Republican state legislators have proposed two bills they claim will strengthen Wisconsin’s workforce, but taking away health care from Wisconsinites struggling to get by will make our state sicker not stronger. These changes will create more barriers that make it harder and more complicated for people to keep their coverage, and they will exacerbate existing racial inequalities in our health care system. They would likely disproportionately harm Black and Latinx Wisconsinites who have been hard hit by the COVID-19 pandemic. All people need access to health coverage and health care now more than ever.
Everyone who works full-time should be able to keep themselves and their family healthy, put food on the table, and a roof over their head. However, far too often jobs pay too little and don’t offer affordable health insurance, leaving people with few options. BadgeCare provides affordable, comprehensive health coverage to low-income adults, parents, and children. But because Wisconsin lawmakers have failed to expand BadgerCare, many people who should qualify do not. For example, a single adult with a full-time minimum wage job, makes too much to qualify for BadgerCare. A single parent with one child making a little less than $9 per hour (assuming a 40-hour work week) doesn’t qualify for BadgerCare.
Instead of expanding BadgerCare so more people can work more hours without risking losing access to health care, legislators seem to imply that they can address the workforce shortage by taking away people’s access to affordable health coverage. Fewer people with access to health care will make the workforce sicker and less healthy. People need to be healthy enough to go to work.
The first bill would disqualify some adults from their BadgerCare coverage for six months if they turn down any offer for a full-time job, increase in hours, or wage increase – even if that job doesn’t offer health insurance that the worker can afford, has hours they can’t make work, or is totally unsuitable for their circumstances. In fact, this bill puts no restrictions on the type of job, level of compensation, or benefits that someone would be forced to accept or else risk losing their BadgerCare eligibility.
There are many reasons why people would refuse to accept a job offer or increase in hours, such as transportation, childcare, work environment, safety concerns, etc. It would be nearly impossible to prove the reason that someone decided not to accept an offer of employment. Nonetheless, someone might have to try to prove that they didn’t turn down a job to stay on BadgerCare or else risk losing their coverage. The pandemic has upended life as we know it and many hard-working Wisconsinites have had to step in to fill gaps in care for children, grandchildren, elderly parents, or others impacted by the pandemic.
Another bill creates costly and unnecessary red tape and hoops people will have to jump through to renew their BadgerCare coverage. It would require some adults covered by BadgerCare to submit twice as much paperwork in order to renew their coverage, punish them for not reporting changes in circumstances fast enough, and forbid the state from using one of the best tools they have to make sure people have uninterrupted health insurance coverage.
Both of these proposals would worsen racial inequities and would likely have a disproportionate impact on Black, Indigenous, and Latinx Wisconsinites, despite the fact that the majority of people covered by BadgerCare are white. These bills would make it harder and more complicated to operate the program. They would require more paperwork, more phone calls, more bureaucracy, and these burdens would fall hardest on people already experiencing health disparities, facing access barriers, and dealing with racism and discrimination. A 2021 report from the Office of Management Budget found that barriers making it harder for people to access public benefits, such as BadgerCare, worsen inequity.
These bills would also increase churn, where state agencies disenroll someone and then that same person is re-enrolled within 12 months. According to an October 2021 report by the Medicaid and CHIP Payment and Access Commission (MACPAC), Wisconsin already has some of the highest rates of churn in the country. More than 12 percent of enrollees are disenrolled and then re-enroll within 12 months. That report also finds that Black enrollees are more likely to be impacted by churn, and needlessly lose coverage more often than their white counterparts. This is another example of how proposals like these that increase administrative burdens can be expected to have an inequitable impact on Black Wisconsinites. Further, language accessibility barriers when using websites, reading communications, and interacting with income maintenance workers would also make it more likely that people who speak a language other than English would be impacted by increased renewals and also needlessly lose coverage.
Despite how they are being spun, these proposals would likely increase the number of people who are uninsured, and do little to address the worker shortage in our state. If the legislature wants to strengthen the workforce, it should help address real barriers to work such as affordable childcare, transportation, and access to broadband. It should recognize that in order to move forward as a state, we need to confront and help mitigate our state’s stark racial inequities in health care access, employment, and economic security.
Scapegoating low-wage Wisconsinites who are fighting to take care of themselves and their families will not strengthen our workforce or move Wisconsin forward. It will make us all weaker and more vulnerable.
William Parke-Sutherland