Affordable Care Act Update

Although reports indicate that the federal healthcare.gov insurance exchange website is working better than when it was launched in October, Wisconsin is taking action to make sure residents who are losing their state coverage, and thus must shop for coverage on the exchange, have plenty of time to do so.

Enrollment in Wisconsin

On December 10, Wisconsin Health News hosted a briefing on the status of health insurance coverage in Wisconsin.

The panel of experts: Kathleen Falk, Region V Director, U.S. Dept. Of Health and Human Services; Kevin Moore, Deputy Secretary, WI Dept. of Health Services; Kevin Hayden, CEO, Group Health Cooperative of South Central Wisconsin; Therese Pandl, President & CEO, Hospital Sisters Health System, Eastern Wisconsin Division; and Dan Schwartzer, Wisconsin Deputy Commissioner of Insurance, discussed federal health reform law enrollment efforts and previewed the changes that begin Jan. 1, 2014.

Special Session Extending ACA Deadlines

Gov. Walker and the Legislature, through the state budget, rejected federal Affordable Care Act (ACA) funding for expanding Medicaid, opting to move 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.

This two-part plan – moving people over the poverty line off BadgerCare while expanding coverage to all childless adults below the poverty line – means a large number of Wisconsinites face a Jan. 1 deadline for finding new health care coverage, by either buying coverage on the federal exchange or enrolling in the state’s BadgerCare program.

Wisconsin’s Department of Health Services (DHS) estimates that nearly 83,000 childless adults will enroll in BadgerCare Plus between Jan 1 Dec. 31, 2014 when the current cap on enrollment is lifted.

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, but it is not clear if they will do so and how much their actual out-of-pocket expense will be after the subsidy.

Gov. Walker called a special session of the Legislature to vote on a bill that would delay both the removal of persons over the poverty line and the addition of persons under the poverty line for three months in order ensure the federal exchange is up and running so that the group of people losing their state coverage will have plenty of time to shop for a new plan.

Republicans say that this bill is only necessary because the federal government was unable to uphold its promise to have a functioning healthcare exchange up and running by October 1. Democrats claim the bill pits the poor against the poorer since the people below the poverty line are not being allowed to enroll in BadgerCare until coverage ends for the people who will be moving from BadgerCare to the federal exchange.

The Joint Finance Committee approved the bill 11-2, with Rep. Jon Richards (D-Milwaukee) joining all Republicans in support of the measure. The bill then went to the Assembly floor on December 4, where it was passed 64-32. The Senate will vote on the bill on December 19.

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