State Policy Changes Result in Sharp Drop in Coverage

BadgerCare enrollment fell by about 4,200 people in September, as the policy changes implemented in July continue to cause people to lose their BadgerCare coverage. In the first three months after those changes were initiated, BadgerCare enrollment has decreased by more than 16,000 people (roughly 15,500 adults and 600 kids).

The drop in enrollment has been more rapid than anticipated.   Back in the spring, when federal officials approved a scaled down version of the changes the WI Dept. of Health Services (DHS) had been seeking, it appeared that about 17,000 adults would lose their BadgerCare coverage in 2012-13 (based on the Legislative Fiscal Bureau’s summaries of the DHS cost-savings assumptions). However, as we noted in a blog post a few weeks ago, the department’s 2013-15 budget request notes that DHS now assumes those policy changes will reduce enrollment of parents and caretakers by about 21,500 by the end of the current fiscal year.Fortunately, any negative effects on children are minimized and indirect because federal officials concluded that the Affordable Care Act’s maintenance of effort provisions don’t allow them to approve policy changes that reduce eligibility of children or restrict their participation (such as premium increases). As a result, DHS was unable to make proposed changes that it had estimated would have caused more than 29,000 kids to lose their BadgerCare coverage. (Read more about the proposed and approved changes here.)

In August, all of the decrease in BadgerCare participation was among adults, while enrollment of children grew by about 800. However, even though the drop in adult enrollees slowed significantly in September, the number of kids in BadgerCare fell by about 1,100 last month. It’s unclear at this point whether that could partially reflect some economic gains that may have caused a small upturn in employer-sponsored coverage last month; or perhaps it’s because some of the parents who are no longer able to afford BadgerCare premiums for their own coverage are failing to sign up for or renew coverage for their children (who aren’t directly affected by the premium changes).

One part of the enrollment decline that is not attributable to the July policy changes is the continued drop in the BadgerCare Core Plan, which serves adults without dependent children. Because of attrition that occurs as people come up for renewal each year or get offers of employer coverage, coupled with the moratorium on new enrollment, the number of Core Plan participants has dropped from more than 65,000 in January 2010 to less than 23,000 now, and ABC for Health reports that there are more than 145,000 people on the Core Plan waiting list.   

We will continue to monitor the enrollment data each month and to seek policy changes that mitigate the increases we anticipate in uninsured Wisconsinites and uncompensated care costs that are shifted onto other health care consumers.

Jon Peacock