Data shows most who lost Medicaid coverage in Wisconsin didn't buy insurance through exchange

MarketsAssociated Press

More than 60 percent of the people in Wisconsin who lost state Medicaid coverage earlier this year did not purchase private insurance through the online marketplace, according to official data released Wednesday.

Gov. Scott Walker has defended his administration's attempts to reach out to the nearly 63,000 people who lost coverage under the more limited income requirements he put in place.

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But the new numbers released by the Department of Health Services fueled criticism from opponents who argue it was wrongheaded of Walker to reject federal money for expanded coverage.

"It's disappointing because it didn't need to happen," said Bobby Peterson, executive director of ABC for Health, a nonprofit law firm in Madison that helps people get health care. "It's disappointing because you hope more people would have made it into the marketplace."

Coverage ended in April for 62,776 people who earn too much to remain on Medicaid; they had until June 1 to buy the federally subsidized insurance offered through the exchange, an online marketplace where applicants can shop for plans.

The new DHS numbers show that 30 percent, or nearly 19,000 people, purchased a plan through the exchange by the June deadline. Nearly 5,900 more, or 9 percent, became Medicaid eligible and received coverage through the state's BadgerCare Plus program, or were enrolled in both Medicaid and the exchange.

But the majority of people, 61 percent or about 38,000, did not get coverage through Medicaid or the exchange.

The new figures are disappointing and reinforce the concern that the marketplace is not a viable option for many low-income families who would be covered by Medicaid if Walker would accept the federal funding, said Jon Peacock, research director for the Wisconsin Council on Children and Families.

Plans sold on the exchange are private but subsidized by the federal government based on a variety of factors, including the applicant's income.

Those 38,000 may be uninsured or they could have purchased a private plan not sold on the exchange, obtained coverage through an employer, or gotten on their spouse's insurance, said state DHS Secretary Kitty Rhoades.

She cautioned that because of those unknowns, the figures did not give a complete picture of the choices made by people who lost Medicaid coverage under the enrollment qualification changes.

DHS remains committed to working with community partners to help low-income people find insurance, said Deputy Secretary Kevin Moore at a news conference. The next open enrollment period for the federal exchange begins Nov. 15 and runs until Feb. 15.

Under Walker's changes, only those earning less than the poverty level — $11,670 for an individual and $23,850 for a family of four — qualify for Medicaid. The federal money he rejected would have expanded coverage to everyone earning up to 138 percent of poverty.

But Walker also expanded Medicaid coverage to all childless adults, ending a waiting list to get onto that program. His administration reported Wednesday that 97,509 additional people had obtained Medicaid coverage in the year through the end of June.

Walker has promised to cut in half the number of uninsured people in Wisconsin, which stood at about 556,000 in March. About 166,000 people became covered through insurance by June 1 of this year, the state Insurance Commissioner's office reported, but it wasn't known how many of them were previously uninsured.

Of that number, nearly 134,000 became covered through plans purchased on the exchange, the office said based on a survey of insurance companies.

"We're well on our way toward reaching the governor's goals," said Deputy Insurance Commissioner Dan Schwartzer.

Walker has touted his approach as he runs for re-election this year, and considers a 2016 bid for president, pointing to a recent Kaiser Family Foundation report that found Wisconsin is the only state without a gap in coverage.

But Walker's Democratic opponent, Mary Burke, said in a statement that his decision to reject the Medicaid expansion was "irresponsible and political."

"And yet again, we see the cost, 38,000 likely without health care," Burke said.


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