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Wednesday, July 31, 2013

Judge Says Walker Administration’s 130,000-Person BadgerCare Waiting List May Not Be Legal

Milwaukee women’s federal lawsuit can proceed

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The Walker administration is likely breaking federal law by accepting federal Medicaid funds at the same time it’s refusing to enroll BadgerCare Core participants and creating a 130,000-person waiting list for the program, according to a federal judge’s ruling last week.

U.S. District Judge William Conley refused to dismiss a case brought by two Milwaukee women on the BadgerCare Core waiting list, striking a blow to the Walker administration’s claim that the women didn’t have a right to sue.

At issue is the agreement the federal and state governments created in 2009, under the Doyle administration, and renewed in 2012 under the Walker administration, that launched the BadgerCare Core program for low-income childless adults. The agreement capped enrollment at 48,500 individuals; Medicaid requires the state to enroll eligible participants “with reasonable promptness,” usually 60 days.

When the program began in October 2012, the Doyle administration actually exceeded the cap and let everyone on the waiting list at that time into the program, about 65,265 individuals.

But under the leadership of Republican Gov. Scott Walker, the Department of Health Services (DHS) allowed people to drop out but ceased enrolling new participants.

The program currently serves a mere 17,791 participants and more than 130,000 individuals are on the waiting list, including the two women who sued the state, Teresa Charles and Susan Wagner. They’ve been on the waiting list for more than three years.

Attorney Pat Delessio of Legal Action of Wisconsin, who is representing Charles and Wagner, called Conley’s decision “significant” because it affirms her clients’ right to sue the state for Medicaid services.

“This issue comes up in federal court about whether or not people have a right to sue,” Delessio said. “More and more conservative administrations are raising that question.”

DHS spokeswoman Stephanie Smiley said she couldn’t comment on pending litigation, but when the suit was filed in June 2012 she told the Shepherd that the federal government required the program to be “budget neutral” and that the state would exceed its budget if it continued to enroll BadgerCare Core participants.

State Rep. Jon Richards (D-Milwaukee) blasted the administration’s refusal to enroll BadgerCare Core participants, the vast majority of whom are working but cannot afford health insurance offered by for-profit companies.

“I think it was the right decision to make,” Richards said of Conley’s order. “It’s a shame that when people need health care in Wisconsin they have to rely on the court. They don’t have a governor fighting for them, which is a real shame. It’s wrong.”

 

30,000 Kids Will Lose Coverage in Five Years

Despite the significance of Conley’s order, it may have little practical impact on low-income Wisconsinites seeking BadgerCare Core coverage.

The waiver creating the program expires at the end of this year and the Walker administration is planning to completely revamp the state’s Medicaid programs, including BadgerCare, while rejecting increased federal funds to expand Medicaid under the Affordable Care Act. The Walker administration is allowing those at or below the poverty level to stay on BadgerCare, but it’s shifting everyone else currently in the program onto the not-yet-established health insurance exchanges, where they can purchase private health insurance.

Walker’s plan will cost state taxpayers an additional $119 million in the next two-year budget, according to the nonpartisan Legislative Fiscal Bureau, although BadgerCare will cover 85,000 fewer people than a full Medicaid expansion.

Walker needs to get a waiver from the federal government to chop up BadgerCare. Its request is in the public comment period until Aug. 5 and can be found on DHS’s website (dhs.wisconsin.gov). DHS’s Smiley told the Shepherd the administration plans to submit the waiver request on Aug. 9.

Richards warned of another health care crisis looming on the horizon. In addition to the Medicaid changes Walker included in the biennial budget, and approved by the Republican-dominated state Legislature, the governor inserted language that would drop 30,000 children from BadgerCare in five years, when other Medicaid requirements expire.

“The Walker administration has played hardball politics,” Richards said. “The far right wing of the Republican Party has won yet again.”