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ACA in Wisconsin, ACA: Medicare & Medicaid, Healthcare in Wisconsin

Number of uninsured Americans drops, but will Wisconsin’s rates rise?

Thanks to the Affordable Care Act, Medicaid, and CHIP, the number of uninsured Americans dropped!

Even as the country continues to feel the effects of the recession (which officially ended in 2009), the number of uninsured Americans dropped by 1.2 million in 2011, the last year for which Census data is available.  According to the Kaiser Commission on Medicaid and the Uninsured, public medical assistance programs such as Medicaid and the Children’s Health Insurance Plan (CHIP) were the main contributors to the decline from 18.5% to 18% rate of uninsured, even though the overall population increased.  Currently, around 8.8% of adults and 29.9% of children are insured through public coverage programs in the nation.

The provision in the Affordable Care Act which allows children under 26 years old to stay covered under their parents’ insurance contributed to the sharp decrease in the number of uninsured in the 19-25 age category.  In addition, the ACA also froze the eligibility levels of states’ Medicaid and CHIP plans until 2014 for adults and 2019 for children.  Therefore, even with the continued effects of the recession and economic strain, states have continued to provide additional Medicaid and CHIP coverage to residents, even as the total number of individuals covered rose greatly because their income dropped below the eligibility level.

According to the Kaiser Family Foundation, “estimates of the ACA suggest that it will have small but generally positive effects on ESI [Employer Sponsored Insurance]” and overall will make insurance coverage more stable, especially during recessions and job losses as individuals transition between ESI, private insurance, and Medicaid.

But, will the rate of uninsured Wisconsinites rise?

While Governor Walker believes his plan to renovate the eligibility for Medicaid will end up reducing our state’s uninsured population by half, it will end up creating greater gaps in care.  In his budget, Walker proposes moving 89,000 parents off of BadgerCare and into the Marketplace, and allowing 82,000 newly eligible childless adults to take those open spots.  The logistical difficulties of moving where 160,000 Wisconsinites get their health insurance will likely end up leaving individuals behind.

Yet, it could be argued that not paying for additional adults to be covered through BadgerCare saves the state money.  However, it ends up costing hospitals money in uncompensated fees when uninsured people use medical services, and even now uncompensated-care costs keep rising in Wisconsin.  This is why the Hospital Association recently suggested postponing the implementation of Governor Walker’s proposed changes to BadgerCare eligibility for 2-3 years.

The Hospital Association believes that the Marketplaces will not be an appropriate method of coverage for low-income Wisconsinites, and additionally speculates that these exchanges will not be ready by early next year for the large number of adults moved off of BadgerCare.  This would leave tens of thousands of low-income individuals without any insurance options after they’ve been removed from BadgerCare.

Expanding BadgerCare with federal funding would eliminate much of this problem.  According to the Legislative Fiscal Bureau, Wisconsin could save around $44 million in state money by preserving current BadgerCare eligibility for parents and adding childless adults up to 133% FPL just through 2015, like the Hospital Association suggests.  However, refusing to fill the gaps in BadgerCare (as Walker has done) will end up costing Wisconsin millions more in the long run than expanding the program.

medicaid hospital association infographic

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  1. Pingback: Enrolling in ObamaCare in Wisconsin: Part 2 | - May 2, 2013

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