​State Medicaid Waiver Proposal Would Undermine Access to Health Care

In May WAWH submitted comments to the Wisconsin Department of Health Services (DHS) regarding the Department’s proposed changes to the BadgerCare program for low-income, “childless adults” who earn an income at or below the federal poverty level.  DHS is currently seeking a waiver from the federal government that would allow the Department to implement changes the program that would otherwise be prohibited by federal law that governs the Medicaid program. 

The proposed changes include:

1. Charge enrollees monthly premiums
2. Charge higher monthly premiums for enrollees engaged in "risky behavior" as indicated through a Health Risk Assessment
3. Impose lifetime eligibility limits for certain enrollees who do not satisfy work or work training requirements
4. Require drug screenings as a condition of eligibility and make referrals to treatment programs for those who test positive for drug use

If implemented, the Department’s proposed waivers would harm low-income adults currently participating in BadgerCare. These changes will actually undermine the Department’s stated goals of reducing the uninsured rate and increasing workforce participation, as many BadgerCare participants who rely on the program to access the health care they need to maintain employment will be thrown off the program as a result of these changes.  This plan will simply shift costs onto low-income people, which will lead to further cost-shifting in the form of uncompensated hospital care that will result from former BadgerCare enrollees having to turn to emergency rooms to treat conditions that could have been prevented with access to preventive care.  Finally, the Department’s approach will waste state funds that could be used to implement far more effective strategies for expanding the Wisconsin workforce and providing adequate resources for substance use disorder treatment.
 
Many other organizations that advocate for greater access to health care and on behalf of health care professionals have expressed similar concerns regarding the Department’s proposed waiver.  The widespread opposition to the proposed waiver is largely based on experiences in other states that have adopted similar policies and significant research that indicates such changes will reduce access to health care for many of the particularly vulnerable populations that would be affected by this proposal and likely have no other means through which they can access health insurance.

A copy of our waiver comments can be found here.