There was good news and bad news from the Department of Health Services (DHS) Wednesday – but mostly it was very disappointing news.

The good part is that DHS released the data that Senator Baldwin and others have been seeking, as I explained in a blog post on Tuesday.  That data is from a cross match of state and federal computer files, to determine how many of the adults who lost their BadgerCare eligibility in April have gotten covered through the new health insurance Marketplace.   I commend DHS for doing this important analysis, and I hope it’s the first of several steps to understand what the state’s policy choices are meaning for low-income households.

The bad news is the substance of the data – confirming the fears of health care advocates and providers who argued to state lawmakers last year that the federal Marketplace would not cover a large percentage of the people who lost their BadgerCare coverage. 

Here are the findings of the DHS analysis, regarding what happened to the 62,776 adults who were sent notices in March that they were losing their BadgerCare eligibility on April 1:

• 18,801 (30%) selected a qualified health plan through the Marketplace by June 13.
• 5,859 (9%) were able to get back on (or remain on) BadgerCare or Medicaid.  (That includes almost 1,000 whose status is uncertain because they also appear to have been approved for a Marketplace plan.)
• 38,116 (61%) aren’t in the Marketplace, BadgerCare or Medicaid, and their insurance status is unknown.

Another way to look at the data is to exclude the 5,859 people who were able to stay on or requalify for BadgerCare or Medicaid (or who were “flagged” as being cover in BadgerCare and the Marketplace).  That’s how the Journal Sentinel analyzed the data, in their article that says (correctly) that one-third of the adults who lost their BadgerCare coverage were insured in mid-June through the Marketplace.

There are a number of reasons why the Marketplace isn’t a workable option for many low-income parents and adults without dependent children:

• For some people, especially those near the poverty level, the combination of premiums, copays and deductibles is unaffordable.
• Some simply don’t have checking accounts or credit cards and aren’t able to pay monthly premiums.
• Others are ineligible for the federal subsidies for Marketplace coverage because of a glitch in the Affordable Care Act that excludes spouses and children from receiving the premium tax credits if another family member has access to an affordable employer-sponsored plan.  (If Congress wants to improve the ACA, many people think that “family glitch” should be at the top of their “to do” list.)

DHS points out that people who lost their BadgerCare coverage may have other insurance options besides the federal Marketplace.   That’s a legitimate point, though I’m not optimistic that a very large portion of the roughly 38,000 people whose status is unknown have gotten private insurance outside the Marketplace.  I hope the state will engage in a more comprehensive analysis that will resolve that important question.

In sum, the findings released today are very disappointing, but not unexpected. The fact that only a third of the adults who lost their BadgerCare eligibility are insured through the Marketplace will make it harder to reach the Governor’s goal of cutting in half the number of uninsured Wisconsinites.  Let’s continue to analyze the data and then reconsider the options for reaching and surpassing that goal.

Jon Peacock