Surge in BadgerCare Enrollment Increases Potential Savings from Federal Funds

Wednesday, March 11, 2015 at 5:54 PM by

Number of Childless Adults in BadgerCare Jumps by More than 7,000 in February  

The latest open enrollment period for the federal insurance Marketplace caused tens of thousands of Wisconsinites to apply for health insurance – sharply increasing the number of people signing up for subsidized plans and also causing a big jump in BadgerCare enrollment. Those trends are a major success story for the Affordable Care Act, but they pose a challenge for state lawmakers.  

The number of childless adults in BadgerCare has jumped by more than 10% since December, which significantly increases the program’s cost.  However, that unanticipated surge in enrollment also substantially increases the amount the state could save if state lawmakers accept the federal funding that would pay almost all of the cost of covering childless adults. Read more

New Figures Show Importance of Capturing Wisconsin’s Share of Medicaid Funding

Monday, March 2, 2015 at 5:44 PM by

The proposed budget bill contains a very substantial increase in state funding for Medicaid programs in Wisconsin, including BadgerCare, but it also makes a number of negative changes to BadgerCare and SeniorCare, as well as to other health care services for the elderly and people with disabilities. 

A new Wisconsin Budget Project summary of the major health care portions of the budget bill explains that the largest factor in the increased spending is the much greater-than-anticipated growth in BadgerCare participation among adults without dependent children.  The following chart uses Legislative Fiscal Bureau data to illustrate the comparative role of different parts of Medicaid in boosting the cost of maintaining current health care programs by $643 million during the 2015-17 budget.   

MA cost-increase-chart-2

As that bar graph shows, the state’s share of spending for childless adults is expected to grow by almost $383 million over the next two years, relative to the amount appropriated for the current fiscal year. Read more

Compromise BadgerCare Expansion Plan Projected to Save $241 Million

Monday, February 16, 2015 at 7:58 PM by

Iowa-based Plan Offers Option to Mitigate Deep Budget Cuts

A bill unveiled today offers a compromise on how to expand BadgerCare, while helping to avoid or scale back some of the deep cuts in the budget bill.  The proposed legislation could save an estimated $241 million in Wisconsin’s 2015-17 budget, while expanding BadgerCare to an estimated 81,000 adults between 100% and 138% of the federal poverty level. 

The compromise legislation, which is now being circulated for cosponsors by Representative Daniel Riemer (D – Milwaukee) and Senator Jon Erpenbach (D – Middleton), is similar to the Medicaid expansion plan being implemented in Iowa because the new BadgerCare coverage for adults over the poverty level would be private insurance plans purchased through the health insurance exchange or “Marketplace,” rather than the current public plan for BadgerCare recipients. This compromise would essentially continue the sort of coverage that adults over the poverty level can now get through the Marketplace, but the subsidies would be delivered through BadgerCare, rather than through the federal premium tax credits.  Read more

Number of Uninsured Adults Drops Sharply after ACA Implementation

Friday, January 9, 2015 at 4:18 PM by

New survey figures released by Gallup this week show that the number of uninsured adults dropped again in the last quarter of 2014 and is down sharply since 2013. Even as Paul Ryan and some other members of Congress argue that the Affordable Care Act is “beyond repair,” the Gallup survey data show the law has been quite successful in achieving a key objective. As the Gallup analysis concludes:

 “The Affordable Care Act has accomplished one of its goals: increasing the percentage of Americans who have health insurance coverage.”

According to the new Gallup findings, the portion of Americans between 18 and 64 who are uninsured declined from 21.2% in the third quarter of 2013 to 15.5% in the fourth quarter of 2014. By my calculations, that amounts to a reduction of more than 10.8 million non-elderly adults who are uninsured – a drop of about 27%. 

change in uninsured adults - thru  2014

Here are some of the other highlights of the new Gallup data:

  • The uninsured rate for adults of all ages, which peaked at 18% in the third quarter of 2013 (as shown in the graph above), declined to 13.4% a year later and to just 12.9% in the last quarter of 2014.
  • Read more

Settling for Second Best: Hospitals Seek to Extend Aid for Uncompensated Care

Tuesday, December 16, 2014 at 8:26 PM by

While Hospitals Elsewhere Back Medicaid Expansion, Wisconsin Hospitals Offer a Fallback Plan 

Hospitals in Wisconsin and many parts of the U.S. are asking state policymakers to take measures to reduce the amount of uncompensated care, although the recommended measures aren’t always quite the same. In our state, the Wisconsin Hospital Association (WHA) is asking state lawmakers to renew an expiring appropriation that provides state financial relief to hospitals that care for a disproportionate share of the uninsured or underinsured. 

The $30 million state appropriation, which expires in June, captures $44 million in federal funds for “disproportionate share hospitals” (DSH). Wisconsin Health News reported last week that WHA plans to ask state policymakers to renew the appropriation. Extending that funding makes sense if state lawmakers continue to refuse to expand BadgerCare to cover more low-income adults, but the expansion option could save the state close to $300 million in the next budget and do far more to improve access to insurance and help hospitals.  Read more

DHS’s Response to Congress Reiterates the Importance of CHIP Funding for Wisconsin’s Children

Friday, December 12, 2014 at 12:09 PM by

The Affordable Care Act (ACA), while authorizing the Children’s Health Insurance Program (CHIP) through federal fiscal year (FFY) 2019, created a funding cliff for states by only providing appropriations through FFY 2015. A letter made public last week, which was submitted to members of Congress by DHS Secretary Kitty Rhoades (on behalf of the Governor), explains why the extension of CHIP funding is extremely important for children in Wisconsin.

CHIP has garnered bipartisan support since its inception in 1997 and has been instrumental in lowering the uninsured rate of children in the U.S. Now, it’s up to members of Congress to continue working together to ensure that ongoing funding for the program is approved by September 2015.

At tail end of summer, the House Committee on Energy and Commerce (E and C) and the Senate Finance Committee sent a letter to the nation’s governors requesting state-specific input on CHIP. Wisconsin, along with 38 other states, provided responses that overwhelmingly stress the importance the program plays in providing low-income children with access to affordable, quality health care.   Read more

New National Reports Document the Value of Medicaid Expansion

Monday, October 27, 2014 at 6:54 PM by

Expansion States Show Much Greater Improvement on Uninsured Rates and Uncompensated Care 

The evidence in favor of expanding BadgerCare keeps growing as new analyses compare the experience of states that have expanded coverage and accepted the increased federal funding and the states that haven’t done so. Several new studies by national organizations show that Medicaid expansion states have seen much larger drops in the uninsured and in uncompensated care, yet their Medicaid costs are growing at a slower rate than in the non-expansion states. 

The following is a brief summary of three recent reports: 

Gallup data on changes in the uninsured ratesGallup survey data from across the nation show that states that have expanded Medicaid eligibility and are operating their own insurance Marketplace have achieved a much larger drop in the percentage of uninsured people than the so-called “non-expansion” states. “The uninsured rate declined 4.0 points in the 21 states that have implemented both of these measures, compared with a 2.2-point drop across the 29 states that have implemented only one or neither of these actions.” 

That difference is made more impressive by the fact that the expansion states already had much lower uninsured rates among non-elderly adults. Read more

Which Candidate’s Plan Expands Obamacare?

Monday, September 29, 2014 at 5:54 PM by

A Walker campaign ad that criticizes Mary Burke for her stance relating to the Affordable Care Act (aka the ACA or “Obamacare”) is based on a false premise. It incorrectly equates supporting the expansion of BadgerCare with supporting an expansion of “Obamacare.”

Although I don’t think one can say that either candidate supports “expanding Obamacare,” I believe a strong case can be made that the Governor’s plan relies more heavily on a key part of the Affordable Care Act. For reasons I’ll explain below, his changes to BadgerCare do more than Burke’s alternative to expand the reach of the core part of the ACA – the new federal Marketplace for health insurance and the substantial federal funding to subsidize Marketplace insurance plans.

One of the major problems with the ad is that implementing part of a federal law and taking advantage of federal funding is not the same thing as supporting expansion of that law. Read more

DHS Budget Bolsters Case for BadgerCare Expansion

Monday, September 22, 2014 at 5:05 PM by

Without intending to do so, the Department of Health Services (DHS) budget request has substantially strengthened the arguments for expanding BadgerCare and taking federal funding available for that purpose, which would  erase much of the state’s currently projected Medicaid funding shortfall.  There are many compelling reasons to accept the federal funding, and the DHS budget request unveiled last week adds to that list.  

The following are four aspects of the budget request that bolster the arguments for expanding BadgerCare eligibility for adults up to 138% of the federal poverty level (FPL).  Although the first point noted below is reason enough to take the federal funding, a closer reading of the DHS budget request reveals other reasons why the strong arguments for expanding BadgerCare are now even stronger.  

1)  The $760 million in additional state revenue needed simply for a cost-to-continue budget – The DHS budget request seeks an increase of $760 million in state General Purpose Revenue (GPR) simply to maintain current Medicaid and BadgerCare benefits.  Read more

Despite Calling Medicaid Expansion Funds Unreliable, State Lawmakers Rely on Other ObamaCare Funds

Tuesday, September 2, 2014 at 4:19 PM by

In the Wisconsin debate about whether to accept federal funding for expanding BadgerCare, there has been little attention paid to a significant inconsistency used in the arguments made by many opponents of using those funds.