Wisconsin has asked for permission from the federal government to change its health care program for the poor – BadgerCare Plus. Wednesday, leaders will hold the first of three town hall meetings to explain the changes.
Wisconsin is one of 13 states that decided not to expand its Medicaid program. The Affordable Care Act offers states money to cover all adults living at up to 130 percent of the federal poverty level. Gov. Walker says he wants fewer people on government coverage, so he’s proposed to cover all adults with incomes up to 100 percent of poverty – about $11,000 a year. The decision means more than 80,000 adults here would become eligible, and the state wants to reach them.
Kevin Moore is deputy director of the state Department of Health Services.
“You know there’s a lot of folks out there right now that live in poverty who don’t have access to health insurance or health care coverage through Medicaid that now, with these reforms, will have access to it,” Moore says.
At the same time, the governor’s plan would boot about 87,000 parents or caretakers of children off BadgerCare because those adults earn a little more than poverty income. The state would still cover the kids but would refer the adults to the new private health care exchange the Affordable Care Act is creating. It will provide subsidies, based on income.
Moore suggests some families on BadgerCare may be reluctant to seek higher incomes so they don’t have to go out and buy private insurance.
“The subsidies from the federal government are tied to income, so you kind of remove that barrier of ‘I don’t want to take an extra shift, or I don’t want to get a pay raise because it’s going to bump me out of eligibility,’” Moore says.
While state leaders express confidence that all 87,000 people set to lose BadgerCare will pick up their own insurance, critics disagree. The non-partisan Legislative Fiscal Bureau called the goal “unreasonably optimistic.”
Robert Kraig agrees many people will not have the wherewithal. He’s executive director of the advocacy group, Citizen Action Wisconsin.
“We think the exchanges were designed for middle-income people and that a number of the people being forced off BadgerCare will not be able to afford the normal insurance premiums and co-pays that you have in private insurance because of how little discretionary income they have,” Kraig says.
Kraig says those adults will also learn that the Affordable Care Act will not require them to purchase insurance because Wisconsin rejected the federal expansion money.
“So a number of people are going to be uninsured because they won’t be able to afford the exchanges and they won’t be forced to buy them because the federal government’s decided not to punish them for the actions of their state,” Kraig says.
One provider perceives both benefits and drawbacks to the state’s BadgerCare reform plan. Dr. Ian Gilson is a staff physician at the Medical College of Wisconsin. He also volunteers at a free clinic the Salvation Army runs. Gilson says he’s pleased many poor, uninsured people would now qualify for BadgerCare, under Gov. Walker’s plan.
“Many more medications will be available to them. They can be seen at a clinic with more extensive hours. They have access to subspecialty care at the hospital, to hospital care,” Gilson says.
Yet Gilson worries about the low-income adults Wisconsin would edge out of BadgerCare, and who may forego private insurance. He says poor people tend to have more health problems, such as obesity and diabetes.
The Department of Health Services intends to notify people both losing and gaining BadgerCare eligibility. One first step are the town hall meetings, starting Wednesday in Eau Claire. Thursday, they come to Wauwatosa.