DHS Requesting Five-Year Extension for BadgerCare Reform Demonstration Waiver
The Wisconsin Department of Health Services (DHS) is requesting a five-year extension for its current Section 1115 BadgerCare Reform Demonstration Project Waiver. The current waiver expires on December 31, 2018, and per federal regulations, DHS must submit an extension request one year in advance of the waiver expiration. Per direction from the Centers for Medicare & Medicaid Services (CMS), the request is being added to the current waiver amendment. The request will not change the waiver amendment DHS submitted to CMS previously.
The extension will allow Wisconsin to continue to provide Medicaid coverage for adults between the ages of 19 and 64 years old, without dependent children, who have income at or below 100 percent of the federal poverty level (FPL). It also continues the requirement of a monthly premium for parents and caretaker relatives who qualify for transitional medical assistance.
DHS will hold two public information sessions to provide information about the extension request and to collect comments from the public. Public comments will be included in the request DHS submits to CMS. DHS intends to submit the request by December 31, 2017.
Public Information Sessions
Tuesday, December 5, 2017
10 a.m.–1 p.m.
Pontiac Convention Center, The Regal Room
2809 N. Pontiac Dr.
Janesville, WI 53545
Thursday, December 7, 2017
10 a.m.–1 p.m.
Brown County Central Library
515 Pint St.
Green Bay, WI 54301
Individuals who are unable to attend a session in person can view a live broadcast of the session online or view a recording of the session online after the session. Information to view a session online will be posted on the DHS website.
Public comments will be accepted from November 24 - January 5, 2018. Written comments can be sent to:
Division of Medicaid Services
P.O. Box 309
Madison, WI 53707-0309
After DHS submits the extension request, CMS will review the application for completeness. Once CMS confirms a complete application, a 30-day federal public notice process begins, along with a 45-day minimum federal decision-making period. During this time, DHS will work with CMS to finalize the details of the waiver. Once the changes to the waiver are approved by CMS, the effective date of the extension will start January 1, 2019.
Wisconsin currently covers adults without dependent children (referred to as childless adults) with incomes not exceeding 100 percent of the FPL at the time of application or renewal under the BadgerCare Plus standard plan. Previously, childless adults with incomes not exceeding 200 percent of the FPL were covered with limited benefits under the BadgerCare Plus Core Plan. However, enrollment closed in a few months due to budget constraints and never reopened. In 2013, the waiting list for the Core Plan was more than 157,000 people. The limited benefit plan also did not meet either the federal creditable coverage requirement or the new Patient Protection and Affordable Care Act (PPACA)-mandated essential health benefits requirements. The BadgerCare Plus Core Plan for childless adults demonstration project waiver expired on April 1, 2014.
Under Governor Walker’s innovative approach to Medicaid expansion, in 2014 all childless adults at or below 100 percent of the FPL became eligible for coverage under the BadgerCare Plus standard benefit plan for the first time in Wisconsin history. The BadgerCare Plus program provides Medicaid coverage for Wisconsin’s most vulnerable populations.
Learn more about the current changes for the Section 1115 demonstration waivers.