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CONTACT: Stephanie Smiley, (608) 266-1683, (608) 260-5196
DEPARTMENT SUBMITS MEDICAID SAVINGS INITIATIVES TO JOINT COMMITTEE ON
FINANCE FOR REVIEW
MADISON—The Department of Health Services today submitted formal
proposals on Medicaid savings initiatives to Wisconsin’s Joint Committee
on Finance. The initiatives aim to preserve the core, safety-net functions
of the program for low-income individuals and are necessary in order to
keep the Medicaid program in balance with the state budget.
The mission and cost of Medicaid in Wisconsin have expanded
dramatically over the years. Medicaid serves one out of every five
citizens and costs nearly $7 billion in state and federal funding each
year. Medicaid pays for 45 percent of all births in the state, and
Medicaid recipients occupy roughly 60 percent of nursing home beds.
State funding for Medicaid had to be significantly increased above the
2009-2011 budget, primarily for two reasons – federal matching funds
decreased by $1.33 billion and previous budget estimates were based on a
projected decline in enrollment. But even after an infusion of $1.2
billion of additional state funding provided by Governor Walker and the
Legislature for the current budget cycle, the Department was tasked with
finding savings to keep the Medicaid program in balance with the state
budget.
Secretary Dennis G. Smith and Deputy Secretary Kitty Rhoades collected
input on the proposed Medicaid efficiencies and cost-savings initiatives
from consumers, community partners, and providers online and at in-person
town hall meetings.
“We have talked with hundreds of people about the need to modify the
Medicaid program over the past several months and many suggestions that we
received were incorporated into our original proposals,” said Secretary
Dennis G. Smith. “From feedback at our most recent town hall meetings in
Madison and Milwaukee, we have made additional modifications.”
Changes incorporated into the Medicaid Savings Initiatives as a result
of feedback received at town hall meetings include:
- Income Eligibility Determination – In the original proposal the
item would allow the State to include the income of all adults living
in the same household, except grandparents, in determining Medicaid
eligibility. The proposal has been modified to allow for temporary
housing situations. Income will now only be considered for individuals
living in a household for 60 days or more.
- Premium Reforms –The original proposal allowed the state
flexibility to increase premiums up to 5% of family incomes for
families with incomes above 150% of the Federal Poverty Level. The
proposal has been modified to allow for a “discount” on premiums
based on family payments for private health insurance.
- Reimbursement to Personal Care Providers – The original proposal
reduced reimbursement due to travel time. The proposal has been
modified to recognize the additional costs associated with travel in
rural communities.
The Federal government has already told states they can drop coverage
for non-disabled, non-elderly adults on Medicaid with incomes above 133%
of the Federal Poverty Level, which would affect 53,000 individuals in
Wisconsin. As outlined in the state budget, if the Department does not
receive approval of its Maintenance of Effort (MOE) waiver request, which
is included in the proposals submitted to the Joint Committee, it is
required to dis-enroll these individuals to balance the state budget.
The Medicaid savings initiatives can be found on the Department’s
website at www.dhs.wisconsin.gov.
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Last Revised: November 01, 2011
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