The standards for determining BadgerCare eligibility changed in a couple of significant ways this week.  Although the major eligibility changes (reducing the income limits for parents and improving coverage for adults without dependent children) have been delayed until April 1, the following two changes have just taken effect:

• The federal government’s annual adjustments to the poverty level – updating those standards for inflation – were released a couple of weeks ago and took effect for BadgerCare purposes on Feb. 1.  (You can find the 2014 standards here.)
• Wisconsin has now begun using the Affordable Care Act (ACA) definitions of income and family size for new BadgerCare applications.

The ACA standards – known as Modified Adjusted Gross Income or MAGI – were supposed to be put into place in Wisconsin in November, to apply to BadgerCare coverage in 2014.  However, those particular computer software changes couldn’t be easily separated from the other eligibility changes that were planned for January 1.  When DHS decided to delay the major BadgerCare changes until April 1, state officials said they would also have to delay the MAGI changes.  We were very concerned about that because the state would have been making decisions at odds with federal law (such as over-counting the income of parents receiving child support), and those inconsistencies would have created a great deal of confusion.

DHS subsequently decided that it wanted to take over from the federal government the primary responsibility for determining BadgerCare eligibility of people who apply for insurance through the federal Marketplace.  Federal officials refused to allow the state to approve the request unless the state put in place the software changes enabling it to apply the MAGI standards to new applicants.  The state has accomplished that and began this week to use those new income and family size definitions.

Returning to the topic of the 2014 federal poverty levels (FPL), WCCF has prepared a one-page document that shows those figures for different family sizes and translates them into the key percentages of the FPL for purposes of BadgerCare and the Affordable Care Act.  It includes the monthly and hourly amounts, as well as the annual figures, and it explains the relevance of different percentages of the FPL.

Another one-pager describes the key dates over the next few months relating to BadgerCare changes, the federal Marketplace, and the individual mandate in the ACA.  As that document (Be Aware of the Ides of March…) explains, one of the changes that just took effect this week is that kids in BadgerCare in families over 200% of FPL are being moved into the Standard Plan, which includes more comprehensive benefits.

Jon Peacock