Department Provides Update Regarding Operationalization of Governor Walker's Entitlement Reforms
MADISON-Wisconsin Department of Health Services Secretary Kitty Rhoades today provided an update regarding BadgerCare Plus enrollment for newly eligible childless adults and a data match that the Department completed with data received from the Centers for Medicare and Medicaid Services (CMS). As of June 30, 2014, 97,509 more Wisconsinites living in poverty now have health care coverage through BadgerCare Plus due to Governor Scott Walker's entitlement reforms because all eligible adults living in poverty now have equal access to the same level of health care benefits through BadgerCare Plus.
The data match that the Department completed with data received from CMS determined how many BadgerCare Plus members who needed to transition into the federal Health Insurance Marketplace because they no longer met program rules as of April 1, 2014 chose to select a qualified health plan through the Marketplace for their private health insurance coverage and were eligible to receive an Advanced Premium Tax Credit.
When CMS and the Department of Health Services finalized Wisconsin's approach to operationalizing the Affordable Care Act in December 2013, both agencies agreed to establish a way to track the number of people who made the transition to securing coverage through the federal Health Insurance Marketplace. This data match fulfills this requirement.
Below is a summary of the 62,776 transitioning BadgerCare Plus members included in the data match:
- 24,660 selected a qualified health plan through the Marketplace as of June 13, 2014 or are now eligible for BadgerCare Plus or Medicaid.
- 18,801 selected a qualified health plan through the Marketplace.
- 4,867 are on BadgerCare Plus or Medicaid.
- 992 were flagged as being on BadgerCare Plus/Medicaid and selecting a qualified health plan.
- 34,915 had incomes above 133% FPL and would have had to transition to the Marketplace regardless of whether or not Wisconsin had accepted the Medicaid expansion.
"Selecting a qualified health plan through the Federal marketplace isn't the only option that the transitioning BadgerCare Plus members had for securing private health insurance coverage," said Secretary Kitty Rhoades. "Other options included purchasing a private plan that was not sold through the Marketplace; selecting health care coverage through an employer; obtaining health care coverage through a spouse's plan; or choosing to forego purchasing private health insurance coverage altogether, despite the federal mandate that is in place to have coverage. This data match provided only the information about whether or not a transitioning member selected a plan through the Federal Marketplace and is therefore not a complete picture of the health care coverage choices made by the transitioning BadgerCare Plus members."
The Department of Health Services is committed to ensuring that the individuals who were transitioning from BadgerCare Plus were able to successfully secure private health insurance coverage. Since July 2013, the Department has worked with community partners to develop a grassroots outreach infrastructure through the creation of 11 Regional Enrollment Networks to provide a mechanism for more than 1,500 community partners and providers to assist Wisconsin residents in learning about their options and enrolling in private health care coverage. In addition, the Department sent more than 200,000 letters to the transitioning BadgerCare Plus members and made more than 330,000 follow-up phone calls to the individuals receiving those letters to make sure they understood their new health care coverage options and took appropriate action to obtain coverage.
The Department of Health Services will continue work with the Regional Enrollment Networks to ensure that individuals know about their health care coverage options and apply for and purchase private health care coverage through the federal Health Insurance Marketplace, the private market or through a spouse or employer during the 2015 open enrollment period that goes from November 15, 2014 through February 15, 2015. The Department remains committed Governor Walker's Entitlement Reform plan that will reduce the number of uninsured adults in Wisconsin by half while ensuring long-term sustainability and predictability for Wisconsin's health care safety net program.