Walker Administration Fails to Listen on BadgerCare Changes

In mid-May, WAWH was one of the many organizations that submitted comments to the Department of Health Services (DHS) in regards to the proposed changes to Wisconsin BadgerCare Program for Childless Adults in the form of a 1115 waiver.  This waiver included proposed changes such as:

• Requiring monthly premiums for a majority of childless adults enrolled in BadgerCare.
• Limiting eligibility by length of time
• Requiring substance abuse screening and testing for eligibility
• Referral to treatment programs where refusal to go would result in ineligibility

WAWH opposed their proposal as it overlooked women of childbearing age that do not have children, those with chronic conditions, and create an unhealthier Wisconsin as a whole.  

DHS received a total of 1,050 comments in regards to the changes proposed by Governor Scott Walker.  Only 5 out of 1,050 comments were in favor of these proposed changes. That means that 1,045 comments, or over 99.5% of those who shared their comments with DHS, were against the Governor’s plan.

DHS is still withholding the names of those that commented, but those that are known include religious leaders, non-profit organizations, doctors, students, and many other Wisconsinites. Of the 5 comments that positively regarded the proposed changes, the only two known supporters are government officials in Scott Walkers corner: Lieutenant Governor Rebecca Kleefisch and state Representative John Nygren.  Kleefisch and Nygren currently co-chair the governor’s task force on opioid abuse.

DHS released a “Summary of Public Comments and Wisconsin DHS Response” that listed the “changes” that were made due to the comments made, but also gave a brief summary of the comments in general.  Misleading statements such as, “Additionally, there were a number of other comments that were either wholly in opposition or approval of the proposed waiver amendment.”  It is a tough pill to swallow that DHS would make a statement that creates the illusion that this was a 50-50 issue.  It required an open records request to see the sheer number of negative comments in relation to the five positive ones.

It is clear that this plan did not take into account the view of the 1,045 comments made, because the changes that were made were essentially irrelevant to the concerns of every group that WAWH worked with and are as follows:

• Premium payments will still be added, but will be two tiered instead of four tiered to avoid confusion.  This still does not address the issue of even small premiums being detrimental to some individuals, leading to lower enrollment in BadgerCare.
• The emergency department copayment would be set at $8 a visit instead of being raised later on.  This is another example of a change that does not address the problem that any copayment can be so harmful that an individual may not go get medical attention when it is seriously needed.
• If a BadgerCare member refuses to consent to substance abuse disorder treatment, instead of being ineligible for six months, an individual may re-enroll whenever they consent to treatment.  This policy essentially forces an individual into treatment in order to receive medical coverage.
• A drug test will not be required for childless adults who indicate they are ready for treatment and you may opt to go to treatment even without a positive substance abuse test.

It is clear that the comments of the Wisconsin people were not taken seriously as the overwhelming majority of commenters’ opposed the changes that are being proposed.  While DHS made changes based on these comments, those changes do not take into account any of the negative effects that WAWH and numerous other organizations see as the harm to Wisconsin.  The waiver purports to increase enrollment in BadgerCare and create a healthier Wisconsin, when in reality it does the opposite.  These concerns have been completely ignored by DHS.

Link here to view the final version of the waiver application submitted to CMS on June 7th.