Report: Health coverage falls for second year in Wisconsin

Trend extends nationwide as Trump administration undermines Affordable Care Act

After falling for several years, the number of uninsured people in Wisconsin rose for a second year in a row in 2018, according to a new report by Kids Forward, a statewide research and advocacy group for children and families.

For people of color, the lack of access to health coverage is especially acute, according to Kids Forward, a Madison-based research and advocacy organization. Among black Wisconsin residents ages 19 to 64, 12.3% lacked health insurance, more than twice the rate (5.6%) for white residents. For other groups, the rate was even higher: 23.4% of Native American adults and 24.4% of Latinx adults in the state lacked health insurance.

Kids Forward based its conclusions on data from the U.S. Census Bureau released last week. 

Before the federal Affordable Care Act took effect, about 518,000 people in Wisconsin lacked health insurance in 2013, Kids Forward reported. After falling for several years, the number of state residents without health insurance rose about 14,000 over the last two years, from about 299,00 in 2016 to about 313,000 in 2018. 

On Tuesday, State Department of Health Services Secretary Andrea Palm announced that her department was awarding $500,000 in existing funds to Covering Wisconsin, a group that helps people sign up for insurance on the federal marketplace, to pay for seven full-time outreach workers. “Lack of health insurance affects far too many Wisconsin families,” Palm said.

The enrollment period for insurance through the federal government’s Healthcare.gov website extends from Nov. 1 through Dec. 15.

A similar though less pronounced trend toward lower rates of insurance is underway nationwide. The number of people in the U.S. without coverage fell by 38%, or 17 million, between 2013 and 2017, bottoming out at 25.5 million, according to William Parke-Sutherland, health policy engagement coordinator for Kids Forward. In 2018 the number crept up to 27.5 million. 

“The disturbing thing about that is that for a long time we’ve been having more people being covered,” Parke-Sutherland said in an interview. “Now we’re moving in the wrong direction.”

Nationally, the Kids Forward analysis attributed the fall in coverage to reduced support for the Affordable Care Act under the Trump administration, including its cuts in outreach and in helping people sign up for coverage under the ACA. Other policies have also effectively reduced enrollments in the insurance marketplace that was created under the act, and new federal rules thwarted immigrants who otherwise would have  enrolled in Medicaid.

Parke-Sutherland called the declines disappointing because both employment and incomes are rising — conditions in which coverage usually increases, he observed. 

And for Wisconsin, the decline in coverage is especially discouraging  given the state’s history of BadgerCare, the Wisconsin alternative to Medicaid. More than a decade ago,  even before the ACA took effect, that program was expanded to cover families with children whose incomes were 200% of the federal poverty level.

“Wisconsin has long been a leader in making sure people have insurance coverage,” Parke-Sutherland said. 

This chart, compiled by Kids Forward, shows how the percentage of people not covered by health insurance has fallen since 2008, until it began creeping up in 2017 and 2018.

Gov. Scott Walker’s continued refusal to accept expanded Medicaid coverage under the ACA has cost the state $1.1 billion since April 2014, he said. That policy continues because the Republican-led legislature removed a Medicaid-expansion provision from the budget submitted by Gov. Tony Evers earlier this year. 

Kids Forward tracks what it says is the cost to state taxpayers of not accepting Medicaid expansion at a special webpage: https://www.betterbadgercare.com/

In place of the Medicaid expansion under the ACA, the state under Walker reduced Medicaid eligibility to poverty level but expanded the program to cover childless adults. In theory, the people cut off from BadgerCare would have qualified for private insurance under the ACA, but at least one follow-up study found that more than a third of people who would have been eligible never managed to obtain private coverage, he said.

In light of the reduced coverage, Parke-Sutherland said, a recent report that unpaid bills are increasing at hospitals statewide should not be surprising. 

He cautioned that he hadn’t looked at the data in detail. But, he said, “it makes sense. If more people are without health insurance coverage, there’s going to be more people getting charity care and more people who can’t afford to pay their hospital bills.”

Erik Gunn
Senior Reporter Erik Gunn reports and writes on work and the economy, along with related subjects, for the Wisconsin Examiner. He spent 24 years as a freelance writer for Milwaukee Magazine, Isthmus, The Progressive, BNA Inc., and other publications, winning awards for investigative reporting, feature writing, beat coverage, business writing, and commentary. An East Coast native, he previously covered labor for The Milwaukee Journal after reporting for newspapers in upstate New York and northern Illinois. He's a graduate of Beloit College (English Comp.) and the Columbia School of Journalism. Off hours he is the Examiner's resident Springsteen and Jackson Browne fanboy and model railroad nerd.

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