Milwaukee County is scrambling to address a lapse in its contract covering employee and retiree health care and pharmacy benefits, one of its largest contracts, after it expired at the end of 2025.
Now, County Board supervisors are faced with making a monumental decision with little time to spare after only learning about the situation during a Jan. 29 Finance Committee meeting. They must either approve a contract extension that hasn’t been fiscally vetted according to county ordinances and carries over outdated oversight capabilities or risk jeopardizing employee health care access.
Supervisor Steve Taylor called the situation “unacceptable” and demanded a timeline from County Executive David Crowley’s administration detailing how the contract lapsed. Crowley is a Democratic candidate for governor.
A Crowley spokesperson told the Journal Sentinel that Crowley has “directed administration officials to resolve the situation and work with the Board of Supervisors to approve the contract next week.”
If supervisors don’t act quickly to approve a five-year extension of the county’s previous contract with UnitedHealthcare and Optum Rx, the county could face “catastrophic risk,” Deputy Corporation Counsel William Davidson told the county’s Finance Committee on Jan. 29.
That’s because operating outside of a contract, as the county has been since the start of the year, could jeopardize the ability for participants in the health plan to receive and pay for services.
Davidson said UnitedHealthcare could theoretically seek to renegotiate higher fees or shut off services and access to reduced rates or negotiated medical care prices.
As of Jan. 1, Milwaukee County has 3,232 participants enrolled in its health plan.
“Say an employee has a large claim, I think this leaves UHC in a position to deny it,” Corporation Counsel Scott Brown told the committee.
At the same time, both Davidson and the Comptroller’s Office directors warned that extending the previous contract exposes the county to other significant risks.
Milwaukee County is self-insured and hires UnitedHealthcare to administer its plan. The previous contract with UnitedHealthcare was first approved in 2009. UnitedHealthcare was selected again to provide health care services to county employees after a request for proposals process in May 2025.
Human Resources Director Tony Maze said he hired an outside consultant, Willis Towers Watson, to conduct the RFP process because the firm would be able to get a larger discount in the marketplace, which could save the county money.
But he also admitted to supervisors that he did not follow county ordinances for RFPs and did not share the RFP process with the Comptroller’s Office.
“That’s disappointing,” Supervisor Shawn Rolland said during the meeting. “That’s why we have ordinances. They’re supposed to be the guiding light for how we do business.”
As a result, the new contract does not meet the county’s current contract standards that require a stronger audit clause, raising legal and oversight concerns, Comptroller Liz Sumner told the board.
Those oversight concerns are especially salient after the county’s medical claim costs ballooned in 2025, Financial Services Director for the Comptroller’s Office Cynthia Pahl said. The county is on track this year to pay almost $85 million in medical and pharmacy claims, which is estimated to be reduced to $35 million through rebates, she said.
“I’m concerned that we probably are looking at somewhat of a significant deficit for 2026,” she said. “We’re seeing some incredible trend rates we haven’t seen before. … These contracts determine what level of rebates we get back.”
And this contract is probably one of the county’s largest and most important contracts, Pahl said.
Expired contract caught county officials off-guard
What’s more, the Comptroller’s Office learned about this situation only one week ago, meaning they haven’t had the opportunity to raise the auditing issues during negotiation or even conduct a full fiscal review, Director of Audits Jennifer Folliard said.
“It’s probably the worst [contract] I’ve ever seen,” Folliard said. The newer auditing standards are in place to protect the county, she said. And it’s not just the audit standards that need to be updated. It’s also information technology, insurance requirements and cybersecurity terms, she said.
“It’s very important that those are included. Not just to us. Not just because it’s county policy. But because the feds also require it for anything that’s put toward a grant,” Folliard said.
“This is serious, and I’m very concerned,” she said. “We do not have the power that I would like to have to look into this on your behalf, based on the language that is in there.”
Maze said the contract does allow for an audit in 2027 and that delays in handling the situation were caused by UnitedHealthcare attorneys not providing the final contract language until January.
The Comptroller’s Office recommended the board approve a one-year extension, which could allow the county to conduct another RFP process and seek a stronger audit clause and clearer financial picture.
Davidson said he and other Corporation Counsel leaders shared the same concerns expressed by the Comptroller’s Office. But he urged the board to approve a five-year extension, saying the county could negotiate for an amendment to the contract in the future. But he also noted that the county has less negotiating power against large companies like UnitedHealthcare.
The Finance Committee ultimately voted unanimously to take up the issue at a special meeting on Feb. 2 at 10 a.m., as suggested by Supervisor Anne O’Connor. At the same time on Feb. 2, the Personnel Committee will also review the situation.
‘The red flags everywhere are incredibly alarming’
Throughout the Finance Committee meeting, county supervisors sat in consternation, learning about the situation as conversations unfolded during the meeting, Rolland later told the Journal Sentinel.
O’Connor said, “The red flags everywhere are incredibly alarming. I think we’re moving into damage control mode.”
Supervisor Steve Taylor was particularly angered, drawing comparisons to previous county financial bombshells like the surprise MCTS deficit and pension scandal.
“When you think it’s bad, it just gets worse,” Taylor said.
“What’s our motto, our mission? To be the healthiest county. Here we’re dealing with an expired health care contract for our own employees,” he said later.
“This is a mess. And we need to handle this just like MCTS, because you saw heads rolled there,” he said. “This is unacceptable. We are better than this. This county is better than this. Why are we trying to make the mistakes of the past.”
Taylor said both Human Resources and the Comptroller’ Office should provide a timeline of how the situation unfolded from each of their perspectives by March.
Supervisor Justin Bielinski suggested the county needs a public calendar or dashboard that shows when extracts expire to prevent situations like this.
Rolland said, “We have a serious problem with trust, and it needs to be rectified. Immediately. And that needs to be sent to every management person across the county.”
Contact Claudia Levens at clevens@usatodayco.com. Follow her on X at @levensc13.
This article originally appeared on Milwaukee Journal Sentinel: Lapsed Milwaukee County health care contract poses ‘catastrophic risk’
Reporting by Claudia Levens, Milwaukee Journal Sentinel / Milwaukee Journal Sentinel
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