State News

Trump administration approves parts of new state healthcare plan mandating additional requirements for coverage

Trump administration partially backs Walker’s changes to BadgerCare including increased premiums and work requirements for low-income recipients.

Image By: Betsy Osterberger

The Centers for Medicare and Medicaid Services approved Wisconsin’s request Wednesday to impose job requirements, increase premiums and benefit length restrictions for low-income Medicaid recipients with no dependents.

Although the agency did not approve the state’s request to require drug screenings, drug and risk assessments can be administered by health care providers as a part of a member’s treatment plan according to the Wisconsin Department of Health Services.

BadgerCare enrollees under the age of 50 earning between $6,070 and $12,060 would have to undergo job training, do community service or be employed 80 hours per month to receive benefits according to the waiver.

Under the plan, an enrollee would lose coverage for six months if they have not worked for four years.

Gov. Scott Walker lauded the proposed change to healthcare coverage in the state.

“We want to remove barriers to work and make it easier to get a job, while making sure public assistance is available for those who truly need it," Walker said in a statement Wednesday.

Recipients at 51 to 100 percent of the federal poverty level would pay a monthly premium of $8 and $8 copays for unwarranted emergency room visits. The copay can be reduced through factors including self-reporting of healthy behaviors and two-person households demonstrating healthy-behaviors.

The nonprofit group Kids Forward is concerned the proposed policy will negatively impact state Medicaid recipients.

“By making it much more difficult for low-wage workers to maintain their BadgerCare coverage, these policy changes will be an impediment to workforce participation,” the group said in a statement.

Other organizations including the American Lung Association voiced their concern over people possibly losing their health coverage.

“The American Lung Association believes everyone should have quality, affordable health coverage, including Medicaid enrollees. The policies approved by CMS today does not further that goal,” the ALA said in a statement.

The plan will take about a year to implement according to the Wisconsin Department of Health Services.

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