BadgerCare toolkit Fact sheet

BadgerCare FACT sheet

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  • How many people lost health care coverage by Wisconsin not taking federal funding for BadgerCare?

A total of 87,400 residents statewide were denied access to BadgerCare. While some of them were able to enroll in coverage at Healthcare.gov, many weren’t able to get coverage at all.

  • Why aren't those who cannot get BadgerCare not being covered by ObamaCare?

Federal Medicaid funds for BadgerCare are actually part of ObamaCare. When the law was passed it was assumed that the most effective and efficient way to cover these individuals was through Medicaid (BadgerCare). The health care marketplace was never designed to be affordable for those who should have received BadgerCare because the out of pocket costs & deductibles make it far too expansive for this group.

  • Why can Wisconsin still accept federal funding for BadgerCare?

The option to reject federal Medicaid funds was originally never up to states, the Supreme Court gave them that power when it ruled on the ACA. So the funds are forever there whenever want them, and likewise Wisconsin could opt out again if it ever stopped being a good deal for us.

  • How much federal funding is available for BadgerCare?

The federal funds keep coming as long as they are needed, just like Medicare. Estimates show that from 2014-2021 $2.4 billion would enter Wisconsin

  • What are the incomes of people impacted?

People who make between 100-133% of the federal poverty line. That comes out to be for individuals: $11,490-$15,282 a year, for a family of four it is between: $23,550-$31,322 a year. And so on.

  • Why is there a health care “coverage gap” in Wisconsin?

Of the 87,400 denied access to BadgerCare, 63,000 were kicked off of the program by the Governor. Those individuals only had 60 days to sign up for private coverage. We learned that over 60% of those (38,000) were unable to enroll in a private plan on Healthcare.gov.

  • I heard this decision impacts private health insurance rates, why is that?

Insurance companies can no longer discriminate against people because of age, gender or preexisting conditions, but they can look at the “average” health of the community. This is known as a “risk pool”. The 87,000 people denied BadgerCare are actually not subject to the ACA’s “individual mandate”, as it was assumed in the law they would be in BadgerCare. So because of that, and because of the high costs of the plans for them, only the people who know they need health insurance will bother to get it. Those who are healthy won’t see the benefit of paying out the nose. This is referred to as “adverse selection”. Insurance companies see that, and to compensate, they raise their rates for everyone. The average Wisconsin residents is charged ~$251 more by their insurance company per person per year because of the Governor’s decision. States like Minnesota that did accept the funds pay far less than Wisconsin.

  • How much is this decision costing Wisconsin?

The state estimates show that Wisconsin is spending $206 million more in this state budget alone to cover fewer people. If Wisconsin had accepted the federal funds over $561 million would have entered the state.

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