As we have indicated before, the budget bill contains a provision that would end BadgerCare coverage of pregnant women over 133% of the federal poverty level. As introduced, the bill would make those women eligible for prenatal care via the current coverage for “unborn children,” which is known as BadgerCare Plus (BC+) Prenatal.

WCCF sent a letter Tuesday to DHS Secretary-elect Kitty Rhoades explaining why we think it’s extremely important not to curtail the current BadgerCare coverage for pregnant women. The letter thanks Secretary-elect Rhoades for her your assurances at the March 20 Joint Finance Committee meeting that it is not the intent of DHS or the Governor to diminish BadgerCare coverage of pregnant women. However, until that part of the budget is fixed, we want to be sure that policymakers understand why it’s so important to preserve the current coverage for pregnant women. Perhaps the biggest drawback of BC+ Prenatal is that it relies on fee-for-service care. In addition to generally being more expensive, fee-for-service care is problematic because women in some areas of the state have difficulty finding an obstetrician who will take new Medicaid patients, and that can be an impediment to receiving timely prenatal. Shifting away from managed care for pregnant women is also likely to undermine the important progress the state has been making in promoting medical homes to improve prenatal care and reduce expensive premature births.

The letter explains a number of other ways that BadgerCare is better than BC+ Prenatal, including the following:

• Express enrollment – Unlike BadgerCare Plus, BC+ Prenatal does not allow the use of express enrollment, and that difference can interfere with access to timely prenatal care.
• Continuous eligibility – In contrast to BC+ Prenatal, which can end anytime that a change in circumstances means that a woman no longer meets eligibility standards, BadgerCare Plus gives a pregnant woman continuous eligibility throughout her pregnancy.
• Post-partum care – The switch to BC+ Prenatal and increased reliance on fee-for-service care could preclude many women from getting post-partum care.

In short, moving pregnant women out of the regular BadgerCare Plus coverage is likely to adversely affect many women by using more expensive fee for service care and by causing delays and interruptions in prenatal care.  It would undermine the progress our state has been making to ensure healthy birth outcomes and reduce the need for very expensive neonatal care.

We will continue to track this part of the budget closely to be sure that DHS and the Governor follow through on their promises to protect BadgerCare coverage for pregnant women.

Jon Peacock