Medicaid funding supports BadgerCare, Family Care, and other programs. On Thursday, November 10, 2011 the Joint Finance Committee of the state legislature will discuss a request from the Department of Health Services (DHS) to make changes to these programs. These changes were identified to save $500 million in the Medicaid budget that was required by the state budget bill. Some items proposed by DHS are causing advocates concern:

1. New Benchmark Plan Replaces BadgerCare Plus

DHS is proposing switching 200,000 people from standard state Medicaid onto a Family Benchmark Plan. The people switched are on BadgerCare. People who get Medicaid through SSI or Katie Beckett would not be affected.

The Benchmark Plan has higher premiums, deductibles, and co-payments with fewer covered benefits than BadgerCare. Many lower-income families have members with chronic health conditions, such as diabetes, or disabilities, that do not qualify for SSI. Advocates are worried lower-income families will not be able to afford the new plan and will be forced to drop coverage. One big problem is DHS has not provided information about how many people may drop coverage. Even those who can afford the coverage may find that they no longer are covered for some of the services they require.

2. Some People with Access to Private Insurance Could Not Enroll in Medicaid

A person who has employer-sponsored insurance who does not have to pay more than 9.5% of their income as a premium could not be enrolled in Medicaid. Many people are on BadgerCare because they cannot afford the employer-sponsored premiums or the benefits do not meet their needs. The Affordable Care Act also considers an employer-sponsored plan to be affordable when it covers at least 60% of total allowed costs. But the DHS proposal would not take into account other out-of-pocket costs when determining whether someone with employer-sponsored insurance could enroll.

3. Increasing Premiums

Some individuals who now pay only a modest premium for their BadgerCare would be required to pay 5% of their household annual income. Studies have shown that many individuals on Medicaid drop their Medicaid when asked to pay premiums at this level. DHS has not provided any estimate of the number of Wisconsin Medicaid recipients who might drop coverage as a result of this change.

Contact your state Representative and State Senator with your concerns. Click here to find out who your legislators are. Legislators need to know that more information is needed about the number of people who may lose or drop their Medicaid coverage as a result of these changes or how many may no longer have access to services they need. Without this information, legislators cannot make an informed decision about changes that could result in a large number of people losing coverage or access to critical services.