Monday, November 20th, 2017

Wisconsin struggles with the Medicaid monster eating the budget


Wisconsin was already looking for $600 million in Medicaid savings when enrollment in Badger Care Plus and the Core Plan exceeded expectations.  Now Wisconsin needs to find even more savings, even as people sit on the waiting list.  Not a pretty picture, but what do you expect when eligibility for Medicaid in Wisconsin is bigger than even the Medicaid expansion under Obamacare?

Unfortunately for many states, the Senate health care reform bill will increase Medicaid costs as the program expands nationally to cover those under 133% of the federal poverty line.

If you are wondering why Senator Ben Nelson of Nebraska gave in to his Democratic colleagues to become the 60th vote necessary to limit debate on the health care bill, Nebraska will receive 100% funding from the federal government to cover the expansion of Medicaid in that state.  

In Wisconsin, we could have used that kind of relief for our versions of Medicaid, Badger Care Plus (including the Core Plan). It is unlikely that Wisconsin’s burden from Medicaid will go up under the new federal health care plan. Not because either Senator Feingold or Senator Kohl was able to cut a deal, but because Wisconsin already spends so much on state run health care. To make matters worse, Wisconsin’s Medicaid programs are $1 billion behind.

If we were to join the rest of the country in providing health insurance for those that are at 133% of the federal poverty line, we would actually be reducing the rolls of Medicaid recipients in Wisconsin. Only 17.2% of Wisconsinites would qualify for Medicaid coverage under the current federal health care plan.

That sounds like a lot, but with the expansion of government coverage in Wisconsin since 1998, nearly one in five Wisconsin residents is receiving Medical Assistance, and enrollment in the state’s Medicaid programs has jumped 174%, according to the Wisconsin Taxpayers Alliance. In 1998, less than one in thirteen residents received medical assistance.

Wisconsin’s Badger Care Plus generally covers residents at 150% of the poverty line, although there are exceptions that even go up to 300% of the federal poverty line. The Core Plan covers childless adults up to 200% of the poverty line if they do not qualify for any other federal assistance, again substantially higher than what other states will be covering.

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