Department Of Health Services Will Hold Town Hall Meetings On Changes To BadgerCare Plus

MADISON—The Department of Health Services today announced town hall meetings that will be held around the state as part of the submission process for a new BadgerCare Plus Demonstration Project Waiver. The waiver is part of Governor Walker’s entitlement reform initiative and will allow Wisconsin to provide health care coverage through BadgerCare Plus to all adults with no dependent children between ages 19 and 64 and who have incomes that do not exceed 100% of the federal poverty level.

“Governor Walker’s entitlement reform initiative will be the first time that all Wisconsin citizens will have access to affordable health care,” said Wisconsin Medicaid Director Brett Davis. “We expect a significant reduction in the number of uninsured adults in Wisconsin as a result of the Governor’s efforts.”

Governor Walker’s entitlement reform plan was approved and signed into law on June 30, 2013 as part of 2013-2015 biennial budget. The Governor’s plan is scheduled to be implemented at the same time that the federal health insurance exchanges and the majority of the PPACA-related changes are implemented. The Department of Health Services is working with the federal government to get the federal approval needed to make these changes.

Wisconsin’s current BadgerCare Plus Core Plan for Adults Without Dependent Children Demonstration Project waiver expires on December 31, 2013. After it is approved by the federal government, the new BadgerCare Plus Demonstration Project Waiver will become effective January 1, 2014 and will provide coverage to individuals who:

Are between ages 19 and 64 years old,

Are not pregnant or parents or caretaker relatives of children under age 19,

Are not otherwise eligible for full benefit BadgerCare Plus or Medicaid,

Are not entitled to Medicare,

Meet all Medicaid non-financial requirements like citizenship and identity, SSN, etc., and

Have a gross income that is calculated using the federally-mandated Modified Adjusted Gross Income (MAGI) methodology that includes a 5% disregard and does not exceed 100% FPL.

The waiver will implement the following changes to BadgerCare Plus:

  • All BadgerCare Plus members will receive health care coverage through the BadgerCare Plus Standard Plan,
  • Eliminate the BadgerCare Plus Core Plan annual enrollment fee and monthly premiums,
  • Remove the current enrollment cap for childless adults under 100% FPL, and
  • Require all parents and caretaker relatives who qualify for transitional medical assistance (TMA) to pay a monthly premium.

The Department will hold three public information sessions to provide information about the BadgerCare Plus Demonstration Project Waiver and to collect comments from the public regarding the waiver request. All public comments will be communicated to the United States Department of Health and Human Services as part of the final waiver request. The Department intends to submit the waiver request to the Centers for Medicare and Medicaid Services (CMS) on August 9, 2013.