Wednesday, December 28, 2011

Ms. Marilyn Tavenner
Acting Administrator
Centers for Medicare & Medicaid Services
Hubert H. Humphrey Building
200 Independence Avenue, SW, Room 3 
Washington, DC 2020]
Dear Administrator Tavenner:
As representatives of the state of Wisconsin, we are proud of our strong Medicaid and Childrens
Health Insurance Programs, known to Wisconsinites as BadgerCare. BadgerCare provides
efficient, affordable coverage to almost 800,000 people in our state and leads the nation in access
to great quality health care. As you know, our state has requested to make changes to the
program that would dramatically change the structure and eligibility requirements. We are
concerned about these changes and urge you to carefully consider the effects of such provisions
on families in our state.
On November 10, 2011, the Walker Administration submitted a waiver to CMS that, if approved,
would result in loss of coverage for an estimated 64,000 Wisconsinites including almost 29,000
children. The Walker Administration asked that this waiver be approved by December 31, 2011
or 53,000 low-income adults would be dropped from the rolls.
As you know, CMS responded to the state on December 9, 201 it made a final decision on the
waiver application that it will not be issued by the end of this year and we support this conclusion. We
urge CMS to carefully review the proposed waiver and remain firm on granting waivers of the
maintenance of effort (MOE) in the Affordable Care Act. CMS has refused so far to grant
waivers of the MOE requirement, because such waivers would erode coverage for low-income
children and adults. We do not believe that the Wisconsin Waiver proposal presents any
justification to change course. It is important that CMS carefully deliberate such changes with
the state so that low income families do not lose health coverage.
Despite the December 31 deadline the state has set, there is still time to formulate other options
that would not require cutting off coverage for adults with incomes above 133 percent of the
poverty line in July 2012. For example, according to the Legislative Fiscal Bureau, Wisconsin
expects to receive a performance bonus based on increased enrollment of children in Medicaid
and CHIP in an amount similar to what the state received last year, which was $23.1 million.
This funding would help resolve budget issues the state faces while still maintaining coverage.
We have worked hard in the past to ensure that our state receives adequate funding and
flexibility to maintain and improve access to BadgerCare; We will continue to do so.
We respectfully ask that you give your immediate attention to this matter and that CMS continue
its close review of the proposal with the goal of maintaining coverage for low-income families. If
you have any questions, please do not hesitate to call upon our staff to assist you.
Senator Herb Kohl
Congresswoman Tammy Baldwin
Congressman Ron Kind
Congresswoman Gwen Moore
Rep. Pasch Statement on Audit of State Health Programs
MADISONState Representative Sandy Pasch (D – Whitefish Bay ) released the following statement regarding the release of a Legislative Audit Bureau (LAB) evaluation of our state’s vital Medical Assistance programs:
“It is clear that we must critically examine options to make our state's Medical Assistance programs more efficient and cost-effective. The LAB audit provides a deliberative analysis and thoughtful range of potential changes to address financial pressures on these important programs. 
“Unfortunately, instead of considering these weighty decisions in an inclusive, accountable and evidence-based manner that allowed for ample public input and legislative oversight, the Walker administration rushed through a misguided and ideologically-driven plan that will punish tens of thousands of the neediest and youngest Wisconsinites. 
“Especially in light of LAB’s findings – as well as the federal government’s announcement that they likely will not be able to meet the Walker administration’s self-imposed deadline to consider their far-reaching proposal – we urge his administration to slow down and work with federal and state officials in order to achieve savings in our important Medicaid and BadgerCare programs without seriously risking the health of our most vulnerable for years to come.”

                Audit Debunks Myth of Widespread Fraud in Medicaid
Statement by Rep. Richards on today’s report by non-partisan audit agency

MADISON—Today the non-partisan Legislative Audit Bureau released a comprehensive audit of Wisconsin’s Medical Assistance program.  In response, Rep. Jon Richards (D-Milwaukee), a member of the Legislative Joint Audit Committee who voted for the audit last January, issued the following statement:

“Today’s report debunks the myth long perpetuated by some lawmakers that widespread fraud exists in the state’s health care programs or that people are moving to Wisconsin solely to obtain Medicaid benefits. 

“The audit offers some responsible ideas on how Medicaid can be made more cost-effective without hurting people.

“Exploring managed care models, less reliance on outside contractors and other administrative efficiencies are much more compassionate options than dropping health care for 29,000 children, as Governor Walker has proposed.

“Medicaid remains the only health care option for tens of thousands of Wisconsin parents, children, seniors and people with disabilities.  Without access to these vital health programs, many people will go without screenings or treatment for diabetes, cancer or high blood pressure.

“The audit gives Governor Walker another opportunity to reconsider his irresponsible plan to drop health care for Wisconsin families and children.  I encourage his administration to work together with the legislature and the Obama Administration to implement responsible reforms that make the state’s health care system sustainable while also keeping people insured.”

Rep. Jon Richards (608) 266-0650  

Tuesday, December 13, 2011

Wisconsin Speaks Out Against Drastic Cuts and Changes to BadgerCare
Over 15,000 Wisconsinites Urging BadgerCare be Protected for the Sake of State’s Health & Economy

Madison - For the last several weeks, the Save BadgerCare Coalition and its partners have been talking to people all over the state about the Wisconsin Department of Health Services (DHS) plan to kick tens of thousands of Wisconsinites off BadgerCare. The verdict is in: people all across Wisconsin are strongly opposed to changes to BadgerCare that would leave their family members, neighbors, and coworkers uninsured.  

Last week marked the final community public hearing on the Medicaid cuts for the year in Rhinelander.  Prior to that, public hearings had been held in Eau Claire, Green Bay, La Crosse, Madison, Milwaukee, Oshkosh, and Wausau.  In total, over 200 individuals attended these hearings and aside from a handful of people, everyone has spoken out against the DHS Medicaid Waiver plan. 

“Since DHS was unwilling to make a serious effort to solicit public input, we stepped up and offered the opportunity,” Finger said. “And the public is saying loud and clear: ‘Don’t do it! There are other, better options that won’t endanger the health of Wisconsin’s children, families, and workers.’”

“I am extremely grateful to have had the opportunity to learn about the proposed changes to BadgerCare and to voice my opinion as a Wisconsin citizen,” said Rachel Fleming, University of Wisconsin Eau Claire student and hearing attendee.  “This plan to cut over $500 million from Medicaid is going to have a significant impact on families throughout our state and we deserve the chance to weigh in.”

In addition the large turnout at the public hearings, tens of thousands of individuals have been involved with this groundswell of grassroots opposition:
  •   655 Save BadgerCare postcards were signed and hand delivered to state legislators and Wisconsin Department of Health Services (DHS) Secretary Dennis Smith asking them to protect BadgerCare in Aprill
  •  2,000 petition signatures were sent to DHS urging them not to slash BadgerCare funding in October
  •  14,686 Save BadgerCare petition signatures are being sent to the Wisconsin State Legislature and Governor Walker before the holidays.

“There was a great deal of confusion, anger, anxiety and frustration expressed from community members throughout the state,” said Sara Finger, coordinator of the Save BadgerCare Coalition. “This extreme proposal from the Walker Administration to drastically change Medicaid is simply out touch with Wisconsin voters, values and priorities.”

The Save BadgerCare coalition is calling on federal officials to reject the portions of the plan that require a Waiver from HHS and has collected almost 700 petition signatures so far that have been sent to U.S. Health and Human Services (HHS) Secretary Sebelius.  The Coalition also calls on state legislators to push back the arbitrary, self-imposed deadline for federal approval that would result in 53,000 adults losing their coverage if the waiver is not approved by December 31, 2011—a deadline HHS has already said it cannot meet.

New Definition Of Family

By Senator, Lena C. Taylor
Senator Lena C. Taylor
As we all know by now, there will be big changes for BadgerCare and other state Medicaid programs in 2012.
The GOP members of the Joint Finance Committee, who comprise the majority, granted the Department of Health Services permission to submit to the federal Centers for Medicare & Medicaid Services the state’s request to change the state Medicaid program’s eligibility and income requirements. One of the most alarming changes to the eligibility requirements is the new method for calculating family income.
Under the already-approved proposal, eligibility will now be based on the combined income of everyone living in the household, not merely the applicant’s income and perhaps that of their spouse or partner. To demonstrate just how detrimental this change will be for some enrollees, I will give you an example of how this provision will apply.
Jane Doe is a single mother of two who is struggling to make ends meet. To ease some of her financial burdens, she decides to move in with her friend, Judy, who works for Private Company.
Her decision to move in with Judy drastically impacts her eligibility for state Medicare because now, Judy’s income will be added to Jane’s income, and Jane’s eligibility will be determined based on that figure. With eligibility based on the combined income of Jane and her friend Judy, it will be more difficult for Jane to qualify. To add insult to injury, because there is no familial relationship between Jane and Judy, Jane and her children will not be covered under Judy’s health insurance through her employer.
One of the biggest indirect consequences of this combined income approach is a decrease in willingness to help others. If allowing a family member or close friend to live with you would jeopardize access to health insurance for yourself and your children, would you be more or less likely to offer a helping hand?
This new eligibility plan is supposed to be a trial implementation of Obamacare, but there is a distinct difference between Wisconsin ’s family income eligibility and Obamacare’s family income eligibility. Under the terms of Obamacare, family income is determined using only the income of the immediate family, excluding grandparents. Wisconsin is using different standards, so this certainly cannot be considered a test of Obamacare.
The plan that DHS has adopted is an effort to shift costs, not reduce costs. Although there was inadequate time for public input (the two public hearings held by DHS provided insufficient information about the proposals and their effects), we must make sure that we remain informed about what these plans mean for our families and communities. If you have any questions or concerns, do not hesitate to contact my office at (414) 342-7176 or me at
As always, I will do my utmost to ensure that those affected by these plans understand the changes and that their responses are based on solid, reliable information.

Saturday, December 10, 2011

Delay in Medicaid changes approval may cut coverage for 53,000

Delay in Medicaid changes approval may cut coverage for 53,000
DAVID WAHLBERG | Wisconsin State Journal | | | (12) Comments| Posted: Friday, December 9, 2011 6:45 pm
The federal government said Friday it likely won't meet Wisconsin's Dec. 31 deadline for approving Medicaid changes.
The state responded by repeating its request for a prompt decision, saying it wants to avoid cutting coverage for 53,000 adults.
"From our perspective, we certainly believe there is still time to reach an agreement," Dennis Smith, secretary of the state Department of Health Services, wrote to the federal Centers for Medicare and Medicaid Services after receiving a letter Friday from the agency.
On Nov. 10, the state asked the agency to approve key parts of its plan to trim $554 million over two years from Medicaid, the state-federal health plan for the poor.
This year's state budget law said lack of approval by Dec. 31 would require ending BadgerCare Plus coverage in July for 53,000 adults who earn more than a third above the federal poverty level. That's about $30,000 a year for a family of four.
Approval of the state's proposals, meanwhile, would cause nearly 65,000 people to leave or be turned away from BadgerCare Plus and other Medicaid programs, the nonpartisan Legislative Fiscal Bureau said. That's mostly because of higher premiums, a required switch to employer insurance and changes in eligibility.
The state also wants to shift 263,000 people into a lower cost plan with fewer benefits.
The letter Friday from the federal agency said "it is unlikely we will be able to meet the State's requested date of December 31, 2011, for all of these proposed sweeping changes to its programs."
The letter said the state doesn't need special federal approval to make four of its proposed changes to BadgerCare Plus for adults who earn more than a third above the federal poverty level. The state also wants to make most of those changes for people with lower incomes.
The changes are:
•Refusing coverage if people can get employer insurance with premiums of less than 9.5 percent of income.
•Increasing BadgerCare Plus premiums to up to 5 percent of income.
•Dropping people for a year if they fail to pay their monthly premium.
•Stopping coverage for people 10 days after their eligibility ends instead of at the end of the month.
Jon Peacock, research director for the Wisconsin Council on Children and Families, said the Legislature should delay the Dec. 31 deadline and find other ways to save money.
"We're pleased that federal officials aren't going to be rushed into deciding all of these complex issues," Peacock said. The state "should get away from this 'our way or the highway' approach."
Sara Finger, executive director of the Wisconsin Alliance for Women's Health and coordinator of the Save BadgerCare Coalition, said she's glad the federal government put the state on notice that it likely won't meet its deadline.
But regardless of federal approval, Finger said, the state plans to end coverage for tens of thousands of people.
"I think they purposely set it up as a win-win for the (Gov. Scott) Walker administration and a lose-lose for Wisconsin families," she said.

Read more:
Representative Sandy Pasch                   
Federal Government, Public Need More Time toReview Extreme WalkerHealth Cuts
MADISON– On Friday, federal officials at theCenters for Medicare and Medicaid Services (CMS) announced that they likely will not beable to meet the Walkeradministration’s self-imposed deadline to consider their far-reachingproposal to slashmore than a half-billion dollars from our state’s health safety net and threaten healthcarefor hundreds of thousands of Wisconsinites.  State Rep. Sandy Pasch (D – Whitefish Bay) released the following statement inwake of their announcement:
“Governor Walker and legislative Republicans chose togive an unelected bureaucrat nearly carte blanche authority to rush throughsweeping changes to our state’s vital health programs, and it is clear that everyone– including the federal government, our state, and the thousands offamilies who will be impacted by these changes – need and deserve moretime to review this rushed plan,” said Rep. Pasch.  “The Walker administration has establisheda lose-lose situation for thousands of our most vulnerable citizens through aclear political ploy, and we must continue to fight to ensure that their bad decisions and misplaced priorities receive morescrutiny than they are allowing.” 
Rep. Pasch also noted that she has introduced Assembly Bill339, which would restore proper legislative oversight and publicinput to Walker’sfar-reaching changes.  It would also remove the arbitrary and seeminglyunattainable deadline the Walkeradministration established for approval by CMS. 
“If it wasn’t clear before, we now know that Walker’s rushed plan to undermine healthcare for Wisconsin children and families is fraught withunanswered questions and serious concerns that we all need more time toexamine,” said Rep. Pasch.  “I urge Gov. Walker to slow down and work with federal andstate officials in order to achieve savings in our important Medicaid andBadgerCare programs without seriously risking the healthof our most vulnerable for years to come.”
Baldwin Blasts Walker Gamesmanship on BadgerCare

Walker's Needlessly Short Timetable Just a Smokescreen to Boot Tens of Thousands of Wisconsinites off BadgerCare

MADISON-- Tammy Baldwin today issued the following statement on the Centers on Medicare and Medicaid Services’ (CMS) announcement that they are unable to make a determination by Gov. Scott Walker's imposed end-of-the-year deadline on Wisconsin’s application for a Medicaid waiver for the state's highly successful BadgerCare program.
The Walker Administration has proposed significant changes to Wisconsin's BadgerCare eligibility standards, and gave the federal government less than one month to consider its waiver application -- a very short timetable considering the number of factors that need to be reviewed in considering a waiver.
Walker’s waiver request would result in the elimination of coverage for an estimated 64,000 individuals, including approximately 29,000 children. Walker's Administration has threatened to end health care coverage for 53,000 Wisconsinites if the waiver is not approved.

Statement of Congresswoman Tammy Baldwin:
“Given the tens of thousands of Wisconsinites who look to the successful, popular BadgerCare program for health care coverage, and the complex process to grant a waiver to the rules and laws that makes BadgerCare possible, it's unreasonable for Gov. Walker to expect a decision in less than a month. This is a obviously a transparent ploy by the governor to shift the political blame for his choice to balance the state budget by booting tens of thousands of Wisconsinites off of health care. I urge Gov. Walker to rethink this decision, and find alternative solutions to Wisconsin's budget shortfall. Forcing thousands more uninsured families to go without health care or end up at the emergency room for costly care will not reduce health care spending, and is the wrong prescription for the state’s budget woes.”
Wisconsin Council on Children & Families
Feds Say They Need More Time to Review Proposed BadgerCare Changes
(Madison)--Federal officials at the Centers for Medicare and Medicaid Services (CMS) announced today

that they probably won’t be able to act as quickly as the Walker Administration had hoped on a complex

set of federal waivers that would allow the state to make sweeping changes to BadgerCare. However,

the letter sent today to Dennis Smith, Secretary of the Department of Health Services, gives the state

the green light to proceed with some portions of its proposals.

Ken Taylor, executive director of the Wisconsin Council for Children and Families, applauded the

decision by CMS not to rush the agency’s consideration of the state’s complex, 221-page waiver request.

“The changes in the waiver request would harm at least 168,000 Wisconsinites. A decision this big

shouldn’t be rushed through just to meet the state’s arbitrary December 31 deadline. Granting the

waiver would also send the message to other states that they can drop millions of people from

Medicaid. The Affordable Care Act was designed to protect people from that, and we shouldn’t

encourage states to undermine this important piece of health care reform. ”

Taylor urged state lawmakers to pass legislation removing or postponing the deadline to allow a wider

range of options to be considered.

“It’s a big mistake to force CMS to choose so quickly between approving the entire proposal and kicking

53,000 adults off of BadgerCare. State residents deserve a more thoughtful process.”

A recent WCCF publication provides a side-by-side comparison of the consequences of those two

options: .

Saturday, December 3, 2011

   Contact: Bob Jacobson
December 1, 2011                                                                                                    (608) 284-0580, x303              

50 Wisconsin Groups Unite to Call Upon Federal Government to Reject DHS Waiver

Madison- In an effort to prevent more than 64,000 Wisconsinites from losing their BadgerCare coverage, 50 groups from throughout Wisconsin, call on U.S. Health and Human Services (HHS) Secretary Sebelius to deny the recent request from the Wisconsin Department of Health Services (DHS) for a waiver of federal maintenance of effort (MOE) requirements. 

As outlined in the attached letter to HHS, a diverse and broad group of organizations urge rejection of the waiver for reasons including:

  • The waiver would jeopardize the care of 168,000 Wisconsinites, including more than 64,000 who are expected to drop out of BadgerCare.
  • Approving the waiver would cost 29,000 children their BadgerCare coverage.
  • The waiver would have disproportionate impact on people with disabling conditions
  • The waiver would harm many extremely low-income families.
  • The waiver would result in cost-shifting, not cost savings.
  • The waiver would increase red tape and reduce enrollment efficiency.

The Save BadgerCare Coalition also faulted the DHS process, which precluded an opportunity for meaningful public input, because the essential details of the proposal were not made available in advance of any public hearings.
Wisconsin has long been a national leader in ensuring that its residents have access to quality health care, and BadgerCare—an immensely popular and effective program--has been a major part of that success story.
Approval of DHS’ waiver proposal would reverse that progress and would conflict with the goal of the health care reform law to make health care better and more affordable.
To be connected with representatives from the signing organizations, or BadgerCare enrollees who can speak to the impact these changes will make in their lives, please contact Bob Jacobson.

The Coming Medicaid Crisis in Milwaukee & Wisconsin!

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The governor and legislature are cutting Badger Care, Family Care, and Senior Care. This will affect tens of thousands people in Milwaukee County who use these critical programs. What will we do? What can we do?
Learn what is happening and voice your concerns at a


Thursday, December 8, 2011

Discussion at 7:00-9:00 p.m.

Light Refreshments at 9:00-9:30 p.m.

  • Ms. Barbara Beckert, Milwaukee Office Director, Disability Rights Wisconsin
  • Dr. Ian Gilson, Doctor of Internal Medicine & Staff Physician at Froedert and the Medical College of Wisconsin
  • Dr. Robert Kraig, Executive Director of Citizen Action of Wisconsin, an expert on Medicaid
  • Ms. Geri Lyday, Disabilities Services Administrator, Milwaukee County
  • Response/Comments from our Elected Officials
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Call the church at 414 273-5257 to reserve childcare or for additional information