Medicaid reform is working
As we work with our partners in Washington on the best plan to ensure that Medicaid is sustainable for the long-term, there are many common sense reforms we can move forward with now, so we can best serve those living in poverty and who need access to affordable health care.
Under our Wisconsincentered approach to Medicaid reform that was implemented in 2014, everyone living in poverty in the state has access to affordable health care. Everyone. Just a few years ago, that was not the case.
Our current reform proposal is aimed at helping more people get healthy, and get back into the workforce, which is why BadgerCare (Wisconsin’s Medicaid) was created in the first place.
In 1999, BadgerCare (Wisconsin’s Medicaid) was launched under thenGov. Tommy Thompson as a health care safety net to help people transition from welfare to work. Here in Wisconsin, we continue to believe in helping one another, particularly in hard times.
However, as Gov. Scott Walker often says, government assistance should be a trampoline, not a hammock.
BadgerCare covers low-income populations, including children, pregnant women and parents, but it was not until 2009 that the previous administration in Wisconsin offered enrollment to the population we refer to as “childless adults” — those between the ages of 19 and 64, who do not have dependent children living in the home.
In 2009, under thenGov. Jim Doyle, Wisconsin created an open-ended entitlement — offering childless adults (living at or below 200% of the federal poverty level access to a limited benefit plan known as the BadgerCare Plus Core Plan. Unfortunately, it was an ill-fated offer for most. Overwhelmed by enrollment, unaffordable costs and a reluctant insurance community, the adminiable stration was forced to cut off enrollment in just a few short months. Enrollment never reopened, and by December of 2013, there were 161,721 childless adults on a waiting list for health care benefits the previous administration promised, but couldn’t deliver or afford.
More recently, Walker’s approach to Medicaid prioritized BadgerCare eligibility, ensuring coverage for those who need it most — people living at or below 100% of the FPL. Under this plan, beginning in 2014, for the first time in Wisconsin history, childless adults were offered access to full, not limited, Medicaid benefits under BadgerCare. The waiting list was eliminated.
With government assistance providing the benefits to those who truly need them, it is time to take the natural next steps and help our neighbors who are able to work to transition from dependence on government assistance to true independence. These are simple, common sense reforms that are standard in the nongovernmental health coverage sector and will prepare our childless adult population for successful transitions:
Pay Premiums: Since our goal is to help people move back into the workforce, under the proposed reform we are asking childless adults — who historically have had no options for health care coverage — to pay a premium for their health care benefits, ranging from $1 to $10 per month, depending on income. This will prepare people for the private market, and eliminate the “eligibility cliff” that can deter people from working, or increasing their income, for fear of losing benefits. These premiums will be reduced for those who engage in healthy behaviors — such as wearing a seat belt, not smoking and maintaining a healthy weight, to incentivize healthy living and control health care costs in the long run.
Worker Training: Childless adults who are physically and mentally to work are also being asked to participate in a worker training program, or work at least 20 hours per week, much like those seeking assistance under FoodShare. Wisconsin has invested more than $50 million in our FoodShare Employment and Training (FSET) program to help eliminate barriers to employment. No one grows up with the dream of living off of the government, and this program is designed to help people reach financial independence. These employment and training services are free, and already have helped more than 18,000 people in Wisconsin move into the workforce.
Drug Screening: Finally, under our Medicaid reform, we are asking childless adults who are seeking BadgerCare to submit to a drug screening and, if necessary, a drug test. We have seen the devastating effect substance abuse can have on families of all income levels, and we are committed to a multifaceted approach in the fight against addiction. In addition, we have heard from employers all across the state who cannot find enough qualified workers who can pass a drug test. For those who need it, we will help them get treatment, regain their health, and enter the workforce.
This week, we learned the unemployment rate in Wisconsin is down to 3.4% — the lowest it has been since 2000. We must invest in our people so they can fill those jobs and get on the path to independence and prosperity.
As a leader in efficiency and innovation, we in Wisconsin believe all states should have the flexibility to manage resources and design programs to best serve their residents. We will continue to lead the way in Medicaid reform, and build on our model to ensure everyone has the opportunity to move beyond government dependence to true independence.
Linda Seemeyer is secretary of the Wisconsin Department of Health Services.