Friday, April 27, 2012

Friday, April 27, 2012

DHS Initiates Changes that Knock about 17,000 Adults from BadgerCare

Affordable Care Act Protects Coverage of Kids and Lower Income Adults

The Department of Health Services (DHS) issued an Operations Memo at 6:15 this evening explaining the changes to BadgerCare that it will implement on July 1. The “ops memo” was distributed after DHS received a letter late today from the federal department of Health and Human Service indicating that the changes to BadgerCare affecting adults over 133 percent of the poverty level have been approved.

The package of policy changes being implemented is a little narrower than what was reviewed and approved by the Joint Finance Committee in mid-March, and by my calculations it will result in at least 17,000 adults losing their BadgerCare coverage. That's only about a fourth of the number of people who wold have lost coverage under the Walker Administration's original proposal. In addition to those who lose coverage, more than 33,000 adults who remain in BadgerCare will have higher premiums.

We are very disappointed that the state is implementing changes that will cause BadgerCare participation to drop by more than 17,000 people, at a time when the shrinking Medicaid deficit gives the state better options for balancing the Medicaid deficit. While the policy changes that were approved are very worrisome, we are relieved that federal officials concluded that the health care reform law does not allow the state to reduce coverage of children and lower income adults.

Thanks to the “maintenance of effort” requirements in the Affordable Care Act (ACA), about 48,000 people – including more than 29,000 children – are going to remain on BadgerCare. However, those requirements will be eliminated if the Supreme Court strikes down the whole law or Congress repeals it.

The federal approval of the changes announced today shouldn’t be misconstrued as an endorsement of those policy choices by the Obama Administration. The Department of Health and Human Services merely determined which of the state’s proposals were allowed by the health care reform law, not whether those options are good public policy.

These changes to BadgerCare are not the last of the cuts that DHS hopes to make. A proposal that is still pending would narrow the health care services covered for all children and parents above the poverty level, and would impose much higher co-pays. If approved by federal officials, those changes would apply to more than 300,000 BadgerCare participants.

For more about the changes to BadgerCare, see the article by Jason Stein posted this evening on the Journal Sentinel website, and the DHS update posted late today on the department's BadgerCare Plus website.

Wisconsin Alliance for Women's Health
PO Box 1726 Madison, WI 53701
[p] 608.251.0139 | 866.399.WAWH | [f] 608.256.3004

Feds OK changes that would bump thousands from Medicaid

By Jason Stein of the Journal Sentinel
April 27, 2012 6:38 p.m.
Madison - Federal officials have signed off on plans by Gov. Scott Walker's administration to cut costs in state health programs that will lead to an estimated more than 17,000 people leaving or being turned away.
President Barack Obama's administration announced late Friday it had approved the changes after previously requiring the Walker administration to scale back the cuts, which would have originally affected 64,800 people. The changes will cause some adults to leave the program but will shield children from impacts originally proposed by the state.
But other possible federal issues remain for the state. Federal officials, for instance, are also threatening to withhold federal funding for state long-term care programs unless the state shows it is complying with federal rules.
The Joint Finance Committee already approved revised Medicaid cuts last month on a party-line vote, with all Republicans in favor and all Democrats against.
There were no immediate figures on how much the final actions will save.
The state is making the cuts to bridge a gap in the Medicaid program, which still faced a projected deficit of about $128 million through June 2013 as of March. The Walker administration is making other ongoing efforts to close that remaining gap through spending cuts.
"Current law allows states to make changes to eligibility for non-pregnant, non-disabled individuals above 133% (of the federal poverty limit) when the state has a budget deficit. Wisconsin has certified a budget deficit and is therefore permitted to make changes in the program that would affect some of the adults in this group," Alper Ozinal, a spokesman for the federal Centers for Medicare and Medicaid Services.
The Medicaid health plans cover about one in five state residents - roughly 1.2 million people - and provide everything from doctor visits for poor families to nursing home care for the elderly. To help control rapidly increasing costs in the programs, the Walker administration sought to increase premiums for tens of thousands of others by up to nearly tenfold and drop coverage for certain participants for at least a year if a family misses a payment.
"These changes aim to preserve the core, safety-net functions of the program for low-income individuals and are necessary in order to keep the Medicaid program sustainable," state Health Services Secretary Dennis G. Smith said. "We would like to personally thank (federal Health and Human Services) Secretary (Kathleen) Sebelius and her staff in CMS in working with us to agree upon a commonsense plan that ensures individuals will continue to have access to affordable health insurance."
Advocates have said they're concerned about the impact of the changes, particularly on the participants who will end up leaving the program because they lose their eligibility or because they can't or won't make the higher premium payments.
"We're very disappointed that the state is going to make the choice of moving 17,000 people out of the program but we're relieved that the federal officials determined the health-reform law protects coverage for children and low-income parents," said Jon Peacock, research director of the Wisconsin Council on Children and Families.
Medicaid programs like BadgerCare Plus and Family Care are jointly paid for by state and federal taxpayers, with the state budgeting to pay nearly $7 billion in state and federal money for them this year. State spending is up significantly, but overall spending in the program will decline this year by an estimated 7% because a surge of federal aid money has run out.
Walker administration and Republican lawmakers have said the state has no other options to deal with the health programs besides raising taxes. They note that Medicaid programs are gobbling up more and more of the state budget and squeezing out other key priorities like schools.
Democrats have said Republicans had approved tax breaks for businesses and the wealthy this year that worsened the cuts. The Democrats said some uninsured will get sick and receive expensive emergency room care, pushing costs off on Wisconsin hospitals and the insured patients who go to those hospitals.
The changes would take effect in July and would:
Increase BadgerCare Plus premiums sharply for families with incomes of more than 1 1/3 of the federal poverty limit - $25,390 a year for a single parent with two children. The new premiums would be between 3% and 9.5% of household income, depending on how much the recipients made and would amount to $29 million more for more than 30,000 recipients. The Walker administration dropped a proposal to raise premiums on children.
For instance, a single parent with two children who makes more than $28,635 a year would typically see his or her annual premiums rise to $1,145 - 9 1/2 times more than the current premium of $120 a year but less than the previously proposed increase to $1,432 a year.
Democrats said the premium increases were unacceptably high. Republicans said those premiums were still less than private-sector workers or state employees would be charged.
Drop adults making more than 1 1/3 the federal poverty limit from the program for one year if participants fail to pay their monthly premium without a valid excuse. Currently, adults are dropped for six months for failure to pay, but children are not. The Walker administration had previously proposed dropping both children and adults from the program for one year.
Prevent adults making more than 1 1/3 the federal poverty limit from receiving BadgerCare Plus if they can get access through their employer and their share of the premium is below 9.5% of their income. The state also wanted to apply that provision to children.
A separate cost-saving proposal already approved by the state but also still awaiting federal approval would move more than 300,000 people in BadgerCare Plus - more than half of them children - into a plan with lower costs for taxpayers but fewer benefits for recipients. Republicans have said the benefits would still be attractive when compared with private plans.
Separately, the federal government also asked the state in a March letter to ensure the state is complying with federal rules surrounding the Family Care program, which provides long-term care to elderly and disabled individuals outside of nursing homes.
The state capped enrollment in the program last summer to hold down costs. Walker announced plans in December to allocate $72 million to resume enrolling people in Family Care, following an order from the federal government, and Walker signed legislation to do it last month.
The federal government wants to make sure the state is notifying citizens of the change and helping any affected people who were improperly prevented from receiving care as a result. The state says it's meeting those requirements but there has not been a final response from federal officials.

Wisconsin Alliance for Women's Health
PO Box 1726 Madison, WI 53701
[p] 608.251.0139 | 866.399.WAWH | [f] 608.256.3004

Friday, April 20, 2012

An Article Worth Reading



[uh-thawr-i-tair-ee-uhn, uh-thor-] Origin


[uh-thawr-i-tair-ee-uhn, uh-thor-] Show IPA
favoring complete obedience or subjection to authority  as opposed to individual freedom: authoritarian principles; authoritarian attitudes.
of or pertaining to a governmental or political system, principle, or practice in which individual freedom is held as completely subordinate to the power or authority  of the state, centered either in one person or a small group that is not constitutionally accountable to the people.
exercising complete or almost complete control over the will of another or of others: an authoritarian parent.
a person who favors or acts according to authoritarian principles. 

Since the 2010 election this has been playing out here in WI. Walker has to be defeated or as he said it will set their progress back 10 years. So the republican party with the backing of Alec and the Koch Brothers have formed an authoritarian government. As the Cap Times article mentioned we will be in serious trouble if Walker is allowed to continue because as he said WI is the template.

New Paper Examines Options for Closing the Medicaid Deficit   

According to a new analysis released today by the Wisconsin Budget Project, the recent contraction of the state’s Medicaid deficit allows the remaining shortfall to be eliminated without damaging cuts to BadgerCare, which could adversely affect more than 300,000 Wisconsinites, and the new report summarizes several options for accomplishing that.

The paper explains that the projected size of the 2011-13 Medicaid deficit declined from $220 million GPR last fall to $82 million in early April. That figure doesn’t take into account various administrative actions DHS has been taking to reduce Medicaid spending, which the department estimated would reduce state GPR spending for Medicaid by about $75 million. As a result, the most current available DHS figures indicate that the state is just $7 million short of balancing the Medicaid deficit.

The Budget Project analysis summarizes the status of changes to BadgerCare proposed by the Department of Health Services (DHS), which could cut the state share of spending for the program by as much as $50 million GPR, and would cause roughly 17,000 adults to lose their BadgerCare coverage, while significantly increasing the cost of coverage for over 300,000 participants.

The paper outlines three alternatives for eliminating the Medicaid deficit without adversely affecting many of the working families who rely on BadgerCare: 1) applying to Medicaid spending, rather than to the General Fund, the next federal performance bonus award for BadgerCare; 2) eliminating one of the new corporate tax breaks approved in the budget bill; or 3) implementing a much narrower change to BadgerCare. The paper concludes that any one of those options would close the anticipated shortfall and avoid the devastating impacts to working families.

Jon Peacock

Monday, April 16, 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!
Conservative Scholar: Supreme Court Should Uphold Obamacare
Huffington Post, Apr. 16, 2012
Yet another prominent conservative legal scholar has stepped forward to urge the Supreme Court to uphold health care reform as firmly within the court's precedents.
The Plot to Keep Health Care Prices From Consumers
The Fiscal Times, Apr. 16, 2012
Markets cannot work when consumers and patients have almost no information about the prices they pay for health care.

Critics say proposed rule would make millions ineligible for insurance subsidies
Kaiser Health News, Apr. 15, 2012
A proposed Treasury Department rule says workers and their families cannot qualify for those subsidies unless their employer's plan is unaffordable because it exceeds 9.5 percent of their household income.

Why Medical Bills Are a Mystery [Opinion]
The New York Times, Apr. 15, 2012
When insurance companies or government bodies try to control costs, they usually make across-the-board reimbursement cuts that ultimately are unsustainable because they have no connection to the true costs of delivering care.

Nursing homes say it's time for states to undo Medicaid cuts
The Hill, Apr. 13, 2012
States should boost their Medicaid spending as the economy improves and their budgets begin to grow back, the nursing home industry said Friday.

Nebraska Governor rejects Prenatal Care Funding For Illegal Immigrants
Reuters, Apr. 13, 2012
Nebraska Governor Dave Heineman vetoed a proposal to restore Medicaid-funded prenatal care for illegal immigrants on Friday, but the initiative could still survive if the state legislature rejects his move next week.

CLICK HERE to keep reading Articles and Opinions.

Core Plan Enrollment Plummets!

As the Wait List Skyrockets to over 128,000 People

After peaking in January of 2010 at 65,265 members, March 2012 enrollment in the BadgerCare Plus Core Plan for childless adults sank to the lowest point yet--just 26,808. But despite the program's plummeting enrollment numbers, the Department of Health Services (DHS) has yet to open the program to new enrollees. The Wait List, which recently topped 128,706 childless adults, includes about 30% of Wisconsin's uninsured adults (based on Kaiser's most recent State Health Facts). According to the DHS Core Plan website, individuals on the Waiting List "will be able to enroll in the Core Plan as space becomes available." When DHS established the Core Plan Wait List in October 2009, there were approximately 46,000 childless adults enrolled in the program: How much more space does DHS need to start enrolling people in the Core Plan again?
Click here or on the chart below for Core Plan enrollment data!
Regular HealthWatch Wisconsin Update readers are familiar with our Wait List counter (see below), a recurring feature that has tracked the growth of the Core Plan Wait List since September 2011. In the seven months since the counter's debut, more than 20,000 people were added to the Wait List, an increase of approximately 20%. Remember, that's 20% even after more than two years passed in which the program took no new enrollees!*
(*Except for those with cancer who were able to take advantage of the Wait List Cancer Bypass from July 2010-March 2011, and those with chronic health conditions who were able to take advantage of a more robust Wait List Bypass from December 15, 2010-March 2011, before DHS discontinued the Bypass option altogether in March 2011, while also freezing the Basic Plan enrollment.)
CORE PLAN STORIES: Do you have a story about the BadgerCare Plus Core Plan? Were you or a client dropped from the program? Do you know people stuck on the Waiting List, uninsured and unrepresented? Please contact HealthWatch Wisconsin with your Core Plan Stories!

Friday, April 6, 2012

WAWH Supporter E-Update
Governor Walker Signs Four
Anti-Women's Health Bills into Law

The Wisconsin Alliance forWomen's Health (WAWH) is expressing extreme disappointment that without full public knowledge, Governor Walker actively signed four bills into law that undermine Wisconsin women's health, safety and economic security yesterday.

SB 306 / Wisconsin Act 217 Legislation that is unnecessary and that interferes with patient-doctor relationship and that was widely opposed by the medical community.

SB 237 / Wisconsin Act 216 Legislation that would repeal Wisconsin's Healthy Youth Act and that would allow schools to deny medically accurate, evidence based human growth and  development education to our young people.

SB 92 / Wisconsin Act 218:  Unnecessary legislation that further restricts the accessibility of  abortion coverage in a state exchange, where the use of public funding for abortion coverage is already sharply restricted under the Affordable Care Act. This bill  would restrict the use of women's own private premium dollars to purchase the health coverage they need.

SB 202 / Wisconsin  Act 219  Repeals Wisconsin Pay Equity Enforcement Law and ends accountability for such pernicious discrimination and grants employers the liberty to deny  women to receive the same salary as men.

"Governor Walker and the majority in our State Legislature understand just how unpopular these bills against women's health are," said Sara Finger, WAWH Executive Director. "It's not surprising that Walker privately signed these bills into law and hid news of their enactments from public view."

Just this week, Governor Walker very publicly signed other bills into law in such venues as Lambeau Field.  Yet important bills that undermine a woman's ability to achieve her optimal health, well-being and economic security were signed into law with no media present.

"We are committed to shedding light on the actions of our legislative leaders this past session and to ensuring voters are educated when going to the polling booths this year," added Finger.  "Women deserve to know how their elected leaders are failing to represent them and their health needs. 

Stay tuned this Spring for the 2012 Wisconsin Women's Health Supporter Voter Guide to be released.

Thank you for continuing to support Wisconsin Women's Health.

Tuesday, April 3, 2012

Feds Issue Final Rule on Health Insurance Exchanges!  

As the Supreme Court was hearing arguments on the Affordable Care Act's Individual Mandate, the Federal Government moved forward on publishing a final rule to explain the operation of health insurance exchanges. On March 27, 2012, the Feds officially published a final rule to guide states as they develop the health insurance exchanges mandated by the Affordable Care Act. They are required to be in operation by January 2014. The goal of the exchanges is to create competitive and transparent marketplaces by bringing together small businesses and individuals in order to generate big group buying power. (For more info on the status of exchanges, click here.)
The final regulations incorporate and expand upon two proposed rules from 2011 to give states as much flexibility as possible in setting up their exchanges in order to account for regional differences in health care markets. However, the federal government retained the right to set up and operate exchanges in states that do not comply with the new regulations. According to the Obama Administration’s most recent progress report, 28 states were already “on their way” towards establishing exchanges. Wisconsin, unfortunately, was not one of these states.
For the full text of the rule, see the Federal Register. For more on this topic, click here.

Supreme Court Hears Health Reform Arguments

Opinion Anticipated in June

Last week, the United States Supreme Court heard a historic series of oral arguments about aspects of the Affordable Care Act, the longest such arguments since the Civil Rights movement. The first day of hearings proved exciting mostly for tax law buffs, but on Tuesday, March 27, the Supreme Court heard arguments on one of the Affordable Care Act's most controversial, and essential, components: the Individual Mandate. The stakes for these proceedings are undeniably high; while the Supreme Court is expected to release their decision in June, the rest of the country will wait with bated breath, some states cautiously moving forward with health reform implementation and others, like Wisconsin, stopped dead on most elements of health reform, including exchanges. HealthWatch Wisconsin discussed the issues on the table both nationally and for our state in a recent episode of the WatchDog -- the latter summed up quite aptly in a commentary called "Health Care De-Form in Wisconsin."
CLICK HERE for more analysis of the Supreme Court's review of the Affordable Care Act! 

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!

What A Dirty Game They Are Playing With The People Of WI!

Medicaid Budget Deficit Changes…Again
Governor Walker and Department of Health Services Secretary Dennis Smith announced new adjustments to the Medicaid budget deficit in a letter to the Joint Finance Committee on April 2, 2012. Recall that 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 in December totaled less that $232 million dollars, a drop of over $300 million. Now, in the April 2 letter, Smith projects the deficit in the budget for Wisconsin’s state health care programs to have again decreased by another $27.5 million over the December numbers, so that Smith now estimates the state portion of the Medicaid deficit to be approximately $81.7 million—a far cry from the March 2011 projection.

Monday, April 2, 2012

Medicaid deficit shrinks yet again
Further proof that Walker’s plan to drop health care for thousands not needed

Madison—The projected deficit in the budget for Wisconsin’s state health care programs shrunk by another $27.5 million since December, according to new estimates received today by the Joint Finance Committee.  In its latest quarterly report to the legislative budget committee, the Department of Health Services estimates the state portion of the Medicaid deficit is now $81.7 million.  It’s the second report in a row to show a decrease in Wisconsin’s projected Medicaid deficit through June 30, 2013.  

Rep. Jon Richards (D-Milwaukee) issued the following statement in response to the new report.  He serves on the Joint Finance Committee and is the ranking member on the Assembly Health Committee.

“Yet again the financial condition of BadgerCare and other state health programs is far less dire than originally predicted.  The new numbers released today clearly demonstrate that Governor Walker’s plan to drop health care for 22,000 people is not necessary to balance the Medicaid budget.  The state health department is already pursuing administrative changes to the Medicaid program that it estimates will save $75.2 million, almost enough to close the new projected deficit. 

“While the state does not need to drop families from BadgerCare, the families relying on BadgerCare need it badly in this challenging economy.

“I encourage Governor Walker to drop his plan to increase the number of uninsured families in Wisconsin.  Otherwise it will be obvious that his budget maneuvers are driven more by ideology than sound math.”