As states have tackled the issues of health care reform and Medicaid eligibility, Wisconsin has taken a unique approach. The good news is that our state doesn’t have a gap in coverage for adults below the poverty level – in contrast to the other 23 state that have turned down federal funding for Medicaid expansions. The bad news is that Wisconsin lawmakers financed expanded coverage for childless adults by knocking about 70,000 parents out of BadgerCare. (Additional drawbacks of this approach can be found here.)
The theory behind slashing the income eligibility limit is that the low-income parents who have been made ineligible for BadgerCare would get private insurance – primarily with the assistance of federal subsidies in the new health insurance Marketplace. In fact, the Walker Administration has argued that the Governor’s plan would cut in half the number of uninsured Wisconsinites, which is based in part on the premise that more than 90% of the adults losing BadgerCare coverage would get private health insurance.
With all of that in mind, health care advocates, providers and policymakers have been anxiously waiting for data showing how many of the adults that the state knocked off BadgerCare have gotten insurance through the new Marketplace. As I noted in a blog post yesterday, Wisconsin Citizen Action filed an open records request last week seeking data from the Department of Human Services (DHS), which should answer that question.
The federal waiver allowing Wisconsin to cut in half the BadgerCare income eligibility limit for parents requires DHS to make periodic reports about whether the adults who were made ineligible for BadgerCare have obtained insurance plans through the new Marketplace. A key step in answering that question is for DHS to do a cross match of the federal computer files on Marketplace coverage in Wisconsin with the state files on former BadgerCare recipients.
Senator Baldwin began in mid-May to ask DHS to release data from the cross match of state and federal computer files, but DHS said it needed more time to address the challenges of cross matching databases. The department said it would report those results by the end of June, but that hasn’t happened yet – prompting Citizen Action to file the open records request.
Like Citizen Action and Senator Baldwin, I’m very anxious to see the data that will answer the question of how many of the parents that the state knocked off of BadgerCare are insured through the Marketplace. I applaud them for pushing to get the data from DHS. That said, I think it can be challenging to do cross matches of large data sets, so I won’t be surprised if the DHS response is that they need a little more time.
While I’m not alarmed quite yet that we haven’t seen data on what happened in April and May to the former BadgerCare participants, I’m very concerned about the broader picture of missing data. As yesterday’s blog post explained, it’s been well over a year since DHS has submitted any of the required quarterly reports regarding the impact of experimental changes made to BadgerCare in July 2012. Although we can tell from the usual monthly enrollment reports that the Wisconsin experiment caused a very large percentage of parents over 133% of the poverty level to drop out of BadgerCare, the long overdue quarterly reports should paint a much more detailed picture of what has been happening.
As I said yesterday, I hope the long blackout on data relating to the effects of the 2012 experiment isn’t an indicator that there will be foot-dragging on the eagerly-awaited data about the effects in 2014 of cutting in half the income ceiling for adults in BadgerCare.
Jon Peacock