[January 4th UPDATE: The quarterly Medicaid report issued today by the Dept. of Health Services estimates that the changes I discuss below and a couple of smaller items are expected to yield net savings of $72.6 million GPR by the end of the biennium.]
A couple of factors should yield significant savings in state spending for Medicaid and BadgerCare during the current biennial budget. If state tax collections don’t fall short (which is a definite possibility), Medicaid savings could be used to build up the states meager budget reserves, and I hope state policymakers will also invest a little in initiatives to make the health care system more efficient, in order to hold down the future growth of Medicaid spending.
Early next week the Department of Health Services (DHS) should release a quarterly report about Medicaid spending from October through December. I expect that report to shed a little more light on the potential savings, but DHS might focus just on the estimated savings during that specific quarter, and not on the much larger savings over the next 18 months of the biennium. Read more
Two state senators released a Legislative Fiscal Bureau (LFB) memo today that provides an updated estimate of the potential savings to Wisconsin from expanding BadgerCare to more adults. The Fiscal Bureau estimates that expanding BadgerCare for adults up to 133% of the federal poverty level would cover an additional 83,000 adults, but would yield a net savings for the state of more than $1 billion over a six-year period – by taking advantage of increased federal funding available for states that expand Medicaid.
If the expansion were to begin on January 1, 2016, the net savings for state taxpayers during the 2015-17 biennial budget period would be $323.5 million. Because that starting date is no longer a realistic option, the paper also lays out the projected fiscal effect of beginning expanded coverage a year later. Under either of those two options, Wisconsin would save an average of more than $15 million per month once the change took effect. Read more
The list of states that are taking federal funding to expand Medicaid got a little longer last week when Montana received approval from CMS for its Medicaid expansion waiver. That makes Wisconsin one of only 20 states that aren’t yet taking advantage of the federal Medicaid expansion funds that Wisconsinites have been helping contribute to the federal treasury.
The approval of the Montana plan reinforces a couple of key points about Medicaid expansions:
- First, even conservative states like Montana, Arizona and Alaska understand the merits of expanding Medicaid for more parents and childless adults. (Ten of the 30 expansion states have GOP governors.)
- Second, it’s possible for states to get federal waivers for compromise expansion plans.
Number of Uninsured Drops by 100,000 in Wisconsin in 2014
The number of people with health care coverage took an unprecedented jump last year, during the first year of implementation of key parts of the federal health care reform law. The number of uninsured Americans dropped in 2014 by 8.5 million , including 100,000 fewer uninsured Wisconsinites.
The new numbers, which were released today by the Census Bureau, provide the first comprehensive data on how the federal health care reform law affected insurance rates in 2014, after key portions of the Affordable Care Act (ACA) took effect. The new figures come from the American Community Survey (ACS), and some of the highlights include the following:
- The percentage of Americans who are uninsured dropped from 14.5% in 2013 to 11.7% in 2014.
- Wisconsin went from a 9.1% uninsured rate in 2013 to 7.3% in 2014.
Pros and Cons of New 2014 Census Bureau Data on Health Insurance Rates in Wisconsin Outlined in New WCCF Report
The Census Bureau’s American Community Survey (ACS) will release new data reflecting the number of uninsured individuals in Wisconsin and across the nation. Many of the ACA’s major laws, including access to health coverage through both the federal and state-based insurance marketplaces went into effect in 2014 and the data will help provide important insights regarding the impact of the Affordable Care Act (ACA) on the uninsured rate in 2014. However, given our analysis of more recent enrollment data, as well as the fact that the ACS data reflects a monthly average of survey data, the new ACS data won’t fully reflect the gains in health insurance enrollment in Wisconsin since January 2014.
WCCF has prepared a new report, “New Census Data Won’t Fully Reflect Health Insurance Gains,” outlining areas in which the new ACS data will shed light on the growth in access to health insurance since major provisions to the Affordable Care Act were implemented, as well as an explanation as to why the new data won’t entirely reflect the growth in health insurance coverage in Wisconsin. Read more
With Labor Day approaching, it’s a good time to reflect on all the families in Wisconsin who are struggling to work their way out of poverty. Unfortunately, many of them are held back by public policy choices made at the state and federal level, as well as changes in the workplace. These obstacles include a stagnant minimum wage, inadequate federal rules on eligibility for overtime, barriers to accessing child care and affordable health care, and the growing use of on-call scheduling of workers.
When we think of low-wage workers, particularly those making the minimum wage, we often think of teenagers working in the fast-food industry. However, data on earnings for low-income parents paints a very different picture, as does recently updated data on the employment of people participating in BadgerCare. Read more
The health care plan unveiled this week by Governor Walker would undo many years of progress on improving access to quality, affordable health care. My biggest concern initially was that it would reverse most of the gains made over the last 5 years under the Affordable Care Act (ACA). However, the damage caused by the Governor’s plan would go much further than that, because it would also undo much of the progress that has been made over the last decade or two as many states improved and expanded Medicaid coverage (such as Wisconsin’s creation of BadgerCare in 1999).
Under Walker’s proposal, millions of adults across the country are likely to lose their Medicaid coverage – as states restrict eligibility in response to the elimination of enhanced federal funding for Medicaid expansions. However, the damage wouldn’t stop there. By block granting Medicaid funding, states would almost certainly be compelled to dial back eligibility and the scope of services. Read more
Preliminary Figures Suggest Strong Improvement in Wisconsin
The Affordable Care Act (ACA) has dramatically reduced the number of uninsured adults, according to new data released by Gallup this week. A nationwide poll of about 88,000 people during the first 6 months of 2015 found that the percentage of adults who were uninsured dropped to 11.7% this year, compared to 13.4% in the second and third quarters of 2014 and 17.3% in 2013. More specifically, the uninsured rate among adults was 11.9% in the first quarter of 2015 and fell to just 11.4% during the second quarter.
The Gallup polling also includes state-level data, and those figures show especially large improvements in insurance coverage in the states that have expanded Medicaid and have embraced the ACA. The seven states with the largest percentage point gains in coverage (AR, KY, OR, RI, WA, CA, & WV) are all states that have expanded Medicaid and have state-run health insurance marketplaces. Read more
Research Finds Long-term Benefits for Covering Kids
Medicaid turns 50 today, which is cause for celebration for Wisconsin children and families. It is a critically important source of health care and financial security for low-income families and individuals, including children, parents, pregnant mothers, seniors, and people with disabilities.
In Wisconsin, Medicaid helps finance BadgerCare and provides health insurance coverage for roughly 1.2 million people, including about 500,000 children.
A new report from the Center for Children and Families at Georgetown University synthesizes the emerging body of research that underscores the importance of Medicaid for kids and families, including long-term benefits for children that last through adulthood. Highlights of the research findings pertaining to the sustained benefits for kids include:
- Long-term health benefits – Children with access to Medicaid showed a 26 percentage point decline in the incidence of high blood pressure in adulthood and had lower rates of hospitalizations and emergency room visits as adults.
Now that the last significant lawsuit challenging the federal health care reform law has been turned aside, it’s clear that the Affordable Care Act is the law of the land. However, that fact will generate more debate in Congress about the law, as its opponents turn more attention to trying to repeal the ACA.
While that debate heats up, we need to look objectively at the evidence regarding the law’s effects – starting with the effect on insurance coverage. In this blog post I’ve pulled together the best available survey data regarding the effects of the ACA on the number of Americans and Wisconsinites who are uninsured. Read more