Governor's Budget Proposes Dramatic Changes to BadgerCare

As we continue to read over the Governor's proposed 2015-2017 budget, one of the most striking proposals involves drastic changes to BadgerCare  for childless adults.  The proposal requires the Wisconsin Department of Health Services (DHS) to apply for a waiver from the federal Department of Health and Human Services (DHHS) that would allow Wisconsin to implement all of the following changes in regard to childless adults receiving BaderCare :

1. Require such enrollees pay monthly premiums as determined by DHS;
2. Impose higher premiums on enrollees who engage in behaviors that increase their health risks;
3. Limit eligibility to no more than 48 months;
4. Require a health risk assessment for all such enrollees; and
   
5. Require a drug screening assessment and, if indicated, a drug test as a condition for eligibility

If the federal DHHS grants Wisconsin's waiver application, this would be extremely problematic for the childless adults who would be affected.  Remember, only childless adults at or below 100 percent of the Federal Poverty Line (FPL) are eligible for BadgerCare.  To put this in perspective, the current federal poverty line for a family of 1 is $11,770 per year, which certainly doesn't leave much wiggle room to pay for any sort of health care premium after paying for basic expenses.  We also have some indication of the real world impact of imposing premiums on BadgerCare recipients.  When Governor Walker implemented a plan to require premium payments to Transitional Medical Assistance adults earning above 138 percent of the FPL in 2012, there was significant program attrition from the affected enrollees.

In addition to being constitutionally dubious, the drug testing provision will do little to actually help people with substance abuse disorders.  Instead, it will unfairly stigmatize people who need BadgerCare in order to access health care.  For a more comprehensive look at the concerns regarding drug testing applicants for public assistance, see this letter from Community Advocates Public Policy Institute to Governor Walker that was signed by the Wisconsin Alliance for Women's Health.

The proposal to limit eligibility to 48 months is also problematic and would unduly restrict much needed access to health care for many people who have fallen on difficult economic times.  Like the other provisions mentioned above, this change would require approval from the federal DHHS. 

Stay tuned for more updates!  We will continue to provide more in-depth analysis of these BadgerCare provisions and other proposals contained in the budget as we continue to study the Governor's proposal.