DHS Says New Legislation Is Needed to Implement BadgerCare Agreement with Feds

by | December 31, 2013

Home 9 Health Care 9 DHS Says New Legislation Is Needed to Implement BadgerCare Agreement with Feds ( Page 6 )

New Bill Will Hasten the Reduced BadgerCare Income Limit for Parents Applying for Coverage, while Aligning Eligibility Standards

In a December 30th letter to state legislators, the Department of Health Services (DHS) explained that it will soon be proposing new BadgerCare legislation to modify the provisions of the Special Session bill signed into law a week or so ago.  The bill will accomplish the terms of an agreement reached by state and federal officials on Dec. 20th concerning the changes in BadgerCare that will be in place for the next three months.

The primary purpose of the next bill is to remedy a messy administrative problem caused by the Special Session bill.  As I noted in a WCCF blog post, that bill delays by three months the implementation of the provisions of the biennial budget that amend the state definitions of income and households to bring those standards into compliance with the Affordable Care Act (ACA).

The practical effect of the delay created by the Special Session bill is that for the next three months the state and federal computer systems will be using different eligibility standards for BadgerCare – with respect to which income sources are counted, which household members are considered to be part of the family, and probably also for the income ceilings.  That is going to create a great deal of confusion for parents and caretakers who are applying for coverage, and even more confusion for caseworkers and everyone else trying to help people get signed up for coverage.

The agreement reached by DHS and HHS on December 20th (which is attached to the Dec. 30 DHS letter) authorizes the state to maintain existing eligibility standards for currently enrolled parents, caretakers and childless adults until April 1.  In addition, it includes the following provisions relating to new applications:

  • The new federal standards relating to income and family size (referred to as Modified Adjusted Gross Income or MAGI) will be applied to new applications from parents and caretakers beginning on Feb.1.
  • The reduction in eligibility to 100% of the poverty level will also apply to new applicants on Feb. 1 (rather than April 1)..
  • If the terms of the agreement are executed by February 1, HHS will allow the state to take over the primary responsibility of determining BadgerCare eligibility for all applicants, rather than deferring to the federal eligibility determinations that are now being made for people who apply using the federal Marketplace application process.

The bill that DHS will ask legislators to take up in January will advance to February 1, 2014, the date for using the MAGI standards and the 100% income limit for new applications from parents and caretakers.  From an advocates perspective, that has the disadvantage of causing some parents and caretakers (between 100% and 200% of the poverty level) who are applying for coverage after the end of January to be denied BadgerCare and to have to try to get private coverage through the Marketplace a month or two sooner than would be the case under the terms of the Special Session bill.  On the other hand, I think that aligning the state and federal eligibility standards more quickly will remove a lot of confusion that will be present in January because of the Special Session bill’s delay in the implementation of the MAGI standards.

You can read more about the anticipated legislation in this article in today’s Journal Sentinel.  I think the article does a very nice job, although the headline may fuel sentiment that the need for the new bill is just the latest example of ACA problems that have caused the Obama Administration to make or require changes.  In my opinion, that headline is a bit misleading because the point of the bill is to ease the messy administrative problems caused by the hastily approved Special Session bill.

I won’t be surprised if some conservatives use the new legislation as an opportunity to take more shots at the Affordable Care Act.   However, it would be ironic if critics of the ACA overplay their hand by arguing that the new legislation is a federal imposition on the state and a limitation on what legislators were doing in the Special Session bill.  In fact, the new bill implements an agreement between state and federal officials that will actually expedite the process of doing what the Walker Administration has been seeking to do all along – which is to move parents over the poverty level into private coverage.

Jon Peacock

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