ACA Enrollment in Wisconsin

Recent communications between the Wisconsin Dept. of Health Services and the Federal Centers for Medicare and Medicaid Services (CMS) reveal 32,000 Wisconsinites have been identified as being eligible to receive BadgerCare after visiting the federal health exchange to obtain health care coverage.

This is a good chunk of the 83,000 childless adults DHS estimated would enroll in BadgerCare Plus between Jan. 1 and Dec. 31, 2014. DHS also estimates that about 72,000 people with incomes above the federal poverty level, who had previously qualified for Wisconsin’s BadgerCare program, will no longer qualify. These people will be able to buy coverage on the federal healthcare exchange with a federal subsidy.

This two-part plan – moving people over the poverty line off BadgerCare while expanding coverage to all childless adults below the poverty line – is part of Gov. Walker’s strategy to expand health care coverage in Wisconsin without expanding Medicaid under the Affordable Care Act (ACA). The plan moves residents over the federal poverty level off of medical assistance while also committing to providing state coverage to all childless adults between ages 19 and 64 and who have incomes that do not exceed 100 percent of the federal poverty level.

Recent action by the legislature, coupled with negotiations between DHS and CMS, will allow Wisconsin residents transitioning from BadgerCare to the private marketplace extra time to make the switch. These persons will be able to stay on BadgerCare until April 1, 2014, as they shop for insurance on the federal exchange.

Based on CMS and DHS negotiations, eligibility changes for parents and caretakers between 100 percent and 200 percent FPL may go into effect as of Feb. 1, 2014, pending legislative action on AB 610/SB 475. These companion bills were respectively introduced and passed in the Joint Finance Committee (11-4) on January 8, 2014, and are expected to be taken up by the full Legislature next week.

The number of persons enrolling in state-funded care is something to keep an eye on as the Walker administration has already announced that the state’s Medicaid programs are projected to run over budget by $93 million, or 1.9 percent, through June 2015.