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.

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