Revised Fiscal Bureau Paper Provides Comprehensive Analysis of Potential Changes to BadgerCare

The Department of Health Services (DHS) has modified some of its proposed changes to BadgerCare during the course of the negotiations with federal officials regarding the requested waiver of federal “maintenance of effort” requirements. Because one or two parts of the DHS revisions are inconsistent with current state law and differ from the proposals previously approved by the Joint Finance Committee (JFC), they trigger the requirement for JFC review.  In particular, the committee needs to approve applying premiums to adults between 133% and 150% of the poverty level, rather than only to families above that income level.

The JFC has scheduled a meeting for this Wednesday, March 14, to consider those changes. Although I expect the changes to be approved easily by the committee, the meeting provides an opportunity for JFC members to question DHS and learn more about the status of the efforts to change BadgerCare. In addition, the scheduling of this meeting prompted the Legislative Fiscal Bureau (LFB) to prepare an updated summary and analysis, which includes both the current and previous changes proposed by DHS.The budget repair and biennial budget bills approved last year allow DHS to make sweeping changes to BadgerCare and Medicaid, even if those changes conflict with current state statutes and regulations, and DHS can make those changes without using the normal rulemaking process. That power shift largely strips the Legislature of its role in shaping BadgerCare; however, there is still one vestige of legislative oversight. Proposed changes that conflict with current state law may be reviewed by the JFC. By longstanding tradition, that “passive review” process means that the committee will hold a meeting on an agency proposal if any committee member objects to the proposal, and at least one member has objected to the revised DHS proposals.

The JFC review process is small consolation for those of us who believe that lawmaking should involve all legislators (and their constituents), but at least the JFC review and involvement of the Fiscal Bureau make additional information available to the public. Last fall, for example, advocates tried unsuccessfully to find out how many people were likely to lose BadgerCare coverage as a result of the changes proposed by DHS. We were unable to get that information directly from the department, but finally got it a couple of days before the JFC meeting in November, when the LFB provided a thorough compilation of the DHS estimates underlying the projected cost-savings.

WCCF is preparing a synopsis of the new 14-page LFB paper, and we will post that on our website on Tuesday. In the meantime, here are a few of the key points from the Fiscal Bureau’s analysis:

• The revised DHS proposals would reduce BadgerCare enrollment by an estimated 22,835 people, including 2,940 children — in contrast to nearly 65,000 people under the original plan.
• The revised MOE-related proposals would reduce BadgerCare spending by $91 million, of which about $36.5 million is state GPR funding (not counting potential savings from the Alternative Benchmark Plan).
• In contrast to the original DHS plan for increasing premiums, which was expected to result in more than 12,100 children losing their BadgerCare coverage, the new plan for raising premiums won’t apply to kids, but is expected to cause a somewhat larger drop in adult coverage (7,595 instead of the previous 7,114).

The JFC meeting will begin at 1:00 p.m. in Room 412 East. The BadgerCare review is the last of seven items on the agenda.

Jon Peacock