Urban Institute Fills in Details about the 181,000 Adults Expected to Gain Eligibility

The Urban Institute estimates that 181,000 Wisconsinites would gain eligibility for BadgerCare if the state takes advantage of the opportunity provided by the Affordable Care Act (ACA). A report they issued with the Robert Wood Johnson Foundation (RWJF) early this month examines the make-up of the population that could gain coverage if Wisconsin uses the federal funding that would cover almost all of the cost of the adults who would be newly eligible for BadgerCare coverage, beginning in 2014.

Their analysis focuses on adults under 138% of the federal poverty level (FPL) who are potentially Medicaid eligible (i.e., adults ages 19-64 who are either citizens or immigrants who have lawfully resided in the U.S. after at least 5 years). The new RWJF/Urban report expands upon the figures from earlier Urban Institute reports, which I summarized in the July 31 Wisconsin Budget Project outline of the costs and benefits of using the Medicaid opportunity in the ACA to close the gap in BadgerCare coverage. Some of the highlights of their latest estimates include the following:

• All of the newly eligible Wisconsinites are in the category generally referred to by the somewhat misleading term “childless adults” – i.e., adults who are the primary custodial parent of a dependent child age 18 or younger. (I prefer the term non-custodial adults.) 
• Of the estimated 181,000 uninsured non-custodial adults, four-fifths (145,000) are below the poverty level, and under the ACA that group won’t be eligible for premium subsidies for coverage purchased through the health insurance exchanges (which is one of the reasons why closing the BadgerCare gap is so important). 
• An estimated 77% are non-Hispanic whites, almost 10% are black, and about 7% are Hispanic. 
• More than three-fifths (62%) are men. Women comprise only 35% of the newly eligible adults ages 19 to 44, but are almost 47% of those 45 to 64. 

A few things should be kept in mind when considering the Urban Institute findings:

• Their estimates are based on augmented data from the 2010 American Community Survey (ACS), which the Urban Institute adjusts to account for the under-reporting of public coverage (plus other minor adjustments made by the U. of Minnesota to account for family relationships). 
• Since 2010 there has been a sharp drop in the number of non-custodial adults in Wisconsin who are covered by BadgerCare (either the Badger Core Plan, or the unsubsidized BadgerCare Basic coverage that serves a small portion of the nearly 136,000 adults on the Core Plan waiting list). 
• The 2010 Family Health Survey data recently released by the WI Dept. of Health Services (DHS) suggests a much lower number of uninsured, low-income childless adults. (See our July blog post for a discussion of the divergent estimates.) 

Census Bureau survey data on insurance status in 2011 is slated to be released in September: the Current Population Survey (CPS) on Sept. 12 and new ACS data about a week later.  I hope those data sources, particularly the ACS, will give us an even better assessment of the number of uninsured adults in Wisconsin who could benefit from closing the gap in BadgerCare coverage.

Jon Peacock