State Takes Steps to Move Residents from Medicaid to Federal Health Exchange

Earlier this year Gov. Walker announced that his administration would work toward insuring more people in the state, but with a goal of making as many Wisconsinites as possible less dependent on the government. To make this goal a reality, Walker and the Legislature, through the state budget, rejected federal Affordable Care Act (ACA) funding for expanding Medicaid, and committed to entitlement reform that would cover childless adults up to the federal poverty level, but no higher. Wisconsin’s Department of Health Services (DHS) is now working with the federal Centers for Medicare and Medicaid Services (CMS) to gain approval of the implementation of the provisions passed in the state budget.

DHS has submitted a new BadgerCare Plus Demonstration Project Waiver to CMS that would cut some people from the state’s Medicaid program, but would allow Wisconsin get rid of its current cap and waiting list and provide health care coverage through BadgerCare Plus to all childless adults between ages 19 and 64 and who have incomes that do not exceed 100% of the federal poverty level. The Department estimates that nearly 99,000 childless adults will enroll in BadgerCare Plus between January 1, 2014 and December 31, 2014 if the cap is lifted.

The waiver is controversial because around 92,000 people, 87,000 parents and caretaker relatives, and 5,000 childless adults 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.

For additional information about Wisconsin’s waiver request, go to