Tuesday, January 31, 2012

Tea Party Trying to Save Itself And Walker In WI

New report puts Wisconsin Medicaid shortfall at $141M

2:13 PM, Jan. 31, 2012 
MADISON — A new report by Wisconsin’s nonpartisan Legislative Fiscal Bureau says the state’s Medicaid programs face a $141 million budget shortfall by July 2013.
Gov. Scott Walker’s Department of Health Services has proposed a number of changes to save $241 million and more than plug the shortfall, including cutting $93 million in BadgerCare Plus, a program that provides medical care to poor families and adults.
If approved by the federal government, DHS projects the changes will result in about 29,100 children no longer being in the program. DHS also wants to save $27.4 million by improving the dispensing of medicine to elderly people in the Family Care program.
The department is also proposing about $75 million in cuts to various Medicaid programs to improve efficiency.

Thursday, January 26, 2012

Walker’s Administration states his budget is not balanced
The governor’s administration certifies that the budget has a deficit in order to kick up to 53,000 people off health care
MADISON—Contradicting repeated claims by Gov. Walker that he has balanced the state budget, his administration told federal health officials late last month in writing that Wisconsin has a budget deficit so it could drop health care for Wisconsin families.  That’s according to documents released today by Rep. Jon Richards (D-Milwaukee).
On Dec. 29, Walker administration secretary Mike Huebsch sent a letter to federal health secretary Kathleen Sebelius certifying that Wisconsin will have a budget deficit through June 30, 2013.  By certifying that its budget isn’t balanced, the Walker administration can now dodge a federal law requiring it to continue providing health care for up to 53,000 residents.  The Walker Administration letter contrasts starkly with public comments by Walker, who has claimed repeatedly since June that his budget is balanced.
“It is troubling that the Walker administration uses one set of math for its press releases and another set of math to justify dropping health care for Wisconsin families,” said Rep. Richards. “His past promises are coming back to haunt him and he cannot have it both ways.  He needs to stop hurting working families, while giving away $2.3 billion for special interests.”
Huebsch’s letter said the deficit was based on Generally Accepted Accounting Principles (GAAP), a budgeting method the state currently does not use to balance its books, but Scott Walker promised to use as a candidate for governor.  Using this method, Walker’s budget would have a $3 billion deficit by June 30, 2013, according to administration budget documents.  In contrast, the non-partisan Legislative Fiscal Bureau says Walker’s budget is balanced based on the accounting principles the state uses for budget purposes, as is required by state law.
Walker’s inconsistency on what constitutes a balanced budget is not new.  As a candidate for governor in 2010, Walker pledged to balance every budget state budget using GAAP—a promise he broke.  Likewise, in his failed bid for governor in 2006, Walker called then-Gov. Jim Doyle a “world champion liar” for saying his budget was balanced, when by GAAP standards it was not.

A Plea To Walker To Save BadgerCare

Mark Millers Response to Walkers State of The State Address

Peter Barca's Response to Walkers State Of The State Address

Saturday, January 14, 2012


Walker wrong to halt work on insurance exchanges

The governor is betting that health care reform will be struck down by the Supreme Court. We think it's a bad bet.

Gov. Scott Walker's decision to stop work on Wisconsin's insurance exchanges, which are mandated by health care reform, is shortsighted and could give the federal government more influence over the state's insurance market than it should have. Walker and state officials should reconsider their decision.
Walker said in December that the state would halt work on the online exchanges until the U.S. Supreme Court rules on the constitutionality of the health care law. The high court is considering a collection of lawsuits challenging the law; a decision is expected this summer.
In a recent interview with the Editorial Board, Walker said that it didn't make sense to proceed with the exchanges until the court sorts through the legal issues. Private insurers will sell insurance on these online marketplaces to both individuals and small businesses.
The problem with Walker's position is twofold.
First, like it or not - and Walker and other Republicans clearly do not like it - health care reform is the law of the land. To shrink from implementing any federal law is risky; the state conceivably could have to give back all or part of a $37 million federal grant to offset the initial cost of the exchanges.
Second, with dozens of decisions required to set up the exchanges, time may not be a luxury the state has. Among the decisions to be made: how much flexibility to give insurers in determining what to cover and what role agents and brokers will play.
Under federal health care reform, the state has to have its plan for implementation in place one year from now. Otherwise, the federal government will set up the exchange for Wisconsin. Even if the state is allowed to continue to work on its plan into 2013, which is possible through a conditional approval, that still gives the public far too little time for input.
"We do not want decisions about Wisconsin's insurance market to be made in Washington," Phil Dougherty, senior executive officer of the Wisconsin Association of Health Plans, told the Journal Sentinel's Guy Boulton recently. The insurers fear they might face stricter regulations under such a scenario than would be imposed by the state.
Essentially, Walker is placing a bet. He doesn't think health care reform will pass constitutional muster. We think he's likely wrong in that assessment. What if the court finds the law is valid? What if the court rules narrowly and strikes down only a portion of the law?
Walker believes that the state could still pull together its exchange by the end of the year if the law is upheld. But we're skeptical, given the number of details that must be decided. And there is another stumbling block: If the law is upheld, the Legislature, now dominated by Republicans, may need to pass a bill to set up an exchange. That likely would mean a long and acrimonious debate that could further delay implementation by the end-of-year deadline.
Originally a conservative idea, well-designed insurance exchanges should make it easier for customers to buy health insurance by allowing comparison shopping and providing a wealth of information for informed purchases. Let's get on with designing the best ones we can.

Should Wisconsin move forward with health insurance exchanges? To be considered for publication as a letter to the editor, e-mail your opinion to the Journal Sentinel editorial department.

Friday, January 13, 2012

Seeking Legal Interns for Summer 2012

ABC for Health is seeking volunteer, work-study eligible, or students on public interest fellowships for this summer! The position requires admission to law school. Students will provide legal research and writing support for firm attorneys that may include client interviewing and follow-up, drafting letters and memos, assisting on court filings and briefs, and facilitating projects with other agencies and legislators. Other duties include interviewing clients at intake, client counseling, and investigation of health benefits denials. Legal research and writing experience are desired, as are proficiency in Microsoft Word for Windows and a background in health care. Ability to speak Spanish and/or Hmong is a plus. To apply, please email a cover letter and resume to Brynne McBride, Assistant Director.

Support Our Efforts!

2011 was a difficult year for many, including ABC for Health. Over $300,000 in funding and funding opportunities were eliminated from our budget. Consequently, our ability to serve Wisconsin families was greatly diminished. Please consider a tax-deductible donation to ABC for Health to keep advocacy, legal services, and projects like HealthWatch Wisconsin sustainable for years to come. Thank you!
The GAO report uses preliminary data submitted to the National Association of Insurance Commissioners (NAIC) on insurer experience in 2010—before the MLR requirements were applicable. Based on the 2010 data, the report concludes that most insurers would have met MLR standards had they applied in 2010. In particular, the data indicates that 77% of large group market insurers (and 70% in the small group market) would have met the standards. The report also notes that MLRs varied widely among insurers and that even MLRs for the same insurer varied widely from state to state
HHS deems insurance rate hikes 'unreasonable' in 5 states
 The Hill, Jan. 12, 2012
Trustmark has raised its rates in Alabama, Arizona, Pennsylvania, Virginia and Wyoming by 13 percent, HHS said. In Alabama, the company has raised premiums by a total of 27 percent over the past year.

Study: Premiums could rise 25 percent without insurance mandate
The Hill, Jan. 12, 2012
Premiums would rise because young, healthy people would be less likely to buy insurance. The purpose of the mandate is, in large part, to force healthy people into the system, offsetting the cost of guaranteeing coverage to people with pre-existing conditions

Medical Transport Lawsuit Gets Federal Injunction
California Healthline, Jan. 12, 2012
In addition to these four lawsuits over the 10% provider cuts, a federal judge also issued a preliminary injunction halting the 20% trigger cuts to In-Home Supportive Services. All of those lawsuits were filed before the governor released his current budget, which includes another series of health care reductions.

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Long-Awaited Medicaid Audit is Released

The Joint Legislative Audit Committee, led by Republican lawmakers, requested that the Legislative Audit Bureau (LAB) conduct a comprehensive audit of Wisconsin’s Medical Assistance programs back in January 2011. Now, almost a year later, the LAB on December 20, 2011 released its comprehensive audit report. The full audit reveals a disproportionate, wasteful dependence on vendors to administer Wisconsin’s Medicaid programs and no evidence of the fraud and abuse that Medicaid opponents cited back when they called for the audit. While the audit report is not as thorough as some we have seen in the past, it still offers valuable insights into the status of Wisconsin’s health care system and spending – insights that could have been used to inform DHS officials and lawmakers before they developed and approved a waiver proposal that may irrevocably alter the face of Wisconsin’s public health landscape. Watch for a future edition of the HealthWatch Reporter devoted entirely to the Medicaid Audit.

Haven't Contacted the Feds Yet about Wisconsin's Proposed Medicaid Cuts?

There's still time!

CMS does not have an "official" public comment process for the Wisconsin MOE waiver request, the proposal to drastically change eligibility for BadgerCare and Medicaid programs in Wisconsin. Instead, you can contact the US Department of Health and Human Services (HHS) directly to comment on the Wisconsin DHS Waiver Request. Please send an email or call the Regional Director for our area, Kenneth Munson:
Kenneth Munson,Regional Director
Region V of the Department of Health and Human Service
Call: 312-353-5160
Mr. Munson will see that ALL comments on the waiver request (pro and con) are directed to appropriate CMS officials.
Tell your BadgerCare or Medicaid Story! Why is BadgerCare or Medicaid important to you and your family? What would happen if BadgerCare or Medicaid ended? CLICK HERE to complete a story form!
SPEAK UP: Comments Wanted by Feds
Insurance Commissioner Nickel Opposes Possible $13 Million Consumer Rebates
At the end of October, Wisconsin's Commissioner of Insurance Ted Nickel sent a letter to the Department of Health and Human Services, seeking an exemption from the federal law that requires health insurers to spend at least 80 cents of every dollar collected in customers' premiums on medical care. Commissioner Nickel said in his letter that he would rather see a gradual "phasing in" of the medical loss ratio requirement. Under the health reform law establishing this "medical loss ratio," the rule is that insurers who fail to meet the 80% minimum would have to provide rebates to their customers. Commissioner Nickel said he would prefer the money, estimated to be about $14 million in rebates to Wisconsin consumers under the law, was instead retained by the insurance companies.HealthWatch Wisconsin covered the story here.  
On January 9, 2012, the feds sent a letter back to Commissioner Nickel. The Department of Health and Human Services Center for Consumer Information and Insurance Oversight (HHS) had several questions for Nickel, asking him to provide support on the numerous claims he made in his request. They asked Nickel in more than one instance to explain his math as the feds could not derive the same numbers as Nickel. They asked him to provide withdrawal notices of the companies Nickel said were leaving the Wisconsin marketplace. In what will most likely be construed as a mighty blow, they very kindly thanked Nickel for “Wisconsin’s cooperation in working together to implement the Affordable Care Act.” In fact, Wisconsin is delinquent in implementing health reform, thanks most recently to an emergency rule promulgated by Commissioner Nickel that prevents federally required changes to independent review.
CLICK HERE to keep reading and learn how to comment to the feds on Wisconsin's MLR Waiver.
Medicaid Budget Numbers Change
Governor Walker and Department of Health Services Secretary Dennis Smith announced new adjustments to the Medicaid budget numbers, protecting 53,000 Wisconsin adults from termination of vital health coverage available through the BadgerCare program. Originally, in March 2011, Wisconsin’s Administration introduced a budget repair and subsequent biennial budget that included a provision to terminate 53,000 childless adults and parents from BadgerCare Plus should the federal review of the MOE waiver request not be completed by December 31, 2011. In a related letter dated December 30, 2011, Smith informed the Joint Finance Committee that new budget numbers indicate that he overstated his initial projection of $554.4 million in savings required to balance the Medicaid budget. Projected budget deficits now total less that $232 million dollars, a drop of over $300 million.

Tuesday, January 10, 2012

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Please Add Your Name to New Save BadgerCare Petition!  Tell Walker & Smith to Protect Health Care Access for Wisconsin Working Families!
January 10, 2012

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Send a message to Wisconsin leaders today - Protect & Save BadgerCare! 

 Wisconsin's Medicaid deficit is now expected to be $322 million less than was anticipated a few months ago, and the state has just received a $24 million federal bonus for BadgerCare's success.  Those developments enable the state to protect BadgerCare, while also lifting the cap on the Family Care program. 

Please join us in fighting to preserve BadgerCare and to oppose changes that would adversely affect children, people with disabilities, and adults, and would result in thousands of families becoming uninsured.
Add your name to our new Save BadgerCare Coalition petition being sent to Governor Walker, DHS Secretary Smith and Joint Finance Committee Co-Chairs - Senator Darling and Representative Vos.
Thank you!
Thank you for supporting BadgerCare and Medicaid.  Be sure to forward this email to others letting them know that MEDICAID MATTERS!  For more information and to join the Save BadgerCare Coalition, visit: www.savebadgercare.org.