(St@teside Published January 23, 2007)

Wisconsin:

The rising cost of health insurance and the uninsured will feature significantly in the current Wisconsin legislative session. Starting with his State of the State address in 2006, Governor Jim Doyle (D) has pressed forward with several related proposals to expand coverage. Governor Doyle also created the Healthy Wisconsin Council in July 2006 to develop policy options to significantly reduce the uninsured in the state. The Council released its final recommendations in January 2007 and many of the solutions proposed by the Council concur with Governor Doyle's health policy vision.

BadgerCare Plus: Building on the success of Wisconsin 's BadgerCare Program, an SCHIP program that covers children and parents to 185 percent FPL, Governor Doyle has proposed BadgerCare Plus to merge Family Medicaid, BadgerCare, and Healthy Start to cover the following populations:

• All children: Currently, BadgerCare covers children up to 185 percent of the federal poverty level (FPL); the new proposal would expand benefits above the previous income ceiling and create a sliding scale so all children would have access to insurance; 
• Pregnant women eligibility increases from 185 to 300 percent FPL; 
• Parents and caretaker relatives covered up to 200 percent FPL;
• Youth (ages 18-20) aging out of foster care regardless of income;
• Parents with children in foster care up to 200 percent FPL; and
• Farmers and other self-employed parents up to 200 percent FPL.

Simplification is a key component of the proposal. BadgerCare Plus would simplify eligibility by switching to a gross income test with two deductions, utilizing presumptive eligibility for certain children and pregnant women, and replacing the current multitude of coverage groups with only three groups: children, pregnant women, and adults.

Covered populations, who earn less than 200 percent FPL, would receive the current Medicaid benefit package. For those individuals who earn above 200 percent FPL, the state would develop a benchmark plan based on the largest, low-cost, commercial plan available in the state plus additional wrap-around benefits such as early childhood development services. Premiums and co-pays would apply for some populations subject to the 5 percent of family income rule.

Healthy Wisconsin: Like many other states, Wisconsin 's employer-sponsored insurance (ESI) rate has dropped. In 2001, 76 percent of Wisconsin residents received insurance through their employers but, by 2004, that figure had declined to 69 percent. The drop in ESI has been particularly acute for firms that employ less than 50 workers. To attempt to stabilize the small group market, Healthy Wisconsin Council has recommended establishing a state-subsidized reinsurance pool for the entire small group market and health insurance purchasing cooperatives but target the subsidy to the smallest low-wage firms. In addition, the Council has recommended expanding Medicaid to cover childless adults up to 200 percent FPL.

Comprehensive Reform: The Healthy Wisconsin Council also recognized that recommendations for important incremental steps should serve as building blocks for future reforms. As such, their final recommendation was to urge the Governor to adopt a comprehensive health care reform to provide broad coverage and lower health care costs.