BadgerCare Work Requirement Waiver Blocked - Paycheck

BadgerCare Work Requirement Waiver Blocked

Wisconsin’s Medicaid program, BadgerCare Plus, came into existence to help provide affordable health care insurance for Wisconsinites whose incomes were up to 185 percent of the federal poverty level. It has gone through various iterations under both Republican and Democratic governors in the state.

            BadgerCare made national news in 2013 when then-Governor Scott Walker declined promised federal funds under the newly minted Affordable Care Act (ACA) to expand Medicaid. Concerned that the federal government would at some point fail to pay the 90 percent of the cost it promised and in opposition to the ACA, the governor stuck with BadgerCare for those under the poverty line.

            According to, by May 2020 of the COVID-19 pandemic, enrollment in BadgerCare expanded to 175,893 non-disabled adults without minor children. That’s up by nearly 23,000 people. According to a 2020 study published by the Robert Wood Johnson Foundation, if the state did accept Medicaid expansion funds and opened to enrollees whose incomes are at or below 138 percent of the federal poverty level, 120,000 more people would be eligible for Medicaid in Wisconsin. It would drop the state’s uninsured rate by 16 percent. Wisconsin’s spending would drop if it were to accept the federal funds to expand Medicaid.

            The implementation of changes to the program that were proposed by the Walker administration in June of 2017 has been delayed due to COVID-19. These changes would have affected childless adults ages 19-64. One of the changes for which the state sought a waiver from Centers for Medicare and Medicaid Services (CMS) was requiring adults without children to work at least 80 hours per month. When Walker lost the governor’s race to Democrat Tony Evers, before leaving office he signed legislation that blocked Evers from changing the work requirement.

            In February, President Joe Biden’s administration blocked Walker’s work requirement for the program. On February 12, CMS informed Wisconsin’s Medicaid division that its waiver for the work requirement was withdrawn. That waiver had been in effect until 2023. Erik Gunn reported for Wisconsin Examiner that the requirement will likely be scrapped altogether.

            “CMS has serious concerns about testing policies that create a risk of a substantial loss of health care coverage in the near term,” the CMS notification read. “The COVID-19 pandemic has had a significant impact on the health of Medicaid beneficiaries.”

            According to Gunn, Wisconsin health care advocates welcomed Biden’s decision. They believe that the requirement violates the objectives that undergird the federal Medicaid program.

            “Medicaid is a lifeline to millions of people across the country—people with disabilities and older adults, low-income people who are working low-wage jobs and kids,” William Parke-Sutherland, health policy coordinator for a state family policy advocate group Kids Forward, told Gunn. “These kinds of bureaucratic red-tape-like work verification requirements make it harder for people to access health care. Especially in a global pandemic…”

            The US Supreme Court has scheduled a hearing of a similar Medicaid requirement in Arkansas in March. Federal courts have struck down such cases in New Hampshire and Kentucky. Stay tuned, Wisconsin.

Georgia Beaverson

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