83,000 of state poor to get BadgerCare coverage under federal waiver

By Jason Stein of the Journal Sentinel

Jan. 9, 2014 - Journal Sentinel

Madison — About 83,000 of the state's poorest residents will gain state BadgerCare Plus health coverage in April and a slightly smaller low-income group will lose that coverage and be shifted to a federal program, under a plan by Gov. Scott Walker that has been approved by federal officials.

In a statement, Walker announced Thursday that President Barack Obama's administration had approved a waiver of federal Medicaid rules to allow the BadgerCare Plus changes. The federal approval runs through Dec. 31, 2018.

"For the first time in our state's history, everyone living in poverty will have access to health care through Medicaid in 2014," said Walker. "Wisconsin has a long history of providing quality care to its residents. Our reforms maintain Medicaid as a safety net for our state's most vulnerable and ensure there is no gap in health care coverage in Wisconsin."

At the core of the governor's vision for the state's health care marketplace is the shift of some patients from BadgerCare coverage for the needy onto subsidized federal markets for private insurance called exchanges. Those online marketplaces were created under the federal Affordable Care Act, also known as Obamacare.

Legislation approved by Walker and GOP lawmakers requires some 77,000 adults in BadgerCare with incomes above the poverty line — $23,550 for a family of four — to be dropped from that state Medicaid coverage.

That transition has been delayed by three months by the state because of problems with the rollout of the federal exchanges.

In a letter to state officials dated Dec. 30, Marilyn Tavenner, administrator of the federal Centers for Medicare & Medicaid Services, said her agency would "work with the state on its transition plan to facilitate a seamless transfer of coverage for those who will be eligible for marketplace coverage."

In the budget approved this summer and again in recent weeks, Walker and his fellow Republicans in the Legislature rejected additional federal money under the Affordable Care Act to expand BadgerCare to a greater number of people.

Democrats note that some GOP governors have extended Medicaid coverage more broadly in their states by taking extra federal money available for that health program under the law. Expanding coverage in that way would save the state up to $119 million through June 2015, according to the nonpartisan Legislative Fiscal Bureau.

Elizabeth Schinderle, a spokeswoman for CMS in Chicago, made the same point Thursday.

"This policy is unfortunately not the long-term solution we would like to see. As a result of the governor's decision to not expand Medicaid coverage, many people in Wisconsin will not have access to affordable coverage because of state-imposed limits on enrollment. We urge Wisconsin to fix this avoidable gap in coverage by expanding Medicaid and taking advantage of generous federal funding," she said in an email.

But Walker and other Republicans say that is not a good long-term strategy for saving state or federal taxpayer money. The federal government can't be trusted for the long term to pay for an expanded Medicaid program, especially given the other problems with Obamacare, they said.

"The governor's reforms will strengthen health care in Wisconsin and provide Wisconsin residents with opportunities in the commercial health care market and will reduce Wisconsin's uninsured rate (by) half," state Health Services Secretary Kitty Rhoades said.