Wisconsin Lags Far Behind in Reporting on National Standards
This week has been Sunshine Week, which is the annual nationwide celebration of access to public information. That makes this a good time to bring up an area where Wisconsin needs to let in considerably more sunshine – health care quality measures for children served by Medicaid and the Children’s Health Insurance Program (CHIP). Federal law encourages voluntary reporting of those measures, but Wisconsin is lagging well behind most other states in reporting that information. Read more
Federal officials recently released the 2016 Federal Poverty Income Guidelines, better known as the federal poverty levels (FPL). States and the federal government use the guidelines to determine eligibility for many public assistance programs, such as Medicaid, BadgerCare and child care subsidies.
Our website has several tables showing the new poverty levels and how they relate to eligibility for various public benefits. In addition to showing the annual income figures, the tables convert those into monthly and hourly income. Read more
President Obama’s Budget Would Make Expansion an Even Better Deal
The budget bill introduced this week by President Obama would make the expansion of Medicaid an even better deal for states like Wisconsin that have not yet taken up the option. If Wisconsin expanded BadgerCare eligibility in January 2017, the president’s recommendations would increase the savings for Wisconsin taxpayers by $252 million by the end of fiscal year 2021.
The president’s proposal calls for reimbursing each state for the full cost of newly-eligible adults for the first three years after expanding coverage, regardless of when the expansion begins. As a result, states that expand coverage of adults this year or any time in the future would get the same enhanced federal funding as the states that expanded coverage in 2014. Read more
[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 (a 19% drop).
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