Fact check: Is everyone living in poverty covered by Medicaid in Wisconsin?
Wisconsin Governor Scott Walker
May 31, 2017
By Cory Eucalitto
At a recent event to promote Wisconsin tourism, Republican Gov. Scott Walker was confronted by Outagamie County Executive Tom Nelson, a Democrat, about his decision to not expand Medicaid under the Affordable Care Act. In response, Walker claimed, “Everyone living in poverty for the first time in our state's history is now covered under Medicaid in the state of Wisconsin."[1]
Is Walker correct that everyone living in poverty in Wisconsin is now covered under Medicaid?
Yes. All adults in Wisconsin with incomes up to 100 percent of the federal poverty level, and all children in households with incomes up to 300 percent of the federal poverty level, are eligible for health insurance coverage through Wisconsin's BadgerCare Plus program.[2]
Background
Scott Walker is serving his second term as governor of Wisconsin and previously served four terms in the State Assembly. He announced his campaign for the presidency on July 13, 2015, and suspended the effort two months later.
Tom Nelson is the county executive of Outagamie County, Wisconsin.[3] He represented District 5 in the State Assembly from 2005 to 2010 as a Democrat, and in 2016 he made an unsuccessful bid to represent the state’s 8th Congressional District.
Walker visited Appleton, Wisconsin, to promote state tourism on May 5, 2017, which was one day after the U.S. House passed the American Healthcare Act by a vote of 217-213. Nelson interrupted the event to press Walker on whether he would support the GOP plan, and he criticized the governor for not expanding Medicaid in the state under the Affordable Care Act.[1]
On the GOP bill, Walker said, “I'm going to wait for what the Senate and the President do and see from there." In defense of his own record on healthcare he said, “Everyone living in poverty for the first time in our state's history is now covered under Medicaid in the state of Wisconsin."[1]
Wisconsin Medicaid eligibility
BadgerCare Plus is Wisconsin's health insurance program for low-income residents.[2] Funding is split between the state and the federal government, with 58.5 percent of expenditures funded by federal Medicaid dollars in fiscal year 2016.[4]
Walker is correct about BadgerCare Plus eligibility requirements. Individuals are eligible if they are a Wisconsin resident, a U.S. citizen or qualifying immigrant, and meet one of the following criteria:
- An adult with income at or below 100 percent of the federal poverty level.
- A child age 18 or younger with family income at or below 300 percent of the federal poverty level.
- A pregnant woman with income at or below 300 percent of the federal poverty level.
- A young adult under age 26 who was in a foster home, court-ordered care, or subsidized guardianship when they turned 18.[2]
The Federal Poverty Level (FPL) is an income measure set annually by the U.S. Department of Health and Human Services (HHS). The following table shows the current Federal Poverty Level by both annual and monthly incomes.[5][6]
| Federal Poverty Level Annual and Monthly Income Levels, 2017 | ||
|---|---|---|
| Family size | Monthly income | Annual income |
| 1 | $1,005.00 | $12,060 |
| 2 | $1,353.33 | $16,240 |
| 3 | $1,701.67 | $20,420 |
| 4 | $2,050.00 | $24,600 |
| 5 | $2,398.33 | $28,780 |
BadgerCare Plus eligibility waiver
Medicaid program eligibility in Wisconsin has changed over time. Before 2014, BadgerCare Plus coverage was available primarily to all uninsured children, pregnant women with incomes up to 300 percent of the FPL, parents with incomes up to 200 percent, and other smaller populations.[7]
Childless adults with incomes at or below 200 percent of the FPL were also eligible, subject to an enrollment cap. Enrollment for this group opened in July 2009 but was closed three months later after surpassing budgetary limits. Those still seeking coverage were placed on waiting lists that included more than 157,000 people by August 2013.[8][9]
As of 2014, states have had the option under the Affordable Care Act to expand Medicaid eligibility to all individuals with household incomes up to 138 percent of the FPL. Federal funding pays for most of these enrollment increases.[10][5][11]
Wisconsin’s current eligibility criteria are the result of a waiver from federal requirements that the state received from HHS.[12] Under the 2014 waiver, Wisconsin changed its eligibility criteria to include all adults with incomes at or below 100 percent of the FPL without an enrollment cap. BadgerCare Plus continues to cover pregnant women and children in families with incomes up to 300 percent of the FPL.[12][9]
Conclusion
Wisconsin Gov. Scott Walker was recently pressed by Outagamie County Executive Tom Nelson for his position on the American Health Care Act. Defending his record as governor, Walker said, "Everyone living in poverty for the first time in our state's history is now covered under Medicaid in the state of Wisconsin."[1]
Walker is correct that the state's BadgerCare Plus program covers all adults with incomes up to 100 percent of the federal poverty level and all children in households with incomes up to 300 percent of the federal poverty level.
See also
- Fact check/Did 14.5 million gain health insurance through Medicaid expansion?
- American Health Care Act of 2017
- Medicaid
Sources and Notes
- ↑ 1.0 1.1 1.2 1.3 WBAY, "WATCH: Governor, Outagamie Co. Executive get into spat over health care," May 5, 2017
- ↑ 2.0 2.1 2.2 Wisconsin Department of Health Services, "ForwardHealth: Your Connection to Health Care Coverage and Nutrition Benefits, Enrollment and Benefits," February 2017
- ↑ Outagamie County, "County Executive Office," accessed May 16, 2017
- ↑ The Henry J. Kaiser Family Foundation, "Federal and State Share of Medicaid Spending," accessed May 16, 2017
- ↑ 5.0 5.1 HealthCare.gov, "Federal Poverty Level (FPL)," accessed May 16, 2017
- ↑ Wisconsin Department of Health Services, "BadgetCare Plus Federal Poverty Levels," accessed May 16, 2017
- ↑ These include parents with children in foster care with incomes up to 200 percent of the FPL, youth (ages 18 through 20) aging out of Wisconsin’s foster care system, and farm families and other self‐employed parents with dependent children with incomes up to 200 percent of the FPL.
- ↑ University of Wisconsin Population Health Institute, "Evaluation of Wisconsin's BadgerCare Plus Core Plan for Adults without Dependent Children," accessed May 16, 2017
- ↑ 9.0 9.1 The Henry J. Kaiser Family Foundation, "Wisconsin's BadgerCare Program and the ACA," February 25, 2014
- ↑ Originally, the law called for withholding the entire federal share of Medicaid payments from states that refused to expand eligibility. However, on June 28, 2012, the U.S. Supreme Court ruled that threatening to withhold the entire federal share of Medicaid from states that did not expand Medicaid was unconstitutionally coercive. SCOTUSblog, "Court holds that states have choice whether to join medicaid expansion," June 28, 2012
- ↑ The federal government would cover 100 percent of the new costs from 2014 through 2016, 95 percent in 2017, 94 percent in 2018, 93 percent in 2019, and 90 percent in 2020 and beyond.
- ↑ 12.0 12.1 Medicaid.gov, "State of Wisconsin, Medicaid 2014 Waiver, 1115 Demonstration Project Application," November 10, 2011
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