Dems roll out BadgerCare Public Option Act

Democratic legislators, together with members of Citizen Action and the Main Street Alliance introduced the BadgerCare Public Option Act during a virtual press conference Monday. 

The bill, an ambitious effort to expand access to health care for Wisconsinites, was introduced by Reps. Kristina Shelton (D-Green Bay) and Supreme Moore Omokunde (D-Milwaukee) with Sens. Chris Larson (D-Milwaukee) and LaTonya Johnson (D-Milwaukee). 

The legislation creates a new basic health plan for single people whose incomes fall between 133-200% of the federal poverty line. For people who make more than 200% of poverty, it establishes a state-based online health insurance marketplace for Wisconsinites so they can purchase coverage through BadgerCare instead of healthcare.gov. Out-of-pocket premiums would be based on income on a sliding scale, with lower deductibles and copays than the private insurance market, Citizen Action’s Robert Kraig told the Examiner. “And, importantly, there would be no claim denials,” Kraig said. “So you don’t get a separate bill for your anesthesiologist after your colonoscopy.”

The bill also allows small business owners with 50 or fewer employees to purchase coverage for their employees at affordable rates, according to its sponsors. And it permits lawfully present immigrants who are ineligible for Medicaid as well as Affordable Care Act coverage because they are not U.S. citizens, to get coverage — as other states, including Illinois, have done.

“It’s about access to hospitals, access to doctors, access to primary caregivers,” said Moore Omokunde. He noted the increased need for health care during the pandemic, “where things like diabetes and high blood pressure etc. are all exacerbated by anxiety and stress.”

“As we emerge from the COVID-19 pandemic, we have seen with clarity that our current health care systems are leaving too many behind, especially when they need health care the most,” said Shelton. “If we have the political will we can actually do something to address the significant gaps in coverage and the rising costs of care and to lift up those who are uninsured.”

Pointing to the state’s $3.8 billion budget surplus and $1.7 billion rainy day fund, Larson noted that Wisconsin is one of a handful of states that refused to accept federal funds to expand Medicaid — instead paying with state funds to cover single adults who are living in poverty. Wisconsin is missing out on about $1.3 billion in federal funds by not taking the federal Medicaid expansion, which would cover the single adults the state is currently covering as well as people making up to 138% of the poverty line. 

“Wisconsin pays more to cover fewer people sending our tax dollars to other states instead,” Larson said.

“This bill would take us up to 200% and expand coverage to small businesses who couldn’t otherwise afford to offer coverage to their employees,” he added.

Kraig said the bill “makes BadgerCare what it was intended to be,” when it was originally proposed by Republican Gov. Tommy Thompson and extended by Democratic Gov. Jim Doyle, providing predictable health insurance coverage to low-income workers.

Patrick DePula, owner of Salvatore’s Tomato Pies, with restaurants in Sun Prairie, Madison and Monona, and a member of the Main Street Alliance, described his struggle to provide insurance coverage to his employees.

“I’ve always felt that health insurance is an economic development tool and it’s frustrating when our elected leaders look at it as some sort of entitlement,” DePula said.

The bill, he added, “makes jobs viable in the hospitality industry,” where many workers are uninsured.

The current cost of private health insurance is “entirely too high,” said DePula — both for employers and for families. When he started his business, he said, the premium payments for health insurance for his family were more than $1,800, and he and his wife decided they couldn’t afford to pay. When he had to have surgery, DePula arranged to pay out of pocket over the course of four years. “Not everyone can do that,” he said.

Michelle Tressler, the owner of Hinterland Brewery in Green Bay, described her struggle to negotiate reasonable health insurance premiums for her 100 employees. Only about one quarter of her employees currently participate in the insurance she offers because it’s so expensive, she said, with premiums as high as $2,000 per month for families. 

“Not too many people can take $2,000 out of their net pay every month,” she said, underscoring that the people affected are “regular people with good jobs,” who make too much money to qualify for the existing BadgerCare program.