CMS Announces Approval Of Key Changes To Wisconsin's Badgercare Program

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pediatrics / Children's Health
Article Date: 29 Nov 2007 - 4:00 PST

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The Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), Kerry Weems, announced that Wisconsin received approval to make important changes to BadgerCare, the State Children's Health Insurance Program (SCHIP) in Wisconsin. These changes reflect the state's ongoing efforts to restructure the BadgerCare program and its financing.

Congress is currently considering legislation that would reauthorize SCHIP nationally. CMS has urged Congress to focus legislation on enrolling poor children first, to eliminate SCHIP funding for adults and to strengthen requirements to avoid displacing private insurance coverage with SCHIP. The Wisconsin proposal was approved because it was consistent with these principles.

'Today's announcement shows how CMS and states can work together to ensure that children in low-income families have access to health insurance,' said Weems.

With the approved changes, Wisconsin will be able to enroll children in families of four making up to $51,625 or 250 percent of the federal poverty level (FPL). The state initially had proposed expanding coverage to 300 percent of the federal poverty level, or $61,950 for family of four. However, to remain within the August 17, 2007, guidelines released by CMS to prevent 'crowd out' of private health insurance coverage at higher income levels, Wisconsin modified its request to seek approval to provide coverage to children in families earning up to 250 percent of FPL.

Wisconsin's program also addresses 'crowd out' in SCHIP by requiring a waiting period prior to a family signing up for BadgerCare. Families that previously had access to employer-provided health insurance would be required to satisfy a longer period of uninsurance before signing up for BadgerCare. Additionally, Wisconsin has already moved two-thirds of the adults covered by BadgerCare into their Medicaid program and has agreed to move the remainder of adults off of the program.

'We are making good progress in moving adults from SCHIP to Medicaid and focusing the program on poor children first,' said Weems. 'We look forward to continuing to work with Congress on SCHIP reauthorization."

Wisconsin estimates that, through this expansion, an additional 7,600 children will be enrolled in BadgerCare. The state reported covering 56,627 children in low-income families in Fiscal Year 2006, and also estimates that about 92 percent of children below 200 percent of the federal poverty level have health insurance.

Centers for Medicare & Medicaid Services