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October 2009 St@teside

High Demand Leads Wisconsin to Suspend Enrollment for Low-Income Childless Adults

The BadgerCare Plus (BCP) program in Wisconsin has had many successes in the past two years. Created in 2008 to provide affordable health coverage to parents up to 200 percent of the Federal Poverty Level (FPL), pregnant women between 185 and 300 percent FPL, citizen children up to 300 percent FPL, youth leaving foster care, and farm families and other self-employed parents up to 200 percent FPL, BCP was expanded in July of this year to offer the Core Plan to low-income childless adults  up to 200 percent FPL.

By August of this year, BCP covered nearly 700,000 adults and children. So why has the program been so successful? Experts and administrators point to several facts. Availability of federal funding for part of the program was a key factor. From a policy perspective, Wisconsin simplified the enrollment process by consolidating benefits previously available through a raft of programs and streamlining income and health insurance status verification; made greater use of online enrollment through an innovative Web portal called ACCESS Wisconsin; adopted presumptive eligibility for kids below 150 percent of FPL; and eliminated premiums for children below 200 percent FPL. In addition, those with incomes above the state’s poverty threshold can buy into the program for a fee, which is set on a sliding scale. The state is also establishing an employer registry with health insurance benefits information, in order to have a more efficient way of determining whether employees have access to a qualified health insurance plan, and to improve the premium assistance program. An evaluation of the program is available here.

Unfortunately, as a result of heavy demand for the program, Wisconsin suspended enrollment for the Core plan earlier this month. Upon announcing the suspension, Governor Doyle pointed to the need for national reform, “since we began taking applications we have received 500 to 600 applications each day and more than half of these individuals have no income whatsoever.  I can think of no clearer demonstration of the need for national health care reform. Despite the tremendous work we have done here in Wisconsin, BadgerCare Plus, and state plans like it, are merely bridges to get us to national health reform.”1

Currently, staff are working on designing a proposal to offer a basic level of coverage for those on the Core Plan waiting list.