Analysts: BadgerCare changes will reduce health coverage

    Close-up of American Dollar banknotes with stethoscope
    Childless adults face new costs under BadgerCare. (Photo by Getty Images)

    New BadgerCare charges for childless adults enrolled in or applying for Wisconsin’s version of Medicaid could leave more low-income state residents without health coverage, a Madison health analyst says — further reversing the state’s one-time leadership in expanding health coverage. 

    Starting Feb. 1, BadgerCare will require childless adults in its program to pay an $8 monthly premium. Additionally, they will have to pay an $8 copay for an emergency room visit if their health care provider concludes the visit was not an emergency.

    Already 300,000 state residents lack health insurance, and “many thousands more cannot afford the health care they need,” William Parke-Sutherland, health policy engagement coordinator for Kids Forward, writes in an analysis published this week. “The changes to BadgerCare will exacerbate the problem and will disproportionately impact communities of color.”

    Kids Forward is a research and policy advocacy group focusing on children and families, particularly people of color and people living in poverty. 

    The new charges were sought by the administration of former Gov. Scott Walker, who obtained a federal waiver authorizing the change. The Republican-dominated state Legislature “resolidified” some of the provisions in the December 2018 lame-duck session held after Gov. Tony Evers defeated Walker’s bid for a third term, Parke-Sutherland said.

    The Walker-led changes “create additional hurdles and red tape for childless adults who rely on BadgerCare,” Parke-Sutherland wrote in his analysis.

    Wisconsin is the first state to win federal permission to charge mandatory monthly premiums for people whose incomes fall below the federal poverty line, according to a blog post by Hannah Katch of the national Center on Budget and Policy Priorities.

    Parke-Sutherland states that the premium requirements for adults without children could apply to people with incomes as low as $500 a month. People who cannot pay face the threat of being kicked out of the program for six months. They can get a discounted premium, he notes, “by completing a voluntary health risk assessment and engaging in so-called ‘healthy behaviors.’”

    While the new rules take effect immediately, the penalties they carry have been delayed. The emergency copays — along with other Medicaid copays — have been suspended until June 30 of this year to give the state time to comply with federal requirements to track Medicaid costs for people enrolled in the program. The state is also giving people in BadgerCare up to a year before having to pay their accrued monthly premiums to avoid being cut off.

    Nonetheless, Parke-Sutherland writes, as the holdover Walker-era policies take effect, “Wisconsin joins a growing number of states who are making it harder for people with Medicaid to keep their coverage and stay healthy…. This will harm thousands of Wisconsinites who are stuck in cycles of poverty and experiencing health disparities and inequities.”

    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.