know we want to be careful. The first budget, you know, we took a swing at uh I think uh uh payment parity. We took a swing at uh increasing reimbursement on um manipulation. And then we also looked at expansion. And I think we probably learned the lesson that that was probably too much, that that was you know, kind of throwing the whole apple at them. And what we got in that budget was an increase in spot and manipulation uh under Medicaid. I think we pegged it at 70%. It wasn't a huge increase, but really what it was is it was proof of concept. I think it showed that we could get things done like that by making incremental progress. And so that was the first thing. And that was you know, probably worth you know, two to three million dollars of additional reimbursement to chiropractors in the state, which is meaningful. The second budget, uh, we took a swing at payment parity. And that was where you and I were literally sitting looking at code lists and you know, trying to figure out what you know, could we tie it to you know, to PT and PTs use different codes? And so that was one without nerding out, we had to be very clear what we were asking legislators because they have a limited bandwidth and they have limited understanding. Some understand CPT codes better than others, but we were able to convince them to say for shared CPT codes with medic medical providers, MDs and DOs, chiropractors should get paid the same. And we got that done. And that was meaningful dollars. I think you went from like $19 for an exam to like 60 something. Um, meaningful. That was that was like four and a half million dollars. Additional investment, you know, and reimbursement. And so payment parity was a nice win.

SPEAKER_01 22:06

Yeah, for clarity purposes, uh, like you said, we went from $19 to equal reimbursement for what a medical doctor or an osteopath receives for an initial examination and x-rays. Yeah.

SPEAKER_00 22:17

So that was real dollars. Yeah, real dollars that put in. Um, it did get the attention of the insurers. I'm I I we have to tell that because they're looking at that going, ooh, chiropractors just got payment parity within um within Medicaid. Are they gonna come back and push for payment parity in commercial plans? And my answer was maybe. I mean, I wasn't gonna give away the ghosts. I was gonna say, maybe. I mean, you know, and so uh this last budget uh was a little more challenging given the political dynamics, but we pushed for expansion. Uh, and people that are maybe not Medicaid providers know that uh chiropractors are pretty much limited to uh spinal and then other services, but they can't do uh extremities and they couldn't do use therapies. And we made a compelling case. Um, I think we put together the uh the operation uh pictogram or infographic uh that showed where uh you know, if you remember the the game operation, it had kind of the the human body and it showed what uh chiropractors could treat versus what PTs could trade. And it was something that was very simple to understand, and we showed it to legislators and staff, and they're like, I didn't know that. And that was just a you know little trick that I learned that the more visual you can be and the simpler you can keep it, the more efficient your time is going to be with legislators. And so we were able to get that done despite some real ups and downs and just the the whole political dynamics of the budget. Um, and but that was only the state piece, and we could talk a little bit more about what's going on. But that was the 40% uh that the state funds for Medicaid and that directed the state Medicaid office to then get approval through the centers for Medicare and Medicaid to get the rest of it and the 60% that comes to the federal government. And we are waiting on that approval. We're still optimistic that that's going to get approved, but if that get that get approved, that would be another big win that would expand not just uh your clinical toolbox, but increase your reimbursement uh for the work you do with Medicaid patients.

SPEAKER_01 24:10

Yeah, and if I could just kind of expand upon that, one thing I learned in the process of going to the Capitol as many times as we did over those three different budget cycles, which is six years, is how little a lot of the legislators knew about what chiropractors were approved to treat. We had to let them know that this was not a sculpt expansion uh as far as what we do with commercial policies. Everything we were asking for, we were already approved to do. It's just a matter of that in the Medicaid world and very similar to Medicare, we only get reimbursed for spinal manipulation adjustments. And we looked at physical therapists and so many procedures that they can do and get reimbursed. If a Medicaid recipient wanted to choose a chiropractor as their provider for those procedures, we thought that was only fair. And we convinced them. And we've done everything that we can do within the state. So our work is done. So now we're just waiting on the federal level.

SPEAKER_00 25:05

Uh and I don't I don't know belabor it, but the clinical argument, you know, we all we try, we should always lead with the clinical argument, which is how does this help patients get better faster and keep them away from prescriptions, opioids, surgeries? Not saying those things aren't appropriate at some point, but legislators, when you talk about, you know, well, why is this important? Why is this just about putting more money in the chiropractor's pocket? Well, we shouldn't shy away from compensation because it's a fair issue. But I think, and I want to thank you and others that came down to talk about clinically how does this work? How does access to this actually help keep those patients away from more expensive and potentially risky um uh solutions for those problems? And that that's very compelling given all the work that legislators have done on opioid you know reduction and things like that. And so the clinical case was was very important. The the the budget case and the number, the crunching that we did with Fiscal Bureau, and again, you you got a uh a look into that process, which is you you got to get your numbers right and you gotta have you know sign off. Then you got to get you know your authors and your advocates. I mean, it's it's it's there's a lot that goes into the soup. And and then that soup sometimes comes to a boil. And then, you know, again, I I won't bore people, but there were some real ups and downs at the end. We were in, we were out, we were back in, and it was uh it was pretty nerve-wracking, but in the end, it was a it was a great result. Now now, you know, we just got to cross our fingers that the Centers for Medicare and Medicaid sees the value of this, and uh we put our best foot forward, as you said, Chris. And I think that's all we can do. And I think our members, you know, should know we're gonna keep fighting. And when uh whole thing gets approved, you're gonna be the first to hear it from us that now here's the date that you can now treat Medicaid patients, you know, for extremities and use therapies. Obviously, it's kind of medically necessary, but we think that'd be a great win.

SPEAKER_01 26:57

Yeah, I wish uh some of our listeners could have witnessed the eve of the budget passing last year in July of you calling me, calling back, calling, calling back, calling, calling back. We're in. Oh, it looks like we're out. Now it looks like we're back in, and now we're back out. So it was quite the teeter-totter, but it was again.

SPEAKER_00 27:15

What was what was driving that at the risk of nerding out was basically the Congress and the Trump administration had passed policy that basically tamped down on this hospital tax issue. States that were using the hospital tax to kind of bring in more Medicaid dollars, and they they they capped that. And Wisconsin increased it in the budget uh, you know, for some policy and budget reasons, and we're trying to beat that deadline because if they passed the budget after that deadline, it they would have lost the ability to raise that hospital tax. And so, in a way, we benefited from a macro political issue. And I'm not gonna say, you know, it's better to be lucky than good because we did a lot of work and we positioned ourselves. I mean, you know, to be, you know, uh, what do they say? You know, you know, uh fortune favors, you know, luck favors the fortune, you know, fortune what's the term is, but had we not done all of our work and put maximum effort into it and fought, you know, ran through the finish line, um, I don't think we could have taken advantage of the macro politics that allowed our our budget provision and a number of provisions to get in. But uh yeah, it was a bit nerve-wracking, but I I'm glad it was a positive answer because a lot of people put a lot of work into that and they should be proud of that.

SPEAKER_01 28:25

Yeah, it will significantly change the way uh chiropractic is delivered to Medicaid patients in the state of Wisconsin. There's no doubt about that. There's only one other state in the country that has approval for extremity and modalities and exercise instruction uh that chiropractors will get reimbursed. There are some states that uh very few states that are modality and therapy only. And there's, I believe, one other state that has adjustments of the extremities. But yeah, Wisconsin will be, I believe, the second state to have both if we get the federal approval that we're looking for.

SPEAKER_00 28:57

And people are are looking and they're look, they're they're asking questions about, I mean, how how we did it. And I would just tell them there's no silver bullet. You know, it's just it's just hard work. It is just dotting your eyes and crossing your T's, it's thinking about everything throughout that process. And uh, I mean, there's states that are losing ground on Medicaid, and it's unfortunate. So uh we should be very thankful that we're able to make, you know, even get marginal gains. I'm not I will never sit there and tell people that that's gonna, you know, really change your practice. But again, it's about hitting, you know, hitting singles and doubles consistently up with the state capital, protecting that scope and gaining where you can. Um, there are never any big wins and losses, or rarely any big wins and losses of the state capitol if we're doing our job right. But if you can, you know, hit a single, if you can score runs consistently, I'm using baseball analogies here, but um, that that's a win. And you know, we just got to keep picking up ground and you know, you know, next budget, we may, you know, try to get something else. And that's just you build on the momentum. But and the other thing is once the word, you know, I mean, we've got a good vibe going on in the state capitol, like people are seeing, hey, chiropractors are getting stuff done on the budget, you know, they must be doing something. And, you know, that kind of like, oh, they must that there must be something going on, and that's a good story. And then they're they're they're interested in being involved in helping you because they see you making, you know, making progress. And so we got to keep that momentum going into the next budget cycle.

SPEAKER_01 30:25

Hello everyone, Chris Rush here. Before we get back to our conversation with John, I want to take a moment to thank all of our WCA members and supporters for everything you do to support chiropractic in Wisconsin. Whether it's being a member, attending our education seminars, or contributing to our political conduit, CairoStrong, everyone here at the WCA definitely wants to thank you. Also, it was great seeing so many of you at the WCA Spring Convention at the Ostov Resort. The energy, engagement, and support of our profession continue to make these events incredibly valuable. And while we're talking conventions, be sure to save the date for the WCA chiropractic fall convention 2026 at the KI Convention Center in Green Bay, Wisconsin, happening September 24th through the 27th, 2026. We're looking forward to another outstanding event filled with education, networking, and collaboration with chiropractors from across the state. And also another reminder, this year's fall convention will feature our awards gala, where we recognize chiropractic technician of the year, the Nels Baki Young Practitioner of the Year, Chiropractor of the Year, and also the Wisconsin Chiropractic Association Lifetime Achievement Award. It's always a great event. Now let's talk a little bit about the Back to Basics podcast episodes. I just want to let you know that they're now all available on all the popular platforms where you already listen to your favorite podcasts, including Spotify, Apple Podcasts, and YouTube, as well as conveniently on our Wisconsin Chiropractic Association website. Again, one last time, don't forget to mark your calendar for the WCAF all convention at the KI Center in Green Bay, Wisconsin, September 24th through the 27th. We hope to see you there. So on the heels of that Medicaid win, just last month, we had a Medicaid curveball. The Medicaid office in Wisconsin made some efforts to impose new pre-authorization requirements affecting chiropractors. Can you talk a little bit about that?

SPEAKER_00 32:21

Well, curveball continuing on the baseball analogy. Yeah. Yeah, this was a weird one because uh let's just, I mean, let's I think part is you got to look at the macro politics. Governor Yvers is not running for re-election again. And so a lot of people within his administration appointed are leaving. They're looking for other jobs and they're shuffling people. And so I think um that was part of the inability or challenge of getting information from the Medicaid office. They have a lot of changes. The Medicaid director left, Bill Hannah left. Um, they just uh appointed a new Medicaid director, and so I think part of it was just the shuffle over there. But we had been hearing about this, you know, as early as the beginning of the year because they had done similar changes to PTOT and speech that were effective January 1. And, you know, we knew about it, but we're like, well, you know, about those changes. But again, they deliver care differently, you know that. And so those changes affected them differently. So we did what we do. We started gathering information. We try to get information, you know, it always has to be, you know, at the risk of sound like a Tom Clancy novel, actionable intelligence, you know, credible information that we can then look at, you know, what should we do? We don't want to overreact, we don't want to underreact, and that's all the issue. It could be nothing, it could be just talk, or it could be something significant. Once we found out that it was something significant, we really put pressure on them to get a meeting with them to really walk through what they were talking about. And it was, they were they're claiming that it had something to do with a federal interoperability rule. I I'm still skeptical on that, but I know that the the Medicaid office, the Medicare Medicaid program in Wisconsin is looking at about a $250 million deficit. I have to imagine the centers for Medicare and Medicaid are telling them you need to show us a plan for some cost savings because we're paying 60% of that. And so I think that we're we're part of an effort for them to find some cost savings. I think they were using that uh, you know, to look at chiropractic and a number of other things. And so, yeah, it was they wanted to change it from 20 visits per spell of illness, which is the current policy, uh, to 20 visits calendar year. And then you'd have to get pre-authorization. And my understanding is that pre-authorization process is not the easiest. I mean, and we just don't generally like pre-authorizations in general because we see them as a, you know, really as a impediment to care, additional paperwork, and delay. And so we had a, I think, a very direct meeting with them uh that you were on, and uh, we were made aware that they felt that they could roll it out basically in the middle of April, and we asked them respectfully, please don't do that. We'd like to help you find a better solution. Um, and they did put a pause on it. Um, and then they came back and said, we are gonna we're gonna pursue doing this through the administrative rules process. And I want to be very careful not to nerd out our listeners, but they really believe that they had the authority to make these types of changes without going through the administrative rules process. And we disagreed with that legally and politically. And that's the process that you have to go through to make these types of changes that are consistent with statutory and budgetary authority, but allows for more stakeholder input. And I think that that's where they were kind of pushing the envelope, maybe legally in terms of thinking they could do this. Uh, but again, we're not looking to get into a political fighting match. We're trying to resolve this through advocacy and conversation. And um, but that was important that they came back and said, we're gonna pursue these changes through the administrative rules process, which I think is a big win for our advocacy efforts. It shows that pushing back using your tools of influence and advocacy is the right thing to do in this case. And I would stand behind that decision because I think it was the right decision. Um, we engaged our political allies. We reached out to Senator Rachel Cabral Guevara, State Representative Clint Moses, chiropractor, uh, certain Democrats on the Senate Health Committee, and we asked them to put influence calls, emails over. Uh, Representative Moses did a letter asking questions. And so I think that was important that we we reacted appropriately and got our political allies to put pressure on them to hold on it, and we're in a better place. Doesn't mean we're out of the woods yet, and we can talk about that, but I think that was a really good example of why a strong state association that can rally advocacy and political pressure in a timely manner matters. Because if we had not done that, I believe we'd be sitting there now with a change in policy that restricts access to chiropractic within Medicaid and really would have, you know, not erase, but really would have been a step back from all the efforts that we made in the last few budgets. And so I'm proud of that work, but we we have more work to do. But I think we should be proud of the work that we did to get them to stop on that and pursue a different process where we'll have a seat at the table.

SPEAKER_01 37:07

Yeah, I think sometimes it's real easy to, you know, look at the last three budget cycles and say, this is what we did and this is what we got accomplished. But sometimes what people don't see is the defense that we have to play on certain issues. And this is an excellent example of that, basically catching it when it's a small fire before it turns into a big fire. So, what's your philosophy on how to approach that?

SPEAKER_00 37:30

I I go back to if we're doing our job as a as an advocacy organization, as a political organization, um, we've got to be looking at putting out the small fires before they become big fires. And I think this is one that we we saw could become a big fire, we put some efforts into putting it out. It's it's everything up at the state capitol. A bill gets introduced, you know, uh somebody puts out a press release, doesn't matter. Uh, somebody makes a statement. Another healthcare provider group makes a statement about something that, again, it could be just talk, or it could be something like, yeah, there's something there. That's our job. It's my job as your chief lobbyist to make sure I've got my finger on the pulse of what's happening up at the state capitol to know that whatever the issue is, you know, we are monitoring it and keeping that small fire and putting it out before it becomes a big fire. Because, you know, call to actions are great, but generally a call to action means there's a big fire that we got to get our members to put out. And I love call to actions because they're kind of fun and they kind of remind me of the old days when I'm sending in faxes and you know, but I've taken a different, little different philosophy, which is only use that tool when it really, really matters. And I think we've had a lot of success of putting out whether it's work workers' comp uh uh fee schedule is another one that that's a small fire that happens every two years, and we we work to put it out. But if you can imagine your workers, those of you who do workers' compensation, now you are getting paid under a managed care fee schedule that is barely better than Medicare. Okay, that's important. That the WCA puts that fire out early every two years, you know, by keeping it from you know becoming a big fire. So, I mean, that that's my philosophy, and I think we've had success, but it requires diligence and it requires resources, not gonna lie.

SPEAKER_01 39:13

Yeah, and I guess when it comes to those resources, I'm gonna take this opportunity to just let people know that uh we do hire lobbyists to help us with this. Uh, John is a major portion of our lobbying efforts. So that's an internal mechanism we have right within the WCA to have John have this experience and his ability to lobby. And I've seen it up close and personal at the Capitol. Uh, I'm probably gonna embarrass you a little bit, but John, you do a great job. You have an excellent reputation at the Capitol. I've never seen uh situation where we weren't allowed to open door policy where uh, you know, our legislators bring you in and and listen to what you have to say and they and they listen intently. So it's very impressive to see that work. But we also hire lobbyists, and that does cost money. So, you know, short of a commercial here, our Cairo Strong efforts, they matter. So uh there's a way to donate to Cairo Strong. And if you could get on the WCA website to do that, we would appreciate that. We had a campaign in 2025, we call it 25 and 25. If you could donate $25 a month to the Cairo Strong effort, that would be very much appreciated. And um, that money goes right to initiatives at the Capitol. Uh, that does not go to any benefits at the WCA. It's uh it's all going right to the Capitol in our in our political initiatives. So I guess enough about that. So unless unless you have anything to add to that, John.

SPEAKER_00 40:34

Well, I mean, we could talk about a little bit. Uh we're gonna do a little preview of the elections a little bit later. And um, yeah, we can talk about a little bit later. But um uh I I don't want to gloss over, you know, since we're embarrassing each other. Uh, you know, your work, your time is valuable. I mean, everybody, you know, I it's interesting when people, you know, time out of a uh out of a um a chiropractor's day is money out of their pocket. I mean, that's this that's just where legislators really and um they appreciate when you know you get involved and when others from their district get involved. Um, but you know, there's other resources too. I mean, the communication resources, yes, do I write a lot of the content, but we we have a we have a marketing consultant that helps us put together really good communication materials uh out to our members and you know to legislators. And so again, it's it just comes down to resources. I mean, we're we're never gonna have the budget of you know General Motors or or the Hospital Association, but we're gonna do the best we can with the dollars you give us to be that voice of chiropractic up at the Capitol and with our members. And and it just takes resources to do that. But we can talk about the political side a little bit more. I want to save that as a teaser towards the end because uh 2026 is one of the most fascinating elections that I think this state's gonna see in a long time. So uh let's save that for the end. How about that?

SPEAKER_01 41:53

All right, sounds good. Well, I'll tell you what, I think we are getting uh close to wrapping up here. So uh we we can escalate this right to uh again, we use the word nerd a couple of times here, but sometimes in our policy steering committee meetings. Uh John, you get a little bit deep into the weeds of uh who's out there and who's running and who are the who are the favorites. So why don't you give us a preview of your 2026 election uh analysis?

SPEAKER_00 42:19

Well, uh I'll start with the hyper-political atmosphere that we have in this country. Love it, hate it, indifferent. Uh, you know, it it is one of the most hyper partisan atmospheres uh in our history. So um to the degree that state elections in Wisconsin are gonna be nationalized, that national issues are gonna affect state elections in Wisconsin, that's a no-brainer. There's no question that there's national influences on on, you know, kind of the thinking and the the you know the thoughts and the voting behavior, uh, what those specific things are gonna be. You know, we're here, we're in May, you know, uh September, October, November is a world away in politics, so who knows what the world will look like. But um that that's the first thing. You're gonna have a national imprint on these elections. Uh it's the first open governance race in a very long time. Years is not running, so you have an open governor's race. You know, uh Congressman Tiffany has pretty much locked up the uh the Republican nomination. Uh the Democrats have a huge field, and that's gonna get sorted out in August. Uh so the governor's race is gonna be kind of the big, you know, probably the big, the big ticket, top of the ticket. Um, you're gonna have a number of congressional seats in play. Uh, the third and the first, uh, Van Orten and Style uh are gonna be you know in play uh just because of uh a lot of factors. And then um the legislature, uh the state senate is is pretty much looking like it's gonna flip to the Democrats because of retirements and because of the maps. And so we'll be watching that very closely. And the assembly, which I would have said was probably a lock or at least a strong lean to stay a Republican, is looking A little bit more and more play because a lot of retirements just saw another retirement today in a swing district, and so uh I think both houses of the legislature are gonna be up for control, uh for partisan control, which means we've got to again we've got to be kind of agnostic and look at we got to support pro-chiropractic candidates of both parties because come January of next year, we need to still have that seat at the table. And um, we'll talk a little bit more. Uh, the filing deadline for nomination papers is coming up in June. And at that point, then you'll know who's on the ballot, and then you'll have the primaries in August. So I mean, we'll have a couple of checkpoints here where maybe we can do a follow-up, you know, podcast to kind of talk about the political dynamics. But um, I think the bottom line is it's it's a very fluid political situation, but that also means there's opportunities for the WCA to be able to um support those pro-chiropractic legislators that are maybe going to be uh running in tough seats, Clint Moses being one, and then other open seats where we're gonna have a conversation with those candidates about uh whether they support chiropractic and we could potentially build some new allies that then we have um you know to work with next session. Uh, and so it's both a challenge and an opportunity, but it comes back to our Cairo Strong Fund. And I know it sounds like a broken record, but the reality is our conduit is our means of basically supporting those candidates and going to these events. But I also want to let people know that, you know, if they have, we just got a call the other day about uh a clinic, the member clinic that was being asked to come to an event for for a candidate in an open seat, and they said, What should we do? And we said, I said, you should go and you know, we'll raise some dollars through the CairoStrong Canada fund, and you should go and talk to them. Uh, same thing with the governors race. So if you're getting asked to go to go to events for candidates, you should go to that event. They're generally low-dollar events that you could go to and you can get to know them. You can talk about chiropractic. And you don't have to be an expert, just have a presence. Just show, hey, I'm a chiropractor, I'm a member of the WCA. Uh, you know, here's what's happening in my clinic. How do you feel about it? And that's where we kind of have this trickle effect of presence until the field is clear, and then we make some bigger decisions about okay, some dollars, you know, into the bigger, into the bigger races. And so let me know. Contact me if you have a relationship where you're being asked to support an event, and we'll talk about it and see if it makes sense because here's our chance to kind of build that footprint and influence the chiropractic at a time when they're asking us for money, and that's a great opportunity to have that conversation. That's how politics works.

SPEAKER_01 46:33

Perfect. Well, I'll tell you what, John, we talked a little bit about uh your past and your uh political efforts, your uh time with the WCA, uh, what we did with uh Medicaid and the political future. So, any final thoughts?

SPEAKER_00 46:49

Well, I would say uh I I've I really enjoy, I still can continue uh consider it to be a pleasure and a privilege to be the executive director. Uh, I learn things every day, uh not just from you know a standpoint of a chiropractic, uh, but just you know politically and organizationally. And so uh I just I want to thank you, Chris, for your service uh as president. I've really enjoyed working with you. Uh, you know, I'm uh I'm not I I got a few years left in the tank here and uh uh and I enjoyed doing it. But uh, you know, I just want to thank our members. You know, uh our members, you know, a really wonderful convention, as you know, is just really a great opportunity to see that goodwill. Uh, we had a really nice social reception with people just relaxing. I mean, uh, for all the challenges we you have as healthcare providers and we have as a state association, it's important to just step back and just kind of enjoy the moment. And you know, convention was a great opportunity to do that. And and our social on on Friday night really kind of restored my you know vigor for seeing all those people there just enjoying each other's company. And uh that was really fun to see. And so I think that that's really in the end, we got to remember that that's what it's all about. We're a family as chiropractors, and so I'm just glad to be part of that family.

SPEAKER_01 48:01

That's awesome. So, yeah, we all love convention and just a little plug for the one that's coming up uh in fall. We'll be in Green Bay the last week in September at the KI Center. So encourage people to join us up uh up in Green Bay.

SPEAKER_00 48:14

So we'd love to have you there. We'll have the marketing out and again, another opportunity to get together and get some good continued education, but also uh enjoy each other's camaraderie, uh, which I think is important. So all right.

SPEAKER_01 48:26

Well, it's been executive director of the Wisconsin Carpike Association, John Murray. I want to thank you very much for being a guest. And this is the first of probably a couple of follow-ups. So I'm gonna be leaning on you again for another uh episode, John. So thank you for uh thanks for joining us today. Thanks for your time. Bye, Chris.