Shortly before Christmas, Governor Walker signed a bill that delays the major changes to BadgerCare (contained in the biennial budget bill).  The following changes, which were originally supposed to take effect on January 1, are being delayed by the Special Session bill until April 1:

• Reducing eligibility for parents and caretakers, as well as childless adults in BadgerCare Core, to the poverty level.
• Extending BadgerCare to all childless adults below the poverty level (i.e, ending the waiting list for childless adults below that income limit).
• Ending the option for unsubsidized BadgerCare coverage for children in families over 300% of the poverty level.
• Making children between 200% and 300% of the poverty level eligible for the full range of BadgerCare services, rather than the more limited range now offered in the BadgerCare Benchmark Plan.
• Moving about 16,000 childless adults now in BadgerCare Core into the regular BadgerCare plan, with its broader range of health care services.

The Special Session bill also delayed until April 1, 2014, the implementation of new standards for measuring income and family size (known as Modified Adjusted Gross Income or MAGI).  However, a new bill that DHS will ask legislators to vote on in the next few weeks will accelerate that change – putting it into place on February 1 for new applications from parents and caretakers. That bill will also accelerate to Feb. 1 the reduction of the income ceiling to the poverty level for new applications from parents and caretakers, but not for existing BadgerCare participants.  (You can find my thoughts about the pros and cons of that bill in this Dec. 31 WCCF blog post.)

Although the key changes to BadgerCare Plus (BC+) have been delayed, a number of less significant changes took effect on January 1.  The BC+ changes that have now been initiated include the following:

Expanded eligibility for former foster care youth – Youths who were in foster care, subsidized guardianships or court-ordered kinship care when they turned 18 will be eligible for BC+ up to age 26, starting January 1.  It doesn’t matter what state the youth was residing in when the youth turned 18.

Pregnancy verification – Verification of pregnancy, the due date, and the number of fetuses is no longer required for BC+ and BC+ Prenatal. These items should not be questioned, unless there is other information that contradicts the applicant’s statement.

Restrictive re-enrollment period (RRP) — This period will now be 3 months for children who fail to pay a premium.  After the 3 month RRP is served, the arrears will be forgiven. Children will also have the option to re-enroll within the 3 month period as long as they pay all premiums due and request to re-enroll prior to the end of the RRP.

Residency — An individual can be considered a resident of Wisconsin if they are physically present in the state and have entered Wisconsin with a job commitment or seeking employment, whether or not they are employed at the time of application.

Verification of citizenship/immigration status — Applicants (and people coming up for annual review) will have 95 days to provide verification of citizenship and/or identify after this verification is requested.

Definition of lawful presence – The state is implementing new federal policies that clarify and expand the meaning of “lawful presence” in the US, as it relates to Medicaid and BC+ eligibility of children under the age of 19, young adults under age 21 residing in an Institute for Mental Disease (IMD), and pregnant women.

Much more detail about each of those six changes can be found in a recent DHS Operations Memo.

Jon Peacock