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

Categories: BadgerCare Plus, Blog, health care reform, Medicaid | Comments Off on Ryan Health Plan Could Be Double Trouble for Former BadgerCare Participants

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

Opponents of BadgerCare Expansion Miss the Mark on Cost Concerns

Wednesday, June 1, 2016 at 2:02 PM by

The Legislative Fiscal Bureau (LFB) has calculated that expanding BadgerCare and thereby qualifying for a higher federal reimbursement rate would yield huge savings for Wisconsin.

The most recent LFB analysis, issued last December, examined the effects of boosting the BadgerCare income limit for adults to 133 percent of the federal poverty level (FPL) from 100 percent of FPL now (which amounts to just $7.70 per hour for single parent with one child). The LFB concluded:

  • Initiating that change in January 2016 would have saved state taxpayers $323.5 million during the 2015-17 biennial budget period, while covering an additional 83,000 adults.
  • The state would have netted nearly $1 billion in savings over a six-year period!
  • A one-year delay in the expansion would reduce the savings by $236 million, but Wisconsin would still save an average of more than $15 million per month once the change took effect.

Opponents of expansion haven’t directly challenged those estimates. Read more

Categories: BadgerCare Plus, Blog, health care reform, Medicaid | Comments Off on Opponents of BadgerCare Expansion Miss the Mark on Cost Concerns

Federal Change Offers Opportunity to Reduce Severe Health Disparities for Native Americans

Wednesday, May 18, 2016 at 1:25 PM by

A change in federal Medicaid policy announced in February creates an exciting opportunity to improve health care for Native Americans. It’s an opportunity that Wisconsin tribes and state officials should seize in order to help alleviate the extreme disparities in health between Native Americans and whites in Wisconsin.

The revised interpretation of Medicaid reimbursement policy expands the scope of health care services for Native Americans that are fully paid for by the federal government, without the usual requirement for state matching funds. In the past, the federal government paid 100% of the cost of Medicaid services provided directly by Indian Health Services (IHS), but not for health care provided outside of IHS facilities. Under the new policy, federal funding will also cover the full cost of Medicaid services delivered to American Indians by providers under contract with IHS, if IHS or a tribal practitioner refers the Medicaid patient and continues to oversee their care. Read more

Categories: BadgerCare Plus, Blog, Medicaid | Comments Off on Federal Change Offers Opportunity to Reduce Severe Health Disparities for Native Americans

Good News on the State’s Medicaid Budget

Wednesday, April 13, 2016 at 7:59 PM by

The latest quarterly report from the Department of Health Services (DHS) projects that state spending for Medicaid and related services during the current biennium will be $85.2 million less than the state budgeted. That amounts to $12.6 million less state spending than the state estimated in its last update, three months ago. (I’m focusing just on the state share of spending; the total reduction from all sources is almost $203 million, relative to the amount budgeted for 2015-17.)

Granted, Medicaid spending trends can change rapidly, but the DHS report is welcome news – particularly since other budget indicators aren’t so good. Recently reduced estimates of national economic growth in 2016 suggest the possibility of less state revenue growth than anticipated, and as we noted in a recent blog post, state tax collections dropped by $91 million in February. Against that backdrop, the latest DHS report provides a bit of positive news relating to the prospects for keeping the state budget in the black. Read more

Categories: 2015-17 biennial budget, Blog, HEALTH & HUMAN SERVICES, Medicaid, spending | Comments Off on Good News on the State’s Medicaid Budget

It’s Time to Shed More Light on State Medicaid Quality

Friday, March 18, 2016 at 2:37 PM by

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

Categories: BadgerCare Plus, Blog, Medicaid | Comments Off on It’s Time to Shed More Light on State Medicaid Quality

BadgerCare Income Limit Updated: $7.70 per Hour for Single Parent with One Child

Monday, February 15, 2016 at 3:55 PM by

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

Categories: BadgerCare Plus, Blog, ECONOMIC SECURITY, Medicaid, poverty | Comments Off on BadgerCare Income Limit Updated: $7.70 per Hour for Single Parent with One Child

The Growing List of Reasons to Expand BadgerCare

Wednesday, February 10, 2016 at 4:35 PM by

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

Categories: BadgerCare Plus, Blog, federal issues, HEALTH & HUMAN SERVICES, Medicaid | Comments Off on The Growing List of Reasons to Expand BadgerCare

Medicaid Savings Could Create Options for Policymakers

Thursday, December 31, 2015 at 5:17 PM by

[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

Categories: 2015-17 biennial budget, BadgerCare Plus, Blog, HEALTH & HUMAN SERVICES, health care reform, Medicaid | Comments Off on Medicaid Savings Could Create Options for Policymakers