Walker's Budget Deficit Enables Deep BadgerCare Cuts
Premiums up, 17,000 priced out, waiting list remains
Beginning in July, about 33,000 of those remaining on BadgerCare will see their premiums increase as much as 10 times what they are currently paying.
The Walker administration is still pursuing federal permission to raise co-pays and decrease covered health care services utilized by an additional 300,000 individuals.
The changes could have been even more significant, but the federal Centers for Medicare and Medicaid Services (CMS) determined that roughly only a quarter of the changes the Walker administration had sought were legal under the federal Affordable Care Act (ACA).
For example, Walker's appointed secretary of Health Services, Dennis Smith, had requested changes that would have forced 65,000 people, including 29,000 children, from the program.
But CMS would not allow Walker and Smith to kick children off of BadgerCare.
Still, Smith spun his efforts to downsize the BadgerCare program as a victory.
"These changes aim to preserve the core, safety-net functions of the program for low-income individuals and are necessary in order to keep the Medicaid program sustainable," Smith said in a statement.
BadgerCare supporters, on the other hand, don't see any upside for Walker's attempt to dismantle the popular program, in which 1.2 million Wisconsinites are enrolled. Ironically, this program was the creation of a Republican governor.
"Even with the permission they got to make changes, they're still intent on kicking 17,000 people off of BadgerCare," said state Rep. Jon Richards (D-Milwaukee).
In February, Richards and state Sen. Jon Erpenbach (D-Middleton) had introduced the BadgerCare Protection Act, which would have repealed a $40 million corporate tax break enacted by Walker and the Republican-led Legislature, allowing some of those funds to be used to shore up the BadgerCare program.
Supreme Court Ruling Could Trigger Deeper Cuts
Walker is making these changes to BadgerCare because of a provision in the Affordable Care Act that allows states with a projected budget deficit to make some changes to their Medicaid program, as long as the state still provides health coverage to their hardest-hit residents—what's known as the "maintenance of effort" requirement.
But that ACA protection is vulnerable.
The U.S. Supreme Court will decide its constitutionality this summer, and Walker has refused to implement its provisions in the state.
So if the court strikes down the ACA, Walker and Smith will likely be able to remove more people from BadgerCare, cut benefits and raise premiums.
"If the Supreme Court says that the ACA is not constitutional, the maintenance of effort requirement would no longer be a legal barrier for the Walker administration," Richards said. "It would give them more tools to kick people off of BadgerCare."
Robert Kraig, executive director of Citizen Action of Wisconsin, said that even if the ACA is upheld, BadgerCare coverage would be diminished. He said that children will likely lose their coverage if their parents lose their own.
"The Walker administration is banking on people leaving the program so they can balance their budget," Kraig said.
He noted that the low-income workers priced out of BadgerCare—especially those who work for small businesses—would have few affordable options in the private insurance market.
"They really have no other options," Kraig said. "BadgerCare is the only alternative for many people."
Overall, an analysis by Wisconsin Council on Children and Families Research Director Jon Peacock argues that Walker's changes are inconsistent with the ACA's goal of expanding access to affordable health insurance. For example, ACA requires states to expand Medicaid eligibility to those earning less than 133% of the poverty level and allows states to provide access to those who earn more than that floor level.
But Walker is "effectively making the floor a ceiling on eligibility for many adults," Peacock wrote.
Walker is "lemon picking" facets of the ACA to deny coverage, not expand it, Peacock concluded.
Walker Refuses to Enroll Eligible Adults
Walker's cuts aren't the only worrisome issue facing BadgerCare.
On Friday, Richards and state Rep. Tamara Grigsby (D-Milwaukee) asked CMS to investigate the Walker administration's refusal to fill a 22,000-person opening in the BadgerCare Plus Core plan.
In 2009, during the Doyle administration, the state had received federal permission to implement this plan, which covers childless adults. Up to 48,500 individuals were allowed to enroll.
However, Richards and Grigsby learned that only 26,800 people are participating in the program, leaving almost 22,000 spots available.
Yet 128,600 people are on the waiting list.
"The Walker administration is not allowing people to enroll in it," Richards said.
Stephanie Smiley, a spokeswoman for the state's Department of Health Services, said the 48,500 "spots" in the program was just an estimate of how many people the allocated funding would cover. Since the Core program was implemented, Smiley said, the department has found that the mix of federal and state funding only covers the expenses of the 26,800 people currently enrolled. The state would have to cover all of the expenses of anyone else who would be enrolled in that program, she said.
Go home and tell your Mother she is calling you baby. Your an Idiot.
What are you smoking? You think HIRSP is cheap? I have HIRSP...$5,000 deductible, $340 a month, and my meds still cost almost $200 a month out of pocket. We're the only first world nation that does not have socialized medicine...and having for-profit medicine is just asking for trouble...
HIRSP is great. $5000 deductible and $300-400 a month. Dude, that is cheap considering you have access to world class health care. How much is good insurance worth to you? Obviously if you have $200 in meds month, it has to be worth a lot. Perhaps everything you have. This is 2012, expect to pay $10k to 25k per year for health costs. Seems to me that would be worth it if it keeps you alive. Just cut out the cokes, smokes, and lotto and most people should easily be able to afford it.
Gee, thanks, Dad. I don't "do" ANY of those things, was just unlucky enough to inherit some bad genes. Any other medical advice you care to share? What kind of doctor are you again? What if I still can't afford it? Just suck it up, eh?
Medicine driven by profit motive is a BAD idea.
Obama knew it was bad when he signed it, but he also knows that when it comes time to vote it down, people will pressure their congresspeople to keep the good parts, fix the bad parts. The Middle Class and working class who can afford to go it alone without assistance will chose to keep these programs, because they can see a clear benefit to themselves (to hell with a benefit to anyone else).
I recently heard a talk program about product quality of items from China. When confronted with a web-page, you have to choose what country you are from. If from the US (where there is profit-only healthcare), you see all the crappy items that have toxic stuff, BPA in the plastics, etc. If you choose a European country (where there is public healthcare), all the bad stuff is blocked.
What the US response should be is to change our marketplace, so things that make us sick can no longer be consumed. Better diets that require subsidizing good, healthy foods, instead of high-profit, easy to process foods. Change how we live, what we eat, what our food stamps buy so that we have less sick people that need "Free" Healthcare.
If you would integrate your communities, make it so everyone had a part to play, you would make it so all could survive healthy and happy, if not rich. People would not be so smelly, people would treat each other with the respect of their position in life. Even the lowest of the low would treat the upper classes with respect if they also had a valued, contributing role. Even in Medieval times, the land-owning nobility and well-to-do capitalist Middle Class also had responsibility for the well-being of their peasant poor, it was just part of the package deal of not giving any control to the peasant poor.
What we have today just plain failed. Perhaps our ancestors who came over on the boats of the 1800's were just that heartless and nasty, they left because they would not give people who were different a place in life, would not accept their own role of being Middle Class but not owning their own land, not having a tiny castle estate in which they could be King of. They came here to have some land of their own, to have a place where they did not have "them" living next door, and where they could do what they wanted on their own land with no regard for consequences to others downstream or downwind.
Let me add another point that calls to mind your Econ 101 training in school, the free market law of Supply and Demand.
When you limit the supply, you can drive up prices, so high that people who cannot afford stop buying, and that reduces demand. Demand eventually equals supply. Does it mean everyone got their needs served? Heck No!
When you reduce the demand, then prices go down. More people will now demand until demand equals supply again.
The idea is to make people healthier, so they will demand less, which brings the prices low enough for everyone to be served. THIS must be governments highest priority, but where is the "profit" in doint it this way? When the vast majority of the lawmakers are millionaires, you know what we will get, laws to favor the wealthy!
Everyone gets into their career to get rich. Doctors, teachers, whatever. A teacher needs no educaiton other than putting in their time and getting a symbolic diploma or certificate, Therefore they are capped at about $150,000. Doctors need a ton of education and they have to have the wherewithal to undergo rigorous study. Therefore they require that they make several hundred thousand per year. People with that kind of intelligence want to be rewarded.
Nobody deserves health care just because they exist. We have free clinics for that. Like anything else in life, a house, car, vacations, food, clothes and other luxuries are earned. Good health care falls into a luxury. So if you want that, get snappy with it, chop chop, and get to work.
If we start handing out free health insurance, then what next? The lazy will then demand a nice home, a nice car, sick days, vacations, college educations. You give the lazy an inch they will want a mile.
Its not fair to people who bravely go out and work everyday. Sure we all have the choice to choose between work or the hammock and the lazy in the hammock have way too much already.
As displayed by the picture in this article, everyone has an alterior motive. If everyone gets healthcare then there is more of a demand for "healthcare professionals". Let's not forget that the reimbursment rates for government healthcare are currently below market. If doctors aren't being reimbursed appropriately then why would people want to become doctors? There is already a shortage of general practitioners in America.
Not too health professionals running a charity. Hell dude, if I'm going to 8 years of medical school and paying sky high malpractice premiums, I want to be earning some good coin and living in a palace. Government health care reimbursements are not going to do this for anyone.
One time I was in an HMO with a doctor that also treated prisoners. It was awful sitting in a waiting room with my kids sharing with with foul mouthed prisoners, even though they were cuffed. Prisoners should have to pay for health care like all the rest of us do. Go down to the county health department and you will get a good idea what government health care looks like. You walk in and are just horrified.