During the past couple months, health care advocates have been working hard to ensure public input is gained before the Wisconsin’s Department of Health Services (DHS) makes any changes to Medicaid – including Wisconsin’s BadgerCare program. DHS announced their plan for over $500 million in cuts to BadgerCare and Medicaid on September 30, 2011 after being granted authority to do so – with limited legislative oversight – in the biennial budget earlier in the year.
In order to impose some of the cuts, however, Wisconsin must be granted a waiver from the federal government – a provision we can thank “ObamaCare” (the Affordable Care Act) for. These maintenance of effort (MOE) provisions place an extra hurdle on states wanting to make changes to enrollment or eligibility levels in state Medicaid programs. In the case of Wisconsin proposals, the proposed DHS changes could harm tens of thousands of hard working people in the state.
Under “ObamaCare” the MOE provision prevents states from the following:
- Implementing cuts to eligibility levels
- Increasing premiums or enrollment fees
- Adding more restrictive policies for enrollment (e.g., more proof of income than currently required or freezing enrollment in a program)
This means that the MOE requirements under “ObamaCare” require states to maintain their current eligibility levels for Medicaid programs until the state insurance marketplaces (Exchanges) are fully operational (see our blog on where Wisconsin currently stands in the development of the state marketplaces) – unless granted an MOE waiver from the federal government.
Although approval for DHS’s requested waivers was arbitrarily due by years end, the federal government has stated that they are taking more time to fully evaluate the requested waiver and have so far not made a decision. While advocates hope to see the waiver rejected – as it will adversely affect more than two-fifths of BadgerCare enrollees – current state law states that, if the waivers are not approved, 53,000 adults would need to be terminated from the program on July 1, 2012. The Walker Administration has recently expressed a willingness to avoid their self-imposed scenario of removing 53,000 adults. This, as well as other recent developments – including a reduced budget shortfall projection and a $24.5 million bonus payment from the federal government – provide the Administration and legislature with an opportunity to go back to the drawing board with regard to the proposed MOE waiver.
Thankfully, the MOE provisions afforded to us by “ObamaCare” slowed down damaging changes to BadgerCare. Wisconsinites need real cost-savings, not just cost-shifting resulting from higher numbers of uninsured.