Emergency Powers Give Wisconsin Authority to use BadgerCare to Fight Coronavirus

For Immediate Release: March 20, 2020
Contact: Robert Kraig (414) 322-5324 [email protected]

Emergency Powers Give Wisconsin Authority to use BadgerCare to Fight Coronavirus

Federal Emergency Declaration opens new avenues to guarantee everyone is tested and treated without cost sharing, fully covering all uninsured Wisconsinites

Statewide: Under pressure from a number of states seeking to stem the alarming speed of novel coronavirus transmission, the federal government late last week issued emergency regulations that would allow Wisconsin to use BadgerCare to guarantee that everyone in Wisconsin has health coverage during the pandemic. This would dramatically improve Wisconsin’s odds for slowing the coming pandemic by removing a major barrier to seeking testing and treatment. The federal government took similar steps during the H1N1 epidemic and in the aftermath of Hurricane Katrina.

If Wisconsin acts boldly and swiftly, this federal declaration gives the Wisconsin state government new power to slow the speed of the pandemic, and potentially save tens of thousands of lives. According to public health experts, one of the most critical things we can do to protect both the afflicted and the general public is to maximize the number of people with symptoms who immediately seek testing and treatment. COVID-19 is so contagious that delays in seeking medical care can lead to the infection of thousands of additional people. After we have tested and treated everyone with symptoms, and the federal government has addressed the shortage of testing kits, it is essential to test and treat community wide, because the disease is spread by seemingly healthy people without symptoms.

The fear of financially crippling health care bills in the profit-centered American health care system is a grave risk not only to affected individuals and their families but the entire community because it actually discourages people from seeking medical care.

The Coronavirus Relief Act passed by Congress this week guarantees free testing for COVID 19, which is a critical step forward, but is silent on the cost of any treatment for that disease or any other underlying illnesses discovered by testing. Without free treatment, many will be deterred from seeking medical help – especially people who lack health coverage, a rapidly expanding group in an economy experiencing mass layoffs!

A survey of 1,000 Wisconsinites in every corner of the state released last week by Citizen Action, in partnership with the Health Value Hub and the Robert Wood Johnson Foundation, found that nearly half of Wisconsinites have gone without needed medical care because of fear of the cost in the last year! This dangerous situation will be intensified by the large number of people losing their income during the pandemic. The affordability crisis in the American healthcare system is dangerous in normal times; during a pandemic, it is a deadly threat to the health of everyone in Wisconsin!

A preliminary analysis of the new emergency rules by Citizen Action of Wisconsin has identified two major steps Wisconsin can take to use BadgerCare to contain COVID-19. We also propose a third vital step that Wisconsin can take to make sure those who have private health insurance will not be deterred from seeking treatment due to unaffordable copays and deductibles associated with even the best American health insurance plans. Many of these proposals are already being pursued by other states. (The Evers Administration may be developing plans internally that are not yet public which include some of these proposals.)

Step 1: Wisconsin has the authority to propose waivers to the federal government, which can be approved within days of submission. These waivers can make it much easier to enroll in BadgerCare and to retain it, including online and phone enrollment, extension of renewal deadlines, suspension of cancellations, and elimination of barriers such as premiums, copays, work requirements, and many other administrative hurdles. 

Critically, Wisconsin could adopt a “presumptive eligibility” policy that allows medical providers, enrollment staff, schools, and community health centers to enroll people in BadgerCare without any income test if they appear eligible. This is especially helpful in an environment where there are mass layoffs and it would be time consuming to confirm that a family was eligible when unemployment insurance claims are likely to overwhelm the state’s processing capacity. The Coronavirus Relief Act which passed Congress this week increases the federal share of Medicaid costs in Wisconsin to 65.5%, offsetting part of the state cost for expanding BadgerCare enrollment.

Step 2: Wisconsin should immediately expand BadgerCare by accepting the Medicaid Expansion authorized and funded by the Affordable Care Act (ACA). Without ACA Medicaid Expansion, “presumptive eligibility” will not work for many adults who do not fit into specific Medicaid eligible categories and are (or appear to be) above the federal poverty line. In addition, as Wisconsin is losing $340 million in the current state budget because it turned down the ACA Medicaid expansion funding, this revenue could immediately be deployed in the fight to contain COVID-19. Accepting Medicaid Expansion would allow Wisconsin to use presumptive eligibility to get the state close to universal health coverage and to reassure the public that cost should not deter them from seeking COVID-19 testing and treatment. It would also defray some and perhaps all of the state’s costs for increased enrollment resulting from all of the emergency measures we propose.

Step 3: The massive level of cost sharing in most private health insurance plans also deters people from seeking COVID-19 testing and treatment, endangering public health. Our recent statewide survey showed that almost half of respondents had avoided medical treatment and services in the last year, and most of them had health insurance coverage. A number of states already mandated that health insurance plans cover COVID-19 testing and treatment with no consumer cost sharing. So far, Wisconsin has only recommended that insurers suspend copays and deductibles. It would be prudent for Wisconsin to actually ban cost sharing as a danger to public health. If this creates too much of a burden on health insurance and self-insured plans, Wisconsin could also outlaw hospital price gouging by requiring them to accept Medicare rates for all treatment that results from a COVID-19 test. There is no justification for hospitals and medical providers to charge unreasonable prices for their services during this state and national emergency.

“We need bold leadership now more than ever. This unprecedented public health emergency focuses our attention on the reality that we are all interconnected, and that leaving people out of our healthcare system risks the lives of everyone in the community,” said Robert Kraig, Executive Director of Citizen Action of Wisconsin. “Tens of thousands of Wisconsinites who could otherwise have avoided infection may be needlessly put at risk if we don’t come together to assure that no one in Wisconsin delays or avoids treatment because they can’t afford the high cost of healthcare.”


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