Exciting News from Wisconsin – For Kids Nationwide – Say Ahhh! A Children’s Health Policy Blog

jon's photo.jpg

By Jon Peacock, Wisconsin Council on Children and Families 

It hasn’t gotten much attention yet, but at an April 11
meeting in Madison
, Secretary Sebelius delivered some great news for children
in Wisconsin and across the nation. 
Following a small meeting about benefits of the health care reform law
for women, Sebelius met with a few reporters and was asked whether the
Department of Health and Human Services (HHS) would waive the Affordable Care
Act’s maintenance of effort (MOE) requirements for Wisconsin.  Sebelius responded that HHS will NOT
approve MOE waivers for any states:  

“That isn’t something that will happen in Wisconsin
or any place else,” she said. “We are eager to work with states for
ways to save money but also to keep the most vulnerable people with the health
care that they need.  Short-term
money saving often ends up with a less productive workforce with folks coming
in through the doors of the emergency room with no payment system at all. That
leads to more uncompensated care and higher cost for disease.  It’s a lose-lose situation.”  (Source: Tim Stumm, Wisconsin Health
News, April 12)

The question arose here because the Walker Administration
submitted an MOE waiver request late last year that would have resulted in more
than 64,000 people losing their BadgerCare coverage, including over 29,000
children. (See my previous blog post for details.)  It’s been pretty clear for several months that HHS was not
going to approve most of the proposed changes affecting kids, but the
Secretary’s statement on Wednesday removes any lingering doubts about the
department’s interpretation that the health care reform law prevents states
from weakening current eligibility standards and enrollment practices for all
children, and also for adults below 133 percent of the poverty level.

Wisconsin will still be allowed to make some of the other
changes to BadgerCare
.  HHS has
made it clear that they will grant plan amendments allowing the state to raise
premiums for adults over 133 percent of the federal poverty level (FPL) and to
deny eligibility to those adults if they have an offer of employer coverage
with premiums that are less than 9.5 percent of family income.   Those changes, which do not
require an MOE waiver (because the state has certified that it has a deficit),
are expected to result in roughly 17,000 adults losing their BadgerCare
eligibility or dropping out of the program because of higher costs. 

Although we are still very concerned about the changes
that Wisconsin’s Department of Health Services will be allowed to make, it’s a
huge relief that this set of changes won’t apply to children and will preserve
BadgerCare coverage for about half of the parents who would have lost that
coverage if the state’s original waiver request had been approved.  And the Secretary’s remarks Wednesday
are tremendous news for children and parents in other states where policymakers
are contemplating similar changes.

As we celebrate the ways that the ACA has already
improved access to health care, let’s not forget the extremely important
contribution of the law’s MOE requirements.   They have ensured a stable source of affordable health
care coverage for America’s children during tough economic times and helped
bring the uninsured rate for children down to a historic low. 

Scroll to Top