Advocates wait for details on $500 million in Medicaid cuts

[undeterred]

DAVID WAHLBERG | [e-mail] | 608-252-6125 | @DavidKWahlberg madison.com | | Posted: Monday, September 12, 2011 8:00 am

More than two months after Gov. Scott Walker’s budget called for almost $500 million in cuts to Medicaid over two years, health care advocates wonder when details of the cuts will be made public. Some decisions, such as whether to drop more than 50,000 people from BadgerCare Plus, depend on federal approval of the state’s plans by Dec. 31, a process that can take months, advocates say. The state Legislature’s Joint Finance Committee also must review the plans. “Further delays in the public release of your recommendations are likely to weaken the opportunities for review and comment on the proposals by the Wisconsinites most directly affected by them,” leaders of a dozen advocacy groups wrote last week in a letter to Dennis Smith, secretary of the Department of Health Services.

Stephanie Smiley, health department spokeswoman, said Friday in an email to the State Journal that the plans “will be rolled out in the next few weeks (early fall).” Smiley said the plans will be made public before being sent to the federal Center for Medicare and Medicaid Services. Smith worked for the federal agency before becoming Wisconsin’s health secretary in January. Smith’s plans could significantly alter Wisconsin’s Medicaid programs, which cover almost 1.2 million people, or one in five state residents. The programs — including BadgerCare Plus, Family Care, SeniorCare and other services — cost $6.7 billion a year, with roughly 60 percent coming from the federal government. Walker’s budget added money for Medicaid to make up for the loss of federal stimulus money but also called for almost $500 million in cuts over two years.

Smith has said Medicaid needs to be reined in to be sustainable. Walker is among several Republican governors who have called for Medicaid to be shifted from an entitlement program to a block grant, as was done for welfare in the 1990s. The move would cap state funding for Medicaid and give states more control over the program. In March, Smith told the State Journal the state’s Medicaid cuts could come in a variety of ways: higher copayments or premiums for patients, flat payments to doctors to manage care for complex patients and hospital payments based on quality measures. Smith also said the state will ask the federal government for permission to review patients’ income levels more often to check if they could get private insurance, and to stop payments right away for people no longer eligible for Medicaid.

If the federal government doesn’t approve such changes by Dec. 31, he said, more than 50,000 adults who make more than 1 1/3 times the federal poverty level and aren’t pregnant or disabled would be dropped from BadgerCare Plus next year. The advocates — groups such as the Wisconsin Council on Children and Families, the Coalition of Wisconsin Aging Groups and AARP — wrote such measures “could substantially increase the number of uninsured and underinsured people in our state.” That would lead to more visits to emergency rooms, a cost that would be shifted to other patients, they said.

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