Health care advocates got some good news this week – albeit for a part of BadgerCare coverage that few people realized was at risk.  A Wisconsin State Journal article by David Wahlberg sums up the story:

“Gov. Scott Walker’s proposed budget would reduce Medicaid coverage for many pregnant women, but state health officials say that wasn’t his intent, and full coverage will be maintained”

WCCF and others noticed soon after the budget bill was introduced that it would limit eligibility for regular BadgerCare coverage of pregnant women to those below 133% of the federal poverty level (FPL), instead of the current 300% income cap. However, because none of the budget summary documents from the executive branch mentioned the change, we pressed state officials to explain what their intent was. And we were extremely relieved when they said Thursday afternoon that the Governor wants to maintain existing coverage for pregnant women. As we understand it, the language in the budget bill wasn’t intended to exclude all the women above the 133% level from prenatal coverage. Although the bill would have made those women ineligible for BadgerCare, “unborn children” would have been eligible, making the women eligible for “pregnancy-related” services through the BadgerCare Plus (BC+) Prenatal program – which currently serves pregnant women who haven’t lawfully resided in the U.S. for at least five years.

The BC+ Prenatal program has a number of drawbacks (compared to BadgerCare), including that it could limit the scope of coverage, restrict eligibility for women with offers of employer coverage (that they often aren’t able to afford), put a larger portion of pregnant women into more expensive “fee for service” care, and cause delays and interruptions in coverage that can be problematic for the women and the state.

For a number of years, Wisconsin has been able to use Children’s Health Insurance Program (CHIP) funds for the BC+ Prenatal program, which saves the state money because the federal matching funds rate is much higher. Apparently, DHS thought the state could save some money by moving more pregnant women into that program, but they were mistaken about those savings. CHIP funds can only be used for prenatal coverage when a state expands eligibility.

After realizing that moving thousands of pregnant women into BC+ Prenatal would have weakened their coverage and wouldn’t yield the higher CHIP matching rate, Walker Administration officials reversed course and pledged to protect the current coverage for pregnant women. We applaud them for that decision.

Read more in the State Journal article.

Jon Peacock