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‘Grinch’ law leaves 80,000 without coverage

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News Superior,Wisconsin 54880 http://www.superiortelegram.com/sites/all/themes/superiortelegram_theme/images/social_default_image.png
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‘Grinch’ law leaves 80,000 without coverage
Superior Wisconsin 1226 Ogden Ave. Ste. 1 54880

BadgerCare recipients have three extra months to sign up for health insurance under a law adopted Thursday by the Wisconsin Senate and signed Friday by Gov. Scott Walker.

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“Scrooge wouldn’t have come up with this idea,” Sen. Bob Jauch, D-Poplar, said of the “Grinch” proposal.

The new law leaves more than 80,000 childless adults in what one local insurance agent calls a “black hole.” They’ll be unable to get coverage until April 1.

“This bill gives the federal government more time to fix major issues with the Affordable Care Act, and it gives Wisconsinites more time to make a logical health care transition,” Walker said.

After rejecting federal money to expand Medicaid, the law creates a tradeoff. It gives 72,000 BadgerCare recipients time to register with the health care marketplace, but it forces about 83,000 childless adults who earn at or below poverty level to wait an extra three months to get on Medicaid.

Figures provided by the Legislative Fiscal Bureau show the extension could save $23.1 million on health programs, the Milwaukee Journal Sentinel reported last month.

When Walker originally floated the idea of extending BadgerCare to give participants time to work their way through the federal insurance market, which had a troubled rollout, Jauch was ready to applaud it. Then he realized it would come at the expense of the poorest of the poor after the state rejected expanding Medicaid.

“I think what the governor’s doing is sinful,” Jauch said. “To deny 80,000 of Wisconsin’s most economically vulnerable citizens health care so they can subsidize health care for people who make more. It just defies common sense and logic for the governor to use the poorest citizens as a bank to pay for his proposal.”

Local impact

As legislators grappled with the law over the past few weeks, area consumers and those who serve them have had to navigate the changing health care landscape.

“It does change on a daily basis,” said Cary Breitlow, economic support supervisor of the Douglas County Department of Health and Human Services prior to the vote. “My staff has noted clients calling in. They’re frustrated; they’re confused. And we don’t have a lot of great answers for them because we don’t know yet.”

The department has been preparing based on the governor’s decision to extend BadgerCare three months.

“For people receiving services they should not be harmed in this process,” said Pat Schanen, director of the Douglas County Department of Health and Human Services.

It should be status quo, but that doesn’t mean they can relax.

The three-month extension allows these people time to apply through the health care exchange. They need to sign up by March 15 if they want the coverage to start by April 1.

They can apply sooner. It’s their personal decision whether to remain on BadgerCare or jump to the health care exchange right away, Breitlow said.

Some people want to stay on BadgerCare longer because it provides dental coverage while the federal marketplace does not, according to Hilary Neste, resource coordinator with Northlakes Community Clinic.

For those who have signed up on the Affordable Care Act website and gotten a letter saying they’re eligible for Medicaid, it has become a waiting game.

Counties will contact them, but not until things are in place, Breitlow said. The department does not expect to get a list of those who received letters until February. And, of course, they can’t get added to BadgerCare until April 1.

There are exceptions to this rule. The change does not affect anyone on Medicare or Elderly, Blind, Disabled Medicaid, according to LuAnn Tiege of Senior Connections. Those on the Family Care program are not affected, and families with children under age 18 can still apply for Medicaid directly through their county health department. Those with affordable insurance through their job can also disregard the marketplace exchanges.

Before signing up with the exchange, people should check if they are eligible for subsidies.

Only those who make between 100 and 400 percent of the poverty level can receive subsidies. If they don’t qualify for subsidies, they could sign up directly with any of three insurance companies with the help of an insurance agent, said Tim Sauter of Johnson Insurance Consultants.

In a move last week, America’s Health Insurance Plans reported consumers who select a plan by Dec. 23 have until Jan. 10 to pay their first month’s premium, instead of the previous Dec. 31.

Neste said she’s been encouraging those who have applied to the marketplace to contact the insurer, Security Health Plan, directly to make payment arrangements.

Navigators offered other advice to those applying for the exchange. If they find a mistake or problem, applicants can remove the application with the remove button and redo.

The move does not remove the account, just the application.

The process is very quick, Sauter said. “Don’t be afraid to remove it.”

A button also was added so users can upload electronic W-2s, letters and verification forms.

Another health insurance change is the loss of HIRSP, a state high-risk coverage. A one-month federal extension and three-month state extension was approved for the plan, Sauter said. But he encouraged those on HIRSP to make the move to the exchange so they don’t end up paying two deductibles.

Getting help

Those who need help navigating the insurance marketplace website, healthcare.gov, can connect with a certified application counselor at 715-466-2201 in Minong, 888-834-4551 in Iron River, and 715-392-1955 in Superior.

Navigators are also available through the Concentrated Employment Program. Call Tasha Hagberg at 715-635-2175 or Sue Stephens at 715-682-9141.

People can also contact a local insurance agent or the county health and human services department, 715-395-1304.

Those transitioning from Medicaid to the federal health care exchange can visit www.dhs.wisconsin.

gov for fact sheets and information.

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Maria Lockwood
(715) 395-5025
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