On Wednesday, Wisconsin expanded its BadgerCare Plus program, to include a new group of low-income residents. Adults without children are now able to buy low-cost health insurance from the state. The goals of the program are to save health care dollars and help thousands of people get primary and preventive care. WUWM's Ann-Elise Henzl reports.
Until now, the state's BadgerCare Plus program for low-income residents only applied to pregnant women and adults with children. They were able to buy low-cost health insurance through the state, on a sliding scale. But secretary of the Department of Health Services, Karen Timberlake, says thousands of people were left out.
"We estimate that around 81,000 people in Wisconsin are potentially eligible for this program, just in terms of our assessment of how many people (are) without dependent children, with incomes below 200 percent of the federal poverty level, and who don't have access to insurance through their employers," Timberlake says.
Timberlake says before the program's expansion, those residents would often go without insurance, or be forced to buy expensive, private coverage. Milwaukee County used to provide some coverage. Now, the BadgerCare Plus program is allowing those adults pay $60 a year to join a managed care plan.
"And then there are nominal co-pays for the various medical services that people may receive, so generic drugs are available at $5 per prescription. For hospital services, the co-pays are a little bit higher, but still well below what people would expect to pay in many of the private insurance plans that are out there," Timberlake says.
For instance, $15 for an outpatient visit, and $100 for an overnight stay. Timberlake says the rest of the money for participants' care comes from federal and state sources, including Medicaid funds, and an assessment on hospitals in Wisconsin.
John Bartkowski says the program will be cost-effective, because more people will seek preventive care, now that they can afford it. Bartkowski is CEO of Milwaukee's Sixteenth Street Community Health Center.
"There are going to be thousands and thousands of people who were uninsured who will now have health insurance, who now will be able to find a medical home, where in the past they may have waited and waited until they got really sick and then ended up in the emergency room," Bartkowski says.
Bartkowski says when patients seek primary and preventive care, not only will they improve their health; it's also better for the clinic's bottom line.
"I think it's a pretty big deal and most of the people working in community health centers believe it's going to be a big deal and help us financially so that we can serve even more people in the future," Bartkowski says.
Bartkowski says for the past six months, his staff has been signing up patients for the BadgerCare Plus expansion.
David Riemer of the Milwaukee agency Community Advocates says the expansion is significant. He says Wisconsin isn't the only state offering low-cost health care programs. But he says it's one of the most generous.
"All over the country, other states are cutting. They're reducing eligibility, they're reducing benefits, they're imposing fees. Wisconsin has gone in a much better direction. Not only have we not cut eligibility or benefits, but we have at last expanded to the one group that's been left out," Riemer says.
Still, Riemer would like to see BadgerCare Plus go further. He says the coverage for low-income adults without children only includes minimal access to treatment for mental health and alcohol or drug abuse. Riemer is pushing the state to expand the program. He believes the state will have to comply, because of a new federal law requiring parity for mental health coverage.
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