Wednesday, July 24, 2013

Federal Court Hands Governor Walker Third Defeat This Month

Health care lawsuit against his administration moves forward

Madison—Governor Scott Walker lost yet another court battle this month when a federal judge ruled that a lawsuit filed against his administration for denying health care to Wisconsin residents should go forward. 

Last summer two Milwaukee County women with serious health problems sued the state after Walker’s health department refused to lift an enrollment cap on the BadgerCare Plus Core health plan, even though there was room available to serve more people.

Walker administration attorneys tried to convince U.S. District Court Judge William Conley that the women had no rights under federal Medicaid law to sue the state in this case.  Conley summarily rejected their arguments and ruled last week that the suit should go forward.  It was the third time this month that Conley has ruled against the Walker administration.  

Rep. Jon Richards (D-Milwaukee) praised Conley’s decision, but said it highlights a worrisome trend. 

“People who need and deserve health care should be able to access it in Wisconsin,” Richards said.  “Instead, the Walker administration has tried every way they know how to block that coverage.  Thankfully the courts are stepping in on the side of consumers.” 

The Core plan provides basic health insurance to people without dependent children.  It was established through a waiver Wisconsin received to federal Medicaid rules.  The state stopped signing up people in late 2009, after demand for the program exceeded its budget as enrollment peaked to 65,000 people.  The number of people in the Core plan has since dropped to less than 17,000, even though there’s enough space to insure up to 48,500 people under the agreement the state struck with the federal government. 

Earlier this month, Conley put a hold on a new state law Walker quickly signed behind closed doors that would severely restrict access to legal and safe abortions in Wisconsin.  Conley extended that hold a second time last week.

Federal Court Allows BadgerCare Core Lawsuit to Proceed

Ruling May Set Important Precedent, but Appears to Be Too Late to Affect BadgerCare

People on the BadgerCare Plus Core waiting list won a preliminary legal victory last week when a federal court allowed their lawsuit against the Wisconsin Department of Health Services (DHS) to proceed. The ruling could be an important precedent, but it’s unlikely to have a direct effect on coverage in Wisconsin because the substantive issues will become moot once BadgerCare eligibility of adults without dependent children is expanded and the current waiver expires, which is likely to be well before the next step in the litigation is resolved.

The crux of the legal dispute is the question of whether a state that gets a Medicaid demonstration waiver has to stick to the terms of that waiver. The decision issued on July 17 by Judge William Conley of the U.S. District Court for the Western District of Wisconsin rejects the DHS argument that the plaintiffs don’t have a right under federal law to get the state to comply with the terms of the BC+ Core waiver.  However, the court has not yet gotten to the more detailed substantive question of whether the waiver’s terms require the state to provide a minimum amount of Core Plan coverage.

The court case was filed on June 1, 2012, after DHS continued to refuse to lift a moratorium on any new enrollment of adults who don’t have dependent children. (Read more here.)  Participation in the Core Plan peaked at more than 65,000 childless adults early in 2010, but by June of this year was less than 18,000 – a 73% decline – while the waiting list grew to more than 150,000.

The plaintiffs have essentially been arguing that although the Core Plan waiver allows the state to cap spending and to restrict participation to about 48,000 childless adults, the state is obligated to serve up to that number (or get federal approval to amend the waiver). Although a DHS legal analysis written at the end of the Doyle Administration supports that interpretation of the waiver, the Walker Administration contends that it is free to serve as few childless adults as it chooses.

The decision last Thursday is a defeat for DHS and a preliminary or partial victory for the plaintiffs (and for Legal Action of Wisconsin, which represents them). But although DHS lost this battle, it will probably prevail in this litigation because the Core Plan waiver expires on December 31, which is likely to be well before the court rules on the more substantive issues involved in this case.

At that point, it appears the debate over childless adult coverage will end with a political compromise, assuming the state is able to get federal approval for the plan approved in the 2013-15 budget bill. The state’s new waiver proposal, which I suspect will be approved by federal officials, would set a lower income limit (100% of the poverty level, instead of 200% now for BadgerCare Core), but would establish an entitlement to full Medicaid coverage for all childless adults below that income level. The Legislative Fiscal Bureau estimates that the number of adults without dependent children participating in BadgerCare will grow to 98,600 by the end of the biennium.

The changes planned next year will be a significant improvement over the current situation, but it’s a shame that it is taking so long to get to the point that we will begin insuring some of the more 150,000 childless adults and noncustodial parents who are on the Core Plan waiting list.  Rather than lapsing CHIPRA bonus funds to the General Fund (using one-time money to increase the size of an ongoing income tax cut that isn't truly paid for), the state could be using that money as a bridge to begin to begin now to insure more childless adults and to avoid the bottleneck of applications that will occur late this fall.

Jon Peacock

Monday, July 22, 2013

Great Resources to Learn How Wisconsin Women Win with Health Care Reform!

Enroll America - Get Covered!
Raising Wisconsin Women's Voices Blog
Raising Women's Voices - Countdown to Coverage
AARP Health Law Guide
Kaiser Subsidy Calculator - Get aestimate of your eligibility for subsidies and how much you could spend on health insurance
Raising the Status of Wisconsin Women's Health
An update from Wisconsin's women's health policy leader

70 Days Until Open Enrollment Begins - Pledge to  Enroll Today!

Starting October 1st, Wisconsin women will be able to enroll in women-friendly health plans through the new Health Insurance Marketplace thanks to the Affordable Care Act (ACA)!

Having health insurance is important! It means that if you or a family member gets sick, you won't have to worry about big medical bills or going bankrupt. 

Here's what you need to know about new health plan options!
  • You will be able to choose a plan that fits your budget.
    Plans will be available at different prices. Some people will get free or low-cost insurance, while others will receive financial aid to help buy a plan.
  • You will be able to find a plan that covers the care you need.   All health plans must cover the basic care you need. This includes doctor visits, prenatal and maternity care, emergency room visits, hospital stays, mental health and prescription drugs (including birth control without co-pays).
  • You will be able to get help choosing the plan that is best for you.  You will be able to easily understand what your plan will cover and how much it will cost. You can get help online, over the phone or in person to pick the plan that is best for you and learn what financial aid you can get. 
Learn more by visiting and Pledge to Enroll today! 

Tuesday, July 16, 2013

Events of Interest
Bipolar Disorder Information Session: The Charles Kubly Foundation is funding a free information session on Bipolar Disorder on July 17th from 6-7:30 with a 5:30 dinner. The information session will consist of a panel that will discuss the challenges and opportunities of living with the disorder from the perspective of a person with lived experience, a mental health provider, and someone from the medical community. For more information please contact Adrienne at or 414-276-3122.
Transit 101: Transportation Session for People with Disabilities: IndependenceFirst is holding a free informational session July 25th 1-3pm specifically designed for people with disabilities, their family members, and service providers who would like to know more about Transit Plus and the Milwaukee County Transit System. For more information, contact Autumn Misko at (414) 226-8387 or via email at Registration is appreciated by July 17.
NAMI Crisis Intervention Partner Training: NAMI Greater Milwaukee is proud to offer the Crisis Intervention Partnership (CIP) educational training. This two-day training, taking place August 20-21, is targeted to meet the needs of personnel training within corrections, residential, vocational, medical and first responder settings. For more information contact Shirley Drakes at 414-344-0447 or
BPDD SPARKS Grant: The purpose of SPARKS Grants is to develop local grassroots groups that will work on identified changes in their communities through grassroots community organizing. Priorities for 2013 SPARKS Grants include, but are not limited to, projects that focus on: Get Out The Vote (GOTV), state legislative issues, and local advocacy activities. For more information on the SPARKS grant, visit the grant page.
Poverty Matters! The Wisconsin Community Action Program Association will be holding its 2013 ‘Poverty Matters!’ conference September 25-26 at the Radisson Paper Valley Hotel in Appleton, WI. This conference brings together organizations and individuals committed to reducing poverty in communities across Wisconsin: community leaders, managers, front-line workers, Board members, human service professionals, educators and advocates. For more info, view their conference event page.
Opportunity to tell your story to a national audience: Genetic Alliance is partnering with Parent to Parent USA (P2P) and Family Voices (FV) to collect resources that will support individuals who wish to act as advocates on behalf of themselves, their families, or others living with the same condition. To date, they have collected over 240 resources that will help users build leadership, communications, outreach, and advocacy skills. The tools will be part of an accessible online toolkit, with advocacy resources grouped by topic area. If interested, please refer to our .pdf for more information.
2013 Summer Family to Family Course: Put on by the National Alliance on Mental Illness, this free, 6-week, course is for family caregivers of individuals with mental illnesses. The course is taught by two trained family members and has had over 115,000 family members graduate from this national program! Classes will fill up quickly; call Shirley at 414-344-0447 or contact her via email for more information.
Parents in Partnership and Youth in Partnership with Parents for Empowerment Training: Parents and other caregivers meet to share their family stories, challenges, joys, and triumphs of raising their children. The program assists parents in developing: communication skills, leadership skills, positive advocacy skills, collaboration skills, their own Community Action Plan. Youth and their parents will hear from speakers and take part in hands-on activities. To learn more about these free trainings, visit the registration page or contact Martha DeYoung.
The Division of Services for Children with Special Health Needs (DSCSHN) of the Maternal and Child Health Bureau (MCHB) monthly webinar series: This series was started by the Division to promote the work of the National Centers to MCHB’s grantees. These Centers provide resources for comprehensive, community-based, family-centered, culturally competent, coordinated systems of care for children and youth with special health needs and their families. Meeting information can be found on their site.
Medicaid for Elderly, Blind, or Disabled (MA EBD). This May, come and learn from the experts about the different Medicaid programs that are available for adults who are elderly or with disabilities, and who may be eligible for which sub-program. RSVP to Heather Dummer Combs.
CLICK HERE to view our online Events of Interest calendar!
CYSHCN Collaborators, please let us know if you have an upcoming event you would like posted to the calendar!

Monday, July 15, 2013

~ Budget Provisions Specific to the 9th Senate District ~

Throughout the recently completed budget process, I received substantial input from citizens across the 9th Senate District who e-mailed, called, wrote letters, attended listening sessions, and met with me directly to share input. Most of the input I have received relates to broad areas of the budget that affect the entire state. For instance, healthcare, education, and taxes and spending have been areas where I have received significant amounts of comment, both in favor and opposed to various budget provisions.

In addition to these broad areas of interest, I have also received input from individuals and groups relating to issues uniquely affecting Sheboygan, Manitowoc and Calumet Counties. Throughout these discussions, a number of very particular issues, unique to our area, have been brought to my attention to be addressed through the budget process. As a member of the legislature’s Joint Finance Committee (JFC) I have been able to work with my colleagues to obtain necessary support for addressing a number of these issues in the budget process, even though many may not affect the state as a whole.

Below is a list of initiatives that were included in the final version of the budget signed into law recently by Governor Scott Walker. These items were added to the budget bill through amendments that I offered as a result of either unique circumstances in our area or at the request of groups that I spoke to in the 9th Senate District.

LEAN Government Initiative- For several months, I have been working with the City of Manitowoc and various Manitowoc area businesses on a partnership model to make local units of government more efficient through the implementation of LEAN initiatives. At the state level, Governor Walker is already requiring state agencies to implement LEAN processes that will reduce waste and bureaucracy in our government. I believe it is important to encourage and support local governments in implementing LEAN initiatives as well. Therefore, I was pleased to offer a budget amendment that will provide some state financial incentives to encourage local units of government to work with area businesses to adopt LEAN practices.

Sheboygan County Highway LS Relocation- I have also been working recently with Sheboygan and Manitowoc Counties, as well as numerous municipal officials and residents in the Sheboygan-Mosel-Cleveland area to address the deterioration of Highway LS along Lake Michigan due to aggressive bluff erosion. As a result of this erosion, the highway is literally falling into the lake and is in need of immediate relocation. As a solution, one possibility is to relocate and build an entirely new highway costing millions of dollars and impacting numerous private properties. At the same time, the Town of Mosel in Sheboygan County and the Town of Centerville in Manitowoc County are facing a separate multi-million dollar rehabilitation of Dairyland Drive, which is actually old State Highway 41 and lies less than ½ mile west of the proposed new County Highway LS route.

The budget provision I offered would encourage and support a more fiscally responsible solution that is also more respectful of private property rights. Under the plan, construction of a new roadway would be eliminated and Dairlyand Drive would be designated as County Highway LS and upgraded appropriately. To facilitate this cooperative process the budget will provide a framework for the state to partner with the appropriate local governments to help resolve this issue. Under the motion, the state would contribute up to $4.2 million for the project, to be matched with equal local funding. In order for state funds to be committed, all impacted local units of government must come to an agreement on the specifics of the project. I look forward to continuing to work with affected individuals to move this project forward.

Sheboygan County Ozone Monitor- Currently, Sheboygan County has been designated “non-attainment” by the Environmental Protection Agency (EPA) for ground-level ozone air pollution. This means that we do not meet the maximum concentration thresholds the EPA has established. As a result, several sanctions have been imposed on the county affecting businesses and consumers negatively. These pollution levels are currently measured by a monitoring station on the coast of Lake Michigan just south of the City of Sheboygan. Over the past number of years, there has been some concern that this single monitor is catching bad emissions in the air stream that comes from Milwaukee, Chicago and Indiana and not producing an accurate representation of the air quality in other parts of Sheboygan County.

As a result, the budget motion I sponsored will provide state support for the construction and operation of a second ozone monitor further inland in Sheboygan County. The goal is to obtain more complete air quality data for all of Sheboygan County that could then be used by EPA in determining non-attainment designations. I was pleased to work with the Sheboygan County Chamber of Commerce on this initiative and am excited to see the results.

Funding for Tuberculosis Response- In the spring of this year, the Sheboygan area was struck by an outbreak of tuberculosis that required rapid response, containment, and medical care. Because of the dangers associated with tuberculosis, response efforts to outbreaks can be expensive. Therefore, I was pleased to work with Governor Scott Walker and other legislators to provide state support for Sheboygan County’s efforts to contain the tuberculosis outbreak. Under the budget provision, $6.1 million will be available from the state to assist Sheboygan County with tuberculosis response efforts. This money can be requested to be released to the county as expenditures occur and is subject to further legislative review and oversight.

Non-Profit Resale Property Tax Exemption- For several years, I have been working with a non-profit resale store in Manitowoc with a property tax concern. This resale store accepts donated merchandise and resells these items to consumers. The profits from these sales fund scholarships for students in the community to attend Manitowoc Lutheran High School. Unlike numerous other non-profit service organizations, resale stores like this are not property tax exempt, despite the fact that they are eligible for an income tax exemption as a 501(c)(3) organization. In order to clarify the law and support non-profits around the state, I authored a budget motion that would make these kinds of non-profit resale stores exempt from property tax liability.

Land Information Program- I was happy to work with various county officials on changes made in the budget to the county land information program. This program, funded by fees on various Register of Deeds services, provides the public access to land information/records and various maps for review. The budget will make a series of changes to the operation of this program that will grant county officials who administer this program additional flexibility while maintaining support for this important service to citizens. The budget will increase the amount of state grants available to counties for this program, increase internet access to these records, and provide for support for the development of a statewide digital parcel map that will increase the ease of access to land information. This program has always been a collaborative effort between the state, individual counties, and the public and I was pleased to participate in continuing this important collaboration.

These are a few of the initiatives that directly impact portions of the 9th Senate District that I was happy to guide through the budget process on behalf of individuals and groups I have spoken with over the past six months. Again, each of these items was included in the final version of the budget bill and is now law. If you would like to review descriptions of other budget provisions, you can review them here:

As always, it has been a pleasure communicating with you. Please remember to communicate with me and share your input by calling 888-295-8750, writing to me at P.O. Box 7882, Madison, WI 53707-7882, or by e-mailing me at You can also log on to the 9th Senate District on-line office at

It is an honor to work for and represent the residents of the 9th District in the State Senate.

As always, it has been a pleasure communicating with you. Please remember to communicate with me and share your input by calling 888-295-8750, writing to me at P.O. Box 7882, Madison, WI 53707-7882, or by e-mailing me at You can also log on to the 9th Senate District on-line office at

It is an honor to work for and represent the residents of the 9th District in the State Senate.

~ Issue Corner ~

Each week, I will highlight a hot topic that is being discussed by the legislature. I intend this section to be a window into the informal conversations happening at the state capitol, but will not indicate an endorsement or position on the issue. In addition, I will review and consider all input I receive about the issue, but due to the volume of emails I already receive, you may not receive a direct reply every time you share input.

Senate Bill 22 

SB 222 relates to providing certain legal immunities to individuals who may currently violate underage drinking laws. Under SB 222, a person who is under the legal drinking age may not be issued a citation for underage drinking if he or she is in the process of requesting or receiving medical assistance for themselves or another person. Furthermore, an underage person who remains at the scene of a medical emergency and thereafter cooperates with medical assistance providers or law enforcement officers may not be issued a citation or convicted of underage drinking. However, there is a provision in this bill that penalizes an individual if he or she requests medical assistance solely for seeking this protection.

Please visit this link to view an electronic copy of SB 222:  Furthermore, you can track this proposal as it makes its way through the legislature by signing up for the legislative notification service:

BadgerCare recipients brace for health insurance exchanges

By Michael Phillis of the Journal Sentinel
July 13, 2013
Madison — When a potentially fatal intestinal problem forced Bethany King into surgery in 2011, the state's BadgerCare Plus coverage paidalmost all of the hefty bill.
But next year, the small business owner's income may rise just enough to bump her from the Medicaid program into the federal insurance marketplace being created under President Barack Obama's health-care law, which King worries may further strain an already tight budget.
"It is all the unknowns that bug me more than anything else," said King. "I have had so much different information and basically everybody doesn't know."
In less than three months, these federal insurance exchanges will start signing up customers, and tens of thousands of low-income BadgerCare recipients such as King, 31, will find out how they fare in this complex and still poorly understood system.
There may be a bright spot. While the private coverage offered through exchanges will likely cost more than BadgerCare, it may not cost as much as some advocates feared.
The question is key in Wisconsin, which is proceeding differently than other states. Neighbors such as Illinois and Minnesota have expanded Medicaid coverage to insure those making just over poverty level wages. Here, about 90,000 people will be moved from BadgerCare coverage to the federal system.
"It's a huge change," said Bob Peterson, executive director of ABC for Health, a public interest law firm. "For the hospitals, for the clinics, for the people seeking care, it turns a lot of things around for them."
He said the exchanges' first few months will be a "white knuckle" adjustment.
Those just over the federal poverty level, $19,530 a year for a family of three, will face a complex choice about whether to purchase insurance to replace their Medicaid coverage.
BadgerCare offers low co-pays to those enrolled in its most subsidized coverage and charges premiums only for a select group of adults making somewhat higher incomes.
Under the federal health care law, Wisconsin could have used federal money to expand Medicaid for those between 100% and 138% of the poverty level and in the process boosted the state budget.
But Gov. Scott Walker and GOP lawmakers chose to put these consumers in the private federal exchanges, saying they were concerned the federal money wouldn't be available over the long term.
Walker spokeswoman Jocelyn Webster pointed out that the governor's plan will actually bring a large group of childless adults onto BadgerCare for the first time.
"Everyone in Wisconsin will have access to affordable health care," Webster said. "Governor Walker's plan will reduce the number of uninsured adults by about 224,580, cutting the uninsured rate by nearly half."

Living on a tight budget

King runs a home remodeling business, Madison Residential, with her husband. She said she will purchase insurance. Her second surgery last year cost at least $126,000, with all but about $100 covered by BadgerCare. Needing to keep her income steady as she cares for her two young daughters, she felt compelled to go back to work a little over a week after her first procedure in May 2011.
"My clients all looked at me and were incredibly worried," she said. "It sucks, but whatever, you get over it."
For now, it's still unclear how current BadgerCare recipients will fare in the exchanges.
Sara Eskrich, a health policy expert at the Wisconsin Council on Children and Families, said her group tries to keep talks on the exchanges "as broad as possible, to stay safe," highlighting the federal program's premiums and potential for higher out-of-pocket expenses.
Eskrich said the state's decision not to expand Medicaid, however, was bad for low-income residents.
"When you are making $11,000 per year, and the majority of that is going to pay rent, every dollar counts," Eskrich said.
Walker's plan, according to DHS, will bring more than 80,000 childless adults living in poverty into BadgerCare, a slightly smaller group than those with higher incomes being forced to leave the exchanges under Obamacare.
"The governor believes that having more people depend on government-run Medicaid should not be our goal. Rather, we want to help individuals and families living above poverty to remain in the private sector for getting their health insurance coverage," agency spokeswoman Claire Smith said.

What to expect

Under the standard BadgerCare plan for adults with children, extremely low co-pays — and not premiums or deductibles — are charged. Prescription costs run between $0.50 and $3, and inpatient hospital care is $3 a day up to a $75 maximum.
A different plan for childless adults has slightly higher prices.
The comparable costs for the exchanges still aren't fully known.
Except for some people on the cheapest plan, coverage will require paying a premium as low as 2% of income. The cheapest plan without a premium, however, has far higher out-of-pocket expenses compared with the coverage specifically aimed at low-income individuals. Co-pays must still be set. Out-of-pocket maximums for those just over the poverty line will be around $2,000 for individuals and $4,000 for families.
The exchange will offer four main tiers of insurance that vary in price and quality. A special category also will be available for those between 100% and 150% of the poverty limit, where the insurer must on average pay 94% of health care costs with the average patient picking up the remainder up to a limit.
In 2011, the Kaiser Family Foundation asked three insurance providers to come up with the basics of a plan that would fit such a model in 2014.
The charges varied widely. The cheapest offer included no deductible and 8% coinsurance (the share of expenses paid by the consumer). The most expensive had a $200 deductible and asked for 10% coinsurance.
Preventive care under the federal health legislation is fully covered.
California has released some prices for its own state exchange, which specifies what individuals will pay for specific kinds of services. That state's estimates use the 94% value and ask individual consumers to pay $4 to $10 for drugs and 10% of a physician or surgeon's fees for a hospital stay.
These numbers, however, will likely be somewhat different in a federal exchange like the one coming to Wisconsin. But they do provide at least a glimpse into what's coming.

Coverage concerns

Rebecca Nelson, a 39-year-old single mother of four living in Eau Claire, also worries about getting removed from BadgerCare and facing cost increases.
She has struggled with severe back and other medical problems — she moves slowly, has trouble walking and can't sit in the same place for more than a half-hour without pain.
On June 5, her landlord knocked on her door and apologized as he handed her a five-day notice saying she must either pay her eight months in back rent or face eviction.
"(My 15-year-old son) went to his room. He started packing his stuff. He knew I didn't have the money," Nelson said.
On medical leave now and living under the poverty line, Nelson said she will likely earn enough to fall just over the line if she is able to return to work next year and therefore be forced onto the exchange market.
Democrats have criticized Walker's decision to turn down the increased federal Medicaid funding, which the nonpartisan Legislature Fiscal Bureau has estimated would save the state about $340 million through 2021.
The Walker administration has responded that its plan doesn't rely on uncertain federal funds and that 93% of those with incomes between 100% and 138% of the poverty limit will sign up for coverage under the federal exchange. The fiscal bureau has said the assumption of a 93% sign-up rate is "unreasonably optimistic."
As for Nelson, she borrowed money from a friend and avoided eviction. But in her case, the federal coverage may end up costing too much.
"It is still more than I would be able to afford," she said.

Blame States For Not Expanding Medicaid, Obama Adminstration Will Tell Poor Residents

Posted: 07/15/2013 12:41 pm EDT

The federal government wants poor residents of states not expanding Medicaid under President Barack Obama's health care reform law to know who's denying them health coverage -- and the administration has a plan to make sure they find out.
When Americans begin shopping for benefits on the law's health insurance exchangeson Oct. 1, the people who would qualify for Medicaid but live in the 20-plus states where Republican governors or state legislators won't approve the expansion will see a note explaining that federal law allows them to get coverage that their states' leaders won't provide them. A senior administration official told reporters about the note Friday.
The health care reform law calls for Medicaid, the joint federal-state health program for the poor, to be opened up to anyone who earns up to 133 percent of the federal poverty level, which is $15,282 for a single person this year. But when the Supreme Court upheld Obamacare last year, justices also ruled that states could opt out of the Medicaid expansion. The result will be millions fewer poor U.S. residents gaining health coverage, mostly among adults without children.
More than 20 states are opting out of the Medicaid expansion because of opposition from GOP governors such as Rick Perry of Texas and Bobby Jindal of Louisiana, or because majority-Republican legislatures blocked expansion plans supported by Republican governors such as Rick Snyder of Michigan and Democratic governors including Missouri's Jay Nixon.
Under the Obamacare law, the federal government will pay the full cost of covering newly eligible people on Medicaid from 2014 to 2016, then will gradually reduce its share of the funding until it reaches 90 percent in 2022 and years following. The federal government currently pays an average of 57 percent of states' Medicaid expenses.
The health insurance exchanges are online marketplaces where people who don't get health benefits at work can compare health plan benefits and costs, and learn whether they qualify for Medicaid or tax credits for private insurance. The federal government will run the exchanges in 34 states, while 16 states and the District of Columbia will manage their own exchanges.
In those states that didn't create exchanges, leaving the federal government in charge, people whose income is below 133 percent of the poverty level will see a notation explaining that their states declined to take up the Medicaid expansion that would have covered them, the official said. The exact wording of the notice hasn't been determined, and senior administration officials spoke to reporters at the Eisenhower Executive Office Building adjacent to the White House last week on the condition they not be named nor quoted.
Some of those left out of Medicaid may qualify for tax credits to use on private health insurance, but many of the poorest likely will remain uninsured.
The health care reform law creates health insurance tax credits for people at the poverty line up to four times the poverty line -- but not below it. This means that those earning less than the poverty level -- $11,490 for an individual this year -- won't have access to these subsidies or Medicaid if their home states don't expand the program. Because these people will fall between the cracks, the Obama administration has exempted them from the law's individual mandate that most U.S. residents obtain health coverage next year.

Tuesday, July 2, 2013


The Department of Health Services seeks your input on its Core Plan Waiver Request. Three "town halls" are scheduled--none for Madison and none for the northern half of the state.

Scott Walker makes 57 vetoes, signs $68 billion Wisconsin budget, Milwaukee Journal Sentinel, June 30, 2013
Governor Walker signed the state budget into law on Sunday, making notable vetoes on bounty hunters and the Center for Investigative Journalism, but not on Medicaid, sticking to his original health care proposal.

Obamacare 1.0: States brace for Web barrage when reform goes live, Reuters, June 30, 2013
What happens when everyone in the US logs on to "" at the same time on October 1? Server meltdown or health care for all?

How Much Will Obamacare Cost?, Politico, June 28, 2013
This is the summer when the country will find out just how "affordable" the Affordable Care Act will be. There's been a sneak peek this spring, when states started to reveal health insurers' proposed rates for 2014, the first year insurers can no longer turn away sick patients and must offer a more robust set of benefits to everyone.

Big Changes Ahead for Those Who Buy Their Own Insurance, Kaiser Health News, June 28, 2013
Most of the debate about how the health law will change the individual market has centered on whether consumers will experience 'rate shock' from higher premiums when key changes go into effect next year. But there's a flip side: new rules that broaden benefits, prohibit discrimination against those with health issues and cap consumers' out-of-pocket costs.

Low-income Americans who live in states that have decided not to expand Medicaid eligibility will not face penalties if they fail to buy insurance next year. That's according to a final rule on exemptions to the health law's individual mandate – the law's controversial requirement that most Americans have health coverage or pay a penalty in 2014. That rule was published Wednesday.

State 2nd worst in poor kids' dental care, Journal Sentinel, June 25, 2013
In Wisconsin, 71.5% of Medicaid-enrolled kids did not see a dentist in 2011 — second only to Florida, where three-fourths of Medicaid-enrolled kids didn't get dental care that year.

As many as one in five children in the United States suffer from a mental disorder in a given year, according to national data recently compiled by the Centers for Disease Control and Prevention.

Monday, July 1, 2013

Town Hall Meetings

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DHS Soliticitng Input on Proposed BadgerCare Changes

July 1, 2013

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DHS Schedules Three Town Halls on BadgerCare Changes
The Department of Health Services today announced it will hold three (3) public hearings and one (1) tribal consultation around the State to solicit input on the BadgerCare Plus Demonstration Project Waiver request. Written or verbal statements can be made at the following public hearings:
Eau Claire Town Hall - Wednesday, July 10th 11am-1pm
Chippewa Valley Technical College Health Education Center
615 W. Clairemont Avenue  
Milwaukee Town Hall - Thursday, July 11th 11am-1pm
Radisson Milwaukee West
2303 North Mayfair Road
Green Bay Town Hall - Thursday, July 11th 11am-1pm
Green Bay Kroc Center Walnut and Oak Rooms
1315 Lime Kiln Road
Individuals who are unable to attend the public information sessions but would to provide a comment will be able to submit comments directly to the department by fax, email, regular mail or online.
Email AddressDHSBCDemonstrationWaiver@dhs.
Mailing AddressAl Matano
Division of Health Care Access and Accountability
P.O. Box 309
Madison, WI 53707-0309
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: