Wednesday, June 1, 2011

Healthwatch Newsletter June 1st

Joint Finance Cuts Medicaid

Last Tuesday, the Joint Finance Committee followed Governor Walker's recommendation to cut more than $466.6 million from Medical Assistance. The details of the cuts are unknown, being identified as "various unspecified changes" in the budget papers.(Budget papers 340, 341). As predicted, Joint Finance implemented a passive review process that will occur through the budget committee, both removing the full legislature from a review process and repealing a budget repair bill provision that would have required DHS to go through normal rulemaking processes. The way that Medicaid was handled in the budget was different from how the Legislative Fiscal Bureau was used to doing business. In one of the budget papers, the LFB writes: “In the Governor's 2011-13 budget, the administration did not present the Legislature with a traditional budget analysis for the MA program. Instead, the administration presented a single funding request that merged current law assumptions with the estimated fiscal effects of program changes the administration intends to implement in the 2011-13 biennium. Working with the administration, this office has attempted to separate the funding changes relating to maintaining the current MA program from the savings DHS expects to generate through those program changes.”
The LFB paper gave examples of what they thought the Medicaid cuts might look like, largely, increasing cost sharing and dropping higher income children from BadgerCare Plus:
  • Bringing the coverage of working families back in line with employer-sponsored insurance
  • Reducing the crowd-out of private health insurance
  • Improving the management of care and coordination with Medicare
  • Realigning provider incentives
  • Improving provider integrity
  • Making changes to eligibility criteria
For a personalized touch on the impact of cutting Medicaid and BadgerCare programs in Wisconsin, see Joe Tarr's May 26 article in the Isthmus, "So Long, Safety Net?"

HealthWatch Public Hearings: The Human Impact of Medicaid/ BadgerCare Cuts in Wisconsin

HealthWatch Wisconsin has posted the complete video footage of public testimony on the impact of proposed BadgerCare+ and Medicaid cuts that will affect 1.2 million Wisconsinites covered by these programs. In March, HealthWatch Wisconsin sponsored two days of public hearings during the HealthWatch Wisconsin Annual Conference, drawing hundreds of people to listen, learn, and for some, to share their stories and the stories of loved ones. HealthWatch Wisconsin staff was on hand to record participants' testimony.
View the public testimony footage online

More From Joint Finance

Family Care: Joint Finance passed a motion prohibiting DHS from enrolling more people in Family Care. The motion states that no more people can be enrolled into Family Care, Family Care Partnership, PACE or IRIS programs than the total number of persons participating in all of those programs in that ADRC region (Budget paper 342). DHS could only enroll people in the long-term care programs that are offered in that person's county of residence. The enrollment cap would not apply after June 30, 2013. DHS could enroll any individual into the Family Care-related programs who is relocated from a nursing home, intermediate care facility for the mentally retarded, or State Center for People with Developmental Disabilities if the individual has resided in the facility for at least 90 days, the facility is not licensed, an emergency exists or the facility is closing or downsizing. In addition, DHS is required to do a cost-effectiveness study of the programs compared to one another and to standard MA card services.

SeniorCare: Joint Finance reversed Governor Walker’s SeniorCare position, no longer requiring eligible seniors to sign up for Medicare Part D (Budget paper 344). Finally, Joint Finance approved a motion requiring DHS to study the effectiveness of using a competitive bidding process for generic drugs. The Committee will be off today returning Thursday, Friday and possibly Saturday, to try to stick to Co-Chairs Vos and Darling’s goal of finishing this week.
IM: Still to be discussed: Joint Finance Agenda Items still include the Centralization of Income Maintenance and the transfer of FoodShare to the Department of Children and Families. (Budget paper 355)

Case Tip
Paper Free Social Security by 2013
The Social Security Administration is well into a new advertising campaign to help spread the word about new federal benefit and non-tax payment methods. In an effort to encourage more individuals to receive their Social Security or Supplemental Security Income (SSI) payments by direct deposit, the Administration has created a Star Trek-inspired public service announcement they are calling "Go Direct." Two familiar faces, George Takei (Ensign Sulu) and guest Patty Duke, encourage payment by direct deposit or Direct Express. As George says, "You’ll get your payment at warp speed.”
The U.S. Department of the Treasury announced the new rule that will extend the safety and convenience of electronic payments to millions of Americans and phase out paper checks for federal benefit and non-tax payments by March 1, 2013. Anyone applying for benefits on or after May 1, 2011 will receive their payments electronically, while those currently receiving paper checks will need to switch to direct deposit by March 1, 2013. To learn more about direct deposit or the Direct Express Debit MasterCard card, or to apply, visit
HealthWatch News

All Aboard! This Summer, Join Up with the BadgerCare+ Express!

HealthWatch continues to plan the “BadgerCare+ Express,” a coordinated, statewide tour of low-enrollment or uninsured areas where HealthWatch Wisconsin staff, members and leaders will educate consumers and service providers about the enrollment, legal and administrative hurdles that families encounter with BadgerCare+ health coverage programs. HealthWatch hopes to make six BadgerCare+ Express stops across Wisconsin, meeting with families and professionals, providing consumer assistance, and most importantly, conducting education on BadgerCare+ programs, complete with printed “3 Steps to Family Health Coverage” kits.
In select locations, ABC for Health's staff will convene workshops for individuals, families, and health care professionals to work through the “3 Steps of Family Health Coverage,” to help promote an understanding of the legal requirements of how to get, use, and keep health coverage. Included in these stops, where appropriate, are counseling sessions, going through eligibility requirements, completing applications, troubleshooting denials, facilitating renewals, and conducting education on other health care coverage programs.
Join us in the final stages of planning or sponsorship: if you know of any local end-of-summer events where the BadgerCare+ Express should stop or would like to help out with organizing a stop, please let us know! The Madison stop of the BadgerCare+ Express will be co-sponsored by the Dane County HealthWatch Coalition and the Dane County Bar Association. The Milwaukee event will occur during Child Health Week, with co-sponsorship by the Milwaukee HealthWatch Coalition. We will announce the remaining stops soon! HealthWatch is eager to begin this very popular and successful model of enrollment and education for complicated BadgerCare+ and Medicaid coverage programs.

CKSN Corner
Covering Kids with Special Needs
The National Youth Leadership Network announces their new curriculum: Reap What You Sow: Harvesting Support Systems Curriculum Training Packages. Reap What You Sow brings youth and adults together to build support systems. For more information, click here.
June 10. Deadline for Family Scholars Program Applications. Association of Maternal & Child Health Programs (AMCHP). If you have any questions, please contact Michelle Jarvis via email or by phone at (202) 775-1472.
July 25-27. Leadership, Legacy, and Community: A Retreat to Advance Maternal and Child Health (MCH) Scholarship and Practice. Hyatt McDonald's Lodge, Oak Brook, IL. Learn more information here, or register here.
September 21. Making Connections: Care in the Community Conference. Radisson Hotel, Wauwatosa, WI. Topics will include advocacy, mental health, transition and a health benefits update. For more information, visit

State & National News
Analysis and Comment

Examining the General Fund Tax Omnibus in Wisconsin:

The roll-back of the “dependent coverage mandate” was rolled into the budget
Introduced in Tuesday’s Joint Finance Committee meeting was the GOP motion on general fund taxes. Joint Finance voted along party lines to approve Governor Walker’s recommendation to offer tax cuts to some corporations while cutting back the Earned Income Tax Credit benefits for low income families. The motion creates a deferral for capital gains reinvested in qualified Wisconsin businesses (LFB paper 310, LFB paper 311) while simultaneously modifying the percentages used to calculate the Earned Income Tax Credit. (The motion decreased the percentages for claimants with two children from 14 percent to 11 percent, and decreased the percentages for claimants with three or more children from 43 percent to 34 percent.) (LFB paper 312)

Tucked into the General Fund Tax Omnibus was also the following: the repeal of Wisconsin’s current dependent coverage law. A private insurance mandate in Wisconsin, incorporated in the 2009-11 budget, required private health insurance policies and self-insured governmental plans to provide coverage for an adult child as a dependent if the child was between 17 and 27 years of age, the child was not married, and the child was not eligible for coverage under a group health benefit through the child's employer. Instead, this week, Joint Finance voted to require that every insurer provide coverage through a disability insurance policy that provides dependent coverage of children, provide coverage for a child of an applicant or insured as a dependent of the applicant or insured if the child is under 26 years old. Sound familiar? Recall a series of bills sponsored by Sen. Vukmir (R-Wauwatosa) and Rep. Nygren (R-Marinette) to eliminate state insurance mandates, examined in an earlier edition of the HealthWatch Reporter. That proposed legislation (LRB 1529 and LRB 373) would have undone the hard-fought consumer protections written into our laws to protect our most vulnerable populations, including autism coverage, maternity, diabetes, cochlear implants, and dependent coverage. The bills would have allowed the Commissioner of Insurance to waive or eliminate these basic protections will prove to either eliminate or drive up the costs of private insurance coverage for families with disabilities, special needs or unique medical situations. In fact, the bills did not get much traction in the capitol. Neither did LRB 0867, an act to repeal dependent coverage and adopt, instead, federal law to exclude from an employee’s income payments from an employer related to medical care. This week, the roll back of the dependent coverage mandate was rolled into the budget and approved by Joint Finance, in a vote that followed party lines.

HHS to lower premiums for high-risk pools
Sam Baker, The Hill, 31 May 2011

"In addition to easing enrollment criteria, the department said it would lower premiums in 18 of those 23 states to bring them more in line with the average cost of an individual plan there. The high-risk pools’ low enrollment was attributed in part to the high cost of the plans — which, by design, cover only the most expensive patients."
So long, safety net?   PLEASE READ THIS! This is heartbreaking!
Joe Tarr, The Isthmus, 26 May 2011
"In other words, the state needs to restrict enrollment, keeping people who need Medicaid and the state program BadgerCare, and would qualify for it under the current system, from getting it. There are different ways of going about this."
The impact of premiums on families in BadgerCare Plus
Joan Alker et al, Georgetown University Center for Children and Families, 24 May 2011
"We modeled two possible scenarios which estimate the impact of charging premiums from three to four percent of families’ incomes on participation rates in BadgerCare Plus. Our findings suggest that such changes would result in between 49,422 and 87,298 fewer children and their parents participating in BadgerCare Plus."
Keeping coverage continuous: Smoothing the path between Medicaid and the Exchange
Kaiser Family Foundation, 20 May 2011

"A key challenge for those implementing the reform law is how to manage churning, when people cycle in and out of public programs as their income varies. What approaches are states and the federal government taking to minimize the disruption from churning? Will people be able to keep their provider as they move from Medicaid to private coverage and back?"
Insurance commissioner moves to undo rule
Guy Boulton, The Milwaukee Journal Sentinel, 18 May 2011
"The Office of the Insurance Commissioner cited the cost to the industry and the pending changes under federal health care reform as two of the reasons for issuing its emergency rule."

No comments:

Post a Comment