Proposed BadgerCare changes hurt access to coverage
Lesley Kieffer 3:14 p.m. CDT June 1, 2015
Columnist
says the governor’s budget proposal would make drastic changes to
BadgerCare — a successful, cost-effective program in both rural and
urban communities.(Photo: File/Getty Images/Creatas RF)
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As
a physician, I believe all Wisconsin residents deserve access to
affordable, quality health care. Unfortunately, I am fearful that many
low-income Wisconsinites to whom I provide care are at risk of losing
health coverage as a result of recommendations contained in the
governor's proposed budget.
The
governor's budget proposes drastic changes to our state's Medicaid
program, BadgerCare. BadgerCare has proven to be a successful,
cost-effective program in both rural and urban communities over the past
decade. It provides more than 800,000 men, women, and children across
the state with access to affordable health care coverage.
The
governor's proposed budget would require the state to request a waiver
from the federal government to make changes to the BadgerCare program
for childless adults. A "childless adult" is defined an adult without
dependent children. The proposed changes include: requiring enrollees to
pay monthly premiums; limiting lifetime eligibility to 48 months; and
requiring drug testing.
These
troubling changes have not received much attention from the media and
seem to have flown under the radar in legislative debates regarding the
budget. Unfortunately, if enacted, these changes would mainly serve to
deny much-needed health care to thousands of low-income Wisconsinites.
While
at first glance some of the changes might seem reasonable, people who
work with low-income patients quickly recognize why they are so
potentially harmful and have been failures when previously tried.
Kieffer (Photo: Submitted)
Wisconsin
already experimented with requiring low-income people enrolled in the
Transitional Medical Assistance program to pay monthly premiums and it
was a disaster: 21 percent of the adults affected by the policy lost
coverage for failure to pay a premium.
Simply put, the people I
see make so little money that they cannot afford to choose between
paying health care premiums and other basic life expenses. If forced to
choose, people will forgo needed medical care to put food on the table.
Limiting
lifetime eligibility to no more than 48 months would be an
unprecedented change that fundamentally undermines the purpose of
BadgerCare, which is meant to be a reliable safety net that provides
low-income people with health care.
Economic hardship doesn't
always come with a time limit, especially given the reality of wage
stagnation and job insecurity. Many of my BadgerCare patients are older
adults waiting for their Medicare eligibility, with no other options for
insurance. They cannot be left without options if they are 62 and have
used their lifetime cap on BadgerCare eligibility.
Rural Wisconsin
has not been immune to struggles with drug abuse. However, the drug
testing provision raises serious constitutional questions, as a similar
proposal for public benefit recipients was recently declared
unconstitutional in Florida.
Just as importantly, similar
provisions in other states have not been cost-effective and do little to
actually help people with substance abuse disorders. If Wisconsin is
truly interested in addressing substance abuse, we should direct our
resources towards effective treatment programs.
In
addition to these troubling proposed changes, the budget also continues
the governor's failed policy of rejecting federal money to expand
BadgerCare. As a result, there are thousands of low-income adults who
cannot afford private health insurance but have too high of an income to
qualify for BadgerCare.
Currently, a childless adult is eligible
for BadgerCare if he or she earns an income at or below 100 percent of
the Federal Poverty Line (FPL), which is only $11,770 for an adult
without dependents, or $980 a month.
Accepting
federal Medicaid dollars would save the state at least $345 million and
provide at least 81,000 additional Wisconsinites with the health care
they need.
The Legislature
should make the morally and fiscally sound decision to accept these
federal dollars and reject the governor's unnecessary and harmful
proposed changes to BadgerCare. Our health depends on it.
Dr. Lesley Kieffer, is a Doctor of Osteopathic Medicine (DO) and a family medicine physician at Bellin Health De Pere West.
