Friday, May 4, 2012

Good Afternoon,

We wanted to take this opportunity to touch base with you regarding the Department’s Medicaid Savings Initiative.

As many of you are aware, the Department has been negotiating with the Centers for Medicare and Medicaid Services about changes to Wisconsin’s BadgerCare Plus Program.

It was announced on Friday, April 27th that the Department and CMS have come to agreement on some of the changes.  Children age 18 and under are not affected by these changes.
The federally approved program changes will only affect income-eligible non-pregnant, non-disabled adults above 133% of the Federal Poverty Level ($25,390 for a household size of three) and do not apply to children. 

Beginning July 1, 2012, there will be changes to:

 *   Monthly premiums (depending on income) – some members will be required to pay premiums and those who already do may see increases to their existing premiums; individuals who do not pay their premium will not be eligible for 12 months

 *   The rules regarding access to employer-sponsored health insurance – individuals described who have access to affordable health insurance through their employer will be asked to utilize that coverage rather than the publicly funded option

 *   Retroactive eligibility – members described above will no longer be eligible for three months of backdated eligibility

If any of these changes affect members, they will receive a separate notice of these changes and their impact (i.e. paying a premium or the new premium amount).  The letter with information specific to the member’s case will be mailed in mid-June.

Now that we have reached federal approval of these policy changes, DHS will be working to make the necessary systems updates (ACCESS and CARES) to support the new policies.  Currently, we are working to determine how these changes specifically impact each of our members. Due to the time that it will take to make the systems enhancements to support the newly approved policies, we won’t know until mid-June how these changes will specifically affect members.

Beginning May 1, 2012, members will receive a notice letting them know about the BadgerCare Plus policy changes that will be effective on July 1, 2012.  All households above 100% FPL will be receiving a letter as the policy changes affect members above 133% FPL.  We wanted to give members advanced notice of the new rules, including changes to monthly premiums that could mean that they will now have a monthly premium or that their monthly premium will increase. We will not know until mid-June, once the systems updates are in place, how the new rules will specifically impact each household.

More information, including a copy of the letter and fact sheet that were sent to members is available at

Please note, beginning July 1, 2012, there are a couple of changes to policies that will expand the income guidelines for retroactive eligibility (backdating) and access to affordable employer sponsored health insurance for kids.

Retroactive Eligibility (Backdating)
Beginning July 1, 2012,
• Infants less than 1 year old with household income at or below 300% of the FPL may qualify for retroactive eligibility
• Children ages 1 though 5 (up to age 6) with household income at or below 185% of the FPL may qualify for retroactive eligibility.
NOTE: Children ages 6 through 18 will remain eligible for three months of backdated eligibility, if their income is at or below 150% of the FPL.

Access to affordable employer sponsored health insurance Children’s access to employer sponsored insurance will continue to be based on whether or not the employer pays at least 80% the premium or the access is to a State Employee’s health care plan. However, effective July 1, 2012, the following groups of children will no longer be subject to the crowd out policy:
• Infants less than 1 year old with household income between 150 - 300% of the FPL will no longer be subject to the access and coverage requirements;
• Children ages 1 though 5 (up to age 6) with household income between 150 -185% of the FPL will no longer be subject to the access and coverage requirements.

DHS plans to hold some partner meetings, including a web cast to discuss these changes with community partners.  An email will be sent out in early May with the dates and locations.
WHN Updates

Smith attacks federal health care policies at Wisconsin Health News event

Speaking to health care industry leaders at Wisconsin Health News' first Lunch Briefing, Department of Health Services Secretary Dennis Smith Wednesday defended the Walker administration's policies and decried the effects of the federal health reform law.

Smith started by painting a rosy picture of health care in Wisconsin. The state has the second-lowest number of uninsured people in the country, Smith said. He also highlighted Governor Scott Walker's infusion of $1.2 billion in new revenues to Medicaid programs. Although the federal government gave the states the option to cut Medicaid services and reduce eligibility, the Walker administration chose not to exercise that option, Smith said. "Those who rely on Medicaid are far better off because we did not adopt those federal options," he said.

Smith stressed that Medicaid users were not a monolithic entity, but rather a diverse group with varying needs. Any reform of Medicaid requires the state to pay careful attention to those groups rather than trying to impose a one-size-fits-all solution.

Previous Medicaid expansions were financed by extra sources of income, he said. "It is not realistic to think there is another new pot of money around the corner," Smith warned. He also chided the previous administration for failing to fund those expansions with state money when the state reached the limits of federal funding.

Smith's speech concluded with stern warnings about the danger of excessive federal meddling in the health care arena. "Above all, health care is personal and local. Centralizing decision-making for over 20 percent of our entire economy will not turn out well for everyone."

"It is an unpleasant task to inform you that you will not find the wisdom of Solomon in the Federal Register," he said.

According to Smith, the president's health care reforms will lead to a federal government that is more invasive and coercive. He also accused the Obama administration of reneging on its promise to fully fund the expansion of Medicaid. "The President's budget includes a proposal for a blended match rate to the states," he said.  "A blended rate that saves the federal government money is a thinly-veiled cost shift to the states."
Watch Smith's speech
Wisconsin Alliance for Women's Health
PO Box 1726 Madison, WI 53701
[p] 608.251.0139 | 866.399.WAWH | [f] 608.256.3004

Tuesday, May 1, 2012

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CMS Announces Approved Changes to BadgerCare  
Contact DHS & Walker Today to Weigh In

May 1, 2012

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Federal Centers for Medicare & Medicaid Services (CMS) Announces Approved Changes to BadgerCare
Late on April 27th, Wisconsin received word from federal officials that the Department of Health Services 
(DHS) may proceed with a portion of the proposed changes to BadgerCare.  DHS immediately initiated
the process of putting most of those changes into effect, beginning on July 1, 2012.  

Good News: 
  • Because of protections in the Affordable Care Act (ACA), CMS didn't approve Wisconsin's Maintenance of Effort (MOE) Waiver as proposed by Governor Walker which would have caused 64,000 Wisconsinites to lose their BadgerCare coverage.
    • Approved changes do not impact kids - higher premiums won't apply.
    • Presumptive eligibility / express enrollment protected.
    • Family unit definition will not be changed.
    • Young adults won't be forced off BadgerCare onto parent's employer sponsored insurance.
Bad News:
  • At least 17,000 adults in Wisconsin will lose their BadgerCare coverage.
  • 48,000 Wisconsinites will now have higher BadgerCare premiums.
  • Enrollment for the BadgerCare Plus Core Plan remains capped with over 128,000 individuals still on the waiting list.
  • Plan could "crowd out" and force adults onto employer sponsored coverage plans regardless of quality or actual affordability.  
 A new fact sheet from WCCF is available that summarizes the CMS approved changes to BadgerCare.
There's Still Work to be Done to Protect BadgerCare!
Send a message* to Governor Walker and Secretary Smith today asking to protect BadgerCare by:
  1. Scheduling a special legislative session to take up and pass the BadgerCare Protection Act which would prevent 17,000 Wisconsinites from losing their BadgerCare coverage, and 
  2. Lifting the BadgerCare Core Plan enrollment cap which could provide essential health care coverage for adults who qualify.
*Simply link here and select Governor Walker & Secretary Smith. Then on the next page, select "Protect BadgerCare" as your subject.
Additional Information & Resources:
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:
Democrats urge Walker to stop plan to drop health care for 17,000 people

Richards, Erpenbach, Pasch and Hulsey call for special session on BadgerCare Protection Act

Madison- Today four legislative Democrats called on Gov. Scott Walker to immediately schedule a special legislative session to stop his administration from moving forward with an unnecessary and harmful plan to drop health care for 17,000 people starting July 1. 

Reps. Jon Richards, Sandy Pasch and Brett Hulsey and Sen. Jon Erpenbach sent the attached letter to Walker today urging him to bring the legislature back to pass the BadgerCare Protection Act.

They wrote the letter in response to an announcement by Walker's health department late Friday that he planned to move forward with a plan to raise premiums, restrict access and implement other changes to BadgerCare.

"Taking affordable health care away from 17,000 people, or the equivalent of the entire city of Menasha, is not necessary to keep the Medicaid program sustainable," they wrote.  "Providing health care coverage to Wisconsin families simply requires the more compassionate and financially responsible approach outlined in the BadgerCare Protection Act."

The four Democrats told Walker his plan goes above and beyond what's needed to close the Medicaid deficit.

"Only $12.6 million in state funding is needed to close the Medicaid deficit," they wrote.  "DHS's planned cuts to coverage cut more than twice the amount that is necessary to close that deficit.  It is clear that DHS is attempting to balance the Medicaid budget on the backs of thousands of Wisconsin families by dropping their health coverage."

Their letter continues: "Without BadgerCare, many will become uninsured and left alone to fear a diagnosis of cancer, heart disease or other life-threatening illness that could ruin their family's financial security forever.  Expensive emergency rooms will then be their only alternative.  This only drives up costs for everyone else who must pay the so-called "hidden tax" of uncompensated care."

The Democrats' alternative plan closes the Medicaid deficit by repealing an expensive new tax loophole for large corporations that will cost the state about $40 million annually.  The large corporations using this loophole are not required to create a single job in Wisconsin to use it.