As we wait anxiously for the Supreme Court to issue their decision on the Affordable Care Act (ACA), we know that children and families in Wisconsin are already benefiting from the law. It is important to recognize these ways in which the ACA is already making an impact and what could be lost if the Court strikes down the whole law. Over the next couple weeks, the WisKids blog will do just that – by highlighting what we think are the top ten ways children and families in Wisconsin are already benefiting from the health care reform law.

#1: Maintenance of Effort

This little known and seldom talked about provision of the health care reform law has played a huge role in Wisconsin families’ ability to continue accessing affordable coverage, so we ranked it as a top benefit.BadgerCare is Wisconsin’s cost-effective and award winning Medicaid program for families. It provides quality health insurance coverage to over 776,000 Wisconsinites, but over the past year the program’s coverage success has been in jeopardy.  Changes proposed by the WI Department of Health Services (DHS) would have caused more than 29,000 children to lose their BadgerCare coverage. Fortunately, there is a stability of coverage provision in the ACA – the maintenance of effort (MOE) requirement – that is protecting health care for these families.

It was because of the MOE provision that the federal government denied the bulk of DHS’ proposals, and preserved coverage for children in BadgerCare.  MOE requires that states maintain eligibility and enrollment processes that were in pace when health reform was enacted (March 2010), for adults until the Medicaid expansion in 2014, and for children until 2019. The one exception to the MOE requirement is for adults above 133% of the federal poverty level, if a state can certify that it is facing a budget deficit. Wisconsin has done so, and the BadgerCare changes that DHS has been allowed to make will apply just to this population. To read more about these approved changes, see our overview and our Q and A on the topic.

The maintenance of effort requirements are intended to preserve coverage during the implementation of the law, and as the economy is still recovering – and they are doing just that here in Wisconsin.

Sara Eskrich