April 27, 2012

Obama Administration Approves Policy Changes to BadgerCare Plus

MADISON-The Department of Health Services today received approval from the Obama Administration to amend BadgerCare Plus for Families and the BadgerCare Plus Core Plan. The changes were submitted to the Centers for Medicare and Medicaid Services (CMS) as part of the Medicaid Savings Initiative.

"These changes 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 sustainable," said Secretary Dennis G. Smith. "We would like to personally thank Secretary Sebelius and her staff in CMS in working with us to agree upon a commonsense plan that ensures individuals will continue to have access to affordable health insurance. This is an important step forward to help ensure equity among working families in Wisconsin as well."

These federally approved program changes will only affect income-eligible non-pregnant, non-disabled adults above 133% of the Federal Poverty Level ($25,390 for a household size of three) and do not apply to children. Beginning July 1, 2012, there will be changes to:

  • Monthly premiums (depending on income) - some members will be required to pay premiums and those who already do may see increases to their existing premiums; individuals who do not pay their premium will not be eligible for 12 months
  • The rules regarding access to employer-sponsored health insurance - individuals described who have access to affordable health insurance through their employer will be asked to utilize that coverage rather than the publicly funded option
  • Retroactive eligibility - members described above will no longer be eligible for three months of backdated eligibility

Individuals and families enrolled in the programs who may be affected by these policy changes will receive a general notice next week notifying them changes will be coming in July. The Department is currently in the process of determining how these changes impact each member and in mid-June will send letters about the changes specific to their situation.

The mission and cost of Medicaid in Wisconsin have expanded dramatically over the years. Medicaid serves one out of every five citizens and costs more than $7 billion in state and federal funding each year. 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. These policy changes are part of the Department's efforts to keep the Medicaid program sustainable now, and in the future.

The Department estimates $28.1 million in state funding will be saved annually as a result of these policy changes.