New ACA Repeal Plan Expected to Cost Wisconsin $29 Billion by 2036

Friday, September 22, 2017 at 12:50 PM by
The new proposal to repeal the Affordable Care Act (ACA) is estimated to reduce federal health care funding for Wisconsin by $29 billion from 2020 through 2036. That’s the conclusion of an analysis released on September 21 by Avalere Health. The Avalere analysis helps illustrate why the new ACA repeal and replace plan, like the ones before it, would result in at least 20 million fewer Americans with health insurance by 2021. And under this plan offered by Senators Graham and Cassidy, the rapid drop in insurance coverage could reach 32 million in 2027, according to a report issued today by the Brookings Institute. The new proposal would make insurance far less affordable for many who now use the subsidized ACA marketplace and would force states to make deep cuts in Medicaid services for children, seniors and people with disabilities.
Categories: BadgerCare Plus, Blog, federal issues, health care reform, Medicaid | Comments Off on New ACA Repeal Plan Expected to Cost Wisconsin $29 Billion by 2036

Trump Budget Demonstrates the Perils of Changing Medicaid

Wednesday, May 24, 2017 at 5:39 PM by

Medicaid Cut Projected to Be 45% in 2026, and More in Future Years

In order to pay for huge tax cuts for corporations and wealthy Americans, the President is proposing massive Medicaid cuts – far beyond the amounts contained in the House plan to “repeal and replace” the Affordable Care Act.

Whereas the House-passed bill is now projected to cut Medicaid by $834 billion over the next 10 years, the Trump budget unveiled this week would cut Medicaid by about $1.3 trillion, according to an analysis by the Center on Budget and Policy Priorities (CBPP).  The following bar graph illustrates how those cuts would get deeper over time. Read more

The Case for Expanding BadgerCare Grows Stronger

Thursday, April 6, 2017 at 5:57 PM by

$190 Million Annual Savings + Threats to Federal Marketplace = Stronger Case for Expansion

There are many reasons why it makes sense for Wisconsin to modestly increase the eligibility ceiling for BadgerCare. A new memo by the Legislative Fiscal Bureau (LFB) sheds light on and strengthens one of those reasons – the large savings for Wisconsin from increasing the BadgerCare eligibility standard for adults.

Ironically, the ongoing efforts to repeal or undermine the Affordable Care Act (ACA) may also bolster the case for expanding BadgerCare, since the individual insurance Marketplace created by the ACA was Governor Walker’s rationale for sharply reducing BadgerCare eligibility. But let’s come back to that point after taking a closer look at the fiscal effect of expansion.

Under the Affordable Care Act, states that expand eligibility of adults to 138% of the federal poverty level are eligible for substantially higher federal cost sharing. Taking that step would qualify Wisconsin for reimbursement of at least 90% federal funding for the costs of covering childless adults, compared to the 58% reimbursement rate in effect now. Read more

Categories: 2017-19 biennial budget, BadgerCare Plus, Blog, health care reform, Medicaid | Comments Off on The Case for Expanding BadgerCare Grows Stronger

New Poverty Guidelines Shed Light on Health Policy Debates

Friday, February 3, 2017 at 6:43 PM by

Federal policy guidelines that were adjusted for inflation last week are worth examining because they help illustrate the challenges faced by low-income working families. They show, for example, that single parents with one child are currently ineligible for BadgerCare if they have a full-time job that pays more than $7.81 per hour!

The federal poverty guidelines are updated early each year, and the 2017 guidelines that were issued on January 31 increase the Federal Poverty Level (FPL) by 1.3%. That raises eligibility for many federal benefit programs, such as Medicaid, food stamps and child care subsidies. An updated table on the Wisconsin Budget Project website shows what the poverty level is for different family sizes and how that affects eligibility for different public benefits. It also translates the annual poverty level figures into monthly and hourly incomes. Read more

Categories: BadgerCare Plus, Blog, health care reform, Medicaid, poverty | Comments Off on New Poverty Guidelines Shed Light on Health Policy Debates

ObamaCare Sharply Reduces Wisconsin Hospitals’ Uncompensated Care

Thursday, October 6, 2016 at 1:33 PM by

New data from the Wisconsin Hospital Association show that the federal health care reform law has had the desired effect of causing a sharp drop in uncompensated care. That’s great news because much of the cost of uncompensated care for people who are uninsured gets shifted to other patients and contributes to higher rates for people with insurance.

The reduced spending for uncompensated care – which is the total of charity care and bad debt – also has the benefit of creating a great opportunity for hospitals to make upstream investments that promote public health and alleviate some of the factors causing severe health disparities.

The new data demonstrate that uncompensated care expenses borne by Wisconsin hospitals have dropped precipitously since 2013, as key parts of the Affordable Care Act (ACA) were being implemented – including the new insurance Marketplace and the expansion of coverage for childless adults. After those provisions had been in place for two years, total uncompensated care fell in Wisconsin by $534 million in fiscal year 2015, a drop of 36.8 percent from the 2013 level. Read more

Categories: BadgerCare Plus, HEALTH & HUMAN SERVICES, health care reform, Medicaid | Comments Off on ObamaCare Sharply Reduces Wisconsin Hospitals’ Uncompensated Care

Very Good Census Bureau News on Health Coverage, Income and Poverty

Tuesday, September 13, 2016 at 4:42 PM by

Uninsured Rate Declines Sharply Nationally and in Wisconsin

New data released today by the U.S. Census Bureau show that the federal health care reform law has been extremely effective in reducing the number of people who are uninsured, both nationally and here in Wisconsin. The new figures also bring very good news on national improvements relating to income and poverty.

The number of Wisconsinites who do not have health insurance fell sharply during the first two years of implementation of the Affordable Care Act (ACA). According to the new data from the American Community Survey (ACS), 195,000 fewer Wisconsin residents were uninsured last year than in 2013, a decline of 37.6%.

The national ACS data show that the number of Americans without health insurance fell by more than a third from 2013 to 2015, and the percentage who are uninsured is now at an all-time low. That reflects a drop in the uninsured population of almost 7 million last year, on top of an improvement of about 8.5 million in 2014, when key parts of the health care reform law took effect. Read more

Categories: BadgerCare Plus, Blog, health care reform, Medicaid, poverty | Comments Off on Very Good Census Bureau News on Health Coverage, Income and Poverty

The Rapidly Mounting Evidence Supporting Medicaid Expansion

Thursday, August 25, 2016 at 12:49 PM by

There’s a rapidly growing body of academic research documenting the benefits of using the Affordable Care Act to expand Medicaid eligibility of adults.

Academic researchers love experiments with control groups, and those kinds of tests of public policy changes can be hard to find. However, the 2013 Supreme Court decision that made Medicaid expansions optional for states has been a boon for researchers. They can now study the changes in 31 states that have extended eligibility for adults to 138% of the poverty level, and can compare those states with the 19 “non-expansion” states. (Wisconsin is in the latter group because it caps BadgerCare eligibility for adults at the poverty level.)

One such study was published this month in the Journal of the American Medical Association Internal Medicine (JAMA). It compares health outcomes for patients in Kentucky and Arkansas – two states that accepted the expansion of Medicaid – with outcomes for patients in Texas, which has rejected it. Read more

Categories: BadgerCare Plus, Blog, health care reform, Medicaid | Comments Off on The Rapidly Mounting Evidence Supporting Medicaid Expansion

Lower-than-Expected Medicaid Spending Offers Relief and Opportunity

Tuesday, July 5, 2016 at 7:44 PM by

Reduced Participation Provides Opportunity and Reason to Streamline Enrollment Procedures

Members of the legislature’s Joint Finance Committee got some very good news last Friday in the form of a quarterly report on the state Medicaid budget from the Wisconsin Department of Health Services (DHS).  The letter from the interim Secretary of DHS indicates that the agency now estimates that Medicaid spending during the 2015-17 biennium will be $418.6 million below the amount lawmakers anticipated when they passed the budget bill a year ago.

The portion of Medicaid spending specifically from state General Purpose Revenue (GPR) is projected to be almost $176 million (3.1%) less than the budget bill set aside. That’s an improvement of $90.6 million GPR since the last projection was made three months ago.

These numbers from DHS are very good news at a time when state revenue projections haven’t been very good. The reduced growth in Medicaid spending improves the prospects for keeping the total state budget in the black – without resorting to additional remedial measures (beyond the delay in debt payments that the Governor already implemented). Read more

Categories: 2015-17 biennial budget, BadgerCare Plus, Blog, Medicaid, spending | Comments Off on Lower-than-Expected Medicaid Spending Offers Relief and Opportunity

Ryan Health Plan Could Be Double Trouble for Former BadgerCare Participants

Monday, June 27, 2016 at 8:00 AM by

If Ryan Plan Passes, Continuation of BadgerCare Changes Would Amount to a “Bait and Switch”

A health care plan introduced last week by Speaker Ryan would roll back many of the improvements in health care that have been achieved over the past several years. It would reverse much of the huge increase in the number of people with insurance, undermine improvements in access to preventive health care services, and raise costs for many people with insurance.

I could go on at length about problems with the plan, but I want to focus now on an important Wisconsin angle – how the Ryan plan would adversely affect many of the 60,000 low-income working parents that state lawmakers removed from BadgerCare two years ago. Many aspects of the Ryan plan would compound the difficulties those parents are already coping with because of the policy choices in Wisconsin, and would take away what they were promised when the state ended their BadgerCare coverage. Read more

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A Missed Opportunity to Learn from Wisconsin’s Health Reform Implementation

Tuesday, June 14, 2016 at 12:56 PM by

National Health Policy Expert Critiques State’s Narrow Evaluation of BadgerCare Changes

Wisconsin received a federal waiver to make significant changes to BadgerCare in 2014, and one of the conditions of that “demonstration waiver” was that the state would evaluate the effects of the policy changes. A national health policy expert, Sara Rosenbaum, reviewed the planned evaluation and in a blog post last week wrote that the analysis designed by state officials fails to address several of the key aspects of the policy changes being implemented in our state. Read more

Categories: BadgerCare Plus, Blog, HEALTH & HUMAN SERVICES, health care reform, Medicaid | Comments Off on A Missed Opportunity to Learn from Wisconsin’s Health Reform Implementation