DHS Unveils New Webpage to Solicit Comments on Medicaid Cost-Cutting

The Department of Health Services (DHS) unveiled a new webpage Monday that contains descriptions of some of their Medicaid cost-cutting plans and provides an online mechanism for the public to submit comments on the department’s proposals. Thus far, most of the measures described there are the ones approved by the Legislature in the biennial budget bill, such as capping enrollment in the Family Care program. 

In addition to containing specific cuts like the Family Care cap, the biennial budget bill directs DHS to cut at least $444 million in state and federal funding from Medicaid and BadgerCare. The three new measures posted on the webpage Monday would save an estimated $15 million (including $6 million of GPR funding). As an Associated Press article by Scott Bauer notes, that amounts to just 3 percent of the additional (“unspecified”) cuts that the department must find. We’ll be checking the new website frequently for updates that reveal how DHS proposes to achieve the other 97% of the unspecified cuts.

Stable for Years, Poverty Skyrockets in Wisconsin

The number of Wisconsinites living in poverty jumped significantly between 2008 and 2010, new figures from the Census Bureau show. Between those years, the poverty rate in Wisconsin increased from 10 percent to 13 percent, and an additional 163,000 Wisconsinites slid into poverty. To put that number in perspective, the number of additional people living in poverty represents a population greater than the entire city of Green Bay. For a family of four, the 2010 poverty line was $22,050.

Wisconsin’s overall poverty rate (13 percent) is still lower than the U.S. average (15 percent), as shown in the chart below. But both the state and national poverty rates have climbed precipitously since 2008. This trend is especially troubling considering that the recession officially ended in June of 2009. Given that the economy made modest gains in 2010, one would hope that the number of people living in poverty in 2010 would level off at a rate similar to 2009. Unfortunately that didn’t happen.

Household Income in Wisconsin Plummets During Recession

Since the recession, Wisconsin household income has plummeted, according to new figures released yesterday by the Census Bureau. Between 2006 and 2010, median household income in Wisconsin dropped by about $3,600, or 7 percent.

In yesterday’s blog post, we discussed how child poverty rose faster in Wisconsin than it did nationally. The same trend is played out in the median household income statistics. Back in 2006, Wisconsin’s median household income was actually about $250 higher than the national average, and we ranked 19th among the states.

Health Care Cuts in the President’s Deficit Reduction Plan

The deficit reduction plan unveiled by President Obama on Monday would cut health care spending by an estimated $320 billion over the next 10 years. About $248 billion of that total would come from Medicare, and $72 billion would be cut from Medicaid. This blog post summarizes the major aspects of those spending cuts and attempts to put them in a broader perspective.

Although a number of the proposed changes are very worrisome for health care providers and advocates (see, for example, the Families USA statement opposing the Medicaid cuts), there are some positive aspects of the plan as a whole -- atl least when it is analyzed relative to other options that have been on the table or are likely to emerge. Those more positive aspects include:

• The President said he would only approve cuts to Medicaid and Medicare if they are coupled with tax increases on the wealthy, in order to prevent low-income and vulnerable Americans from bearing a disproportionate share of the burden of deficit cutting.
• Coupling entitlement cost-savings with additional revenue will help over the longer haul to protect Medicaid, Medicare and the health care reform initiatives.
• The proposed Medicaid cut is about $22 billion less than the President recommended as part of his budget in April.
• The significant Medicaid proposals are delayed and generally won’t affect Wisconsin until 2014 or later, after the state should start to realize savings from the health care reform law’s more generous matching rates.

Child Poverty Spikes in 2010

The number of children living in poverty rose dramatically in Wisconsin in 2010, according to new figures released today by the U.S. Census Bureau. In 2010, a quarter of a million Wisconsin children lived below the poverty line, about 36,000 more than in 2009.

Unfortunately, the increase in child poverty in Wisconsin is nothing new. It’s part of a troubling longer-term trend dating back to 2008. Between 2008 to 2010, Wisconsin’s child poverty rate rose from 13.3 percent to 19.1 percent. The number of children living in poverty increased by 43 percent between 2008 and 2010. The chart below shows the significant increase in the number of children in poverty in recent years.

Did DCF Violate State Law by Overriding Administrative Rules?

Last month the Department of Children and Families (DCF) made an abrupt and significant policy change to the Wisconsin Shares payments to licensed family child care providers. But in doing so, according to the non-partisan Wisconsin Legislative Council, they neglected to follow legal procedure. The new policy was released as an "operations memorandum" even though it directly "contradicts the current rule." In order to comply with the law, DCF needs to make such changes through promulgating an administrative rule.

Rep. Tamara Grigsby points this out in a press release dated 9/20/11. She argues that the Department should "cease its implementation of an illegal policy change". The above rule that is affected by DCF's policy change states that a provider may be paid on an attendance basis "if the agency has documented three separate occasions where the provider significantly overreported the attendance of a child" or “if the schedule of child care to be used is expected to vary widely.” However, the new payment scheme applies to ALL family child care, not just in instances of serious and repeated fraud or a widely varying child care schedule.

WCCF and the Early Learning Coalition agree that the new policy, implemented without hearing or consultation with the child care community, is unfair and damaging to licensed family child care providers and to the families they serve. We encourage the Department to reconsider this legally questionable and unnecessary policy change. We fear that in the Department’s zeal to address fraud they are punishing honest, conscientious child care programs serving the low-income families in Wisconsin Shares.

Daithi Wolfe

New Census Bureau Data Shows Poverty Holding Steady in WI Amid Big National Increase, But Household Income Continues to Shrink

Today the U.S. Census Bureau released data from its Current Population Survey (CPS) on poverty, household income, and health insurance coverage. Nationally, more people are living in poverty--46.2 million in 2010--than at any other time since the federal government began estimating poverty 52 years ago. The national poverty rate jumped from 14.3% in 2009 to 15.1 last year, the highest national poverty rate since 1993 and the fourth consecutive yearly increase. The child poverty rate rose from 20.7% in 2009 to 22.0% in 2010.

Census Data Shows BadgerCare Has Filled the Gap for Many Families and Individuals Who Lost their Job-Based Coverage Due to the Recession, However 504,000 Non-Elderly Wisconsinites Still Lack Insurance Coverage

As WCCF noted in a press release today, the U.S. Census bureau released the Current Population Survey (CPS) data this morning, showing that more Americans are living in poverty -- 46.2 million in 2010 -- than at any other time since the federal government began estimating poverty 52 years ago. The national poverty rate jumped from 14.3% in 2009 to 15.1% last year, the highest national poverty rate since 1993 and the fourth consecutive yearly increase. The child poverty rate rose from 20.7% in 2009 to 22.0% in 2010.

Though we mention it at the end of the release, the health insurance coverage data from the CPS is not insignificant. The recession and its aftermath have also reduced the number of people who are covered by employer-sponsored health care insurance. An estimated 504,000 non-elderly Wisconsinites (10.6%) lacked health insurance in 2009-10, according to the new CPS data, an increase of about 31,000 since 2007-08, when 9.8% were uninsured. (The Census Bureau averages two years of CPS data in order to make the estimates more reliable.)

Wisconsin Scores 5th in the Nation on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers

A first of its kind report by AARP, The Commonwealth Fund, and The Scan Foundation measured state-level performance of long-term services and support (LTSS) systems providing assistance to older people and adults with disabilities.  The report is called “Raising Expectations: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers.” 

Across the four dimensions, Wisconsin scored 5th.  However, the report emphasizes that all states have room for improvement and that public policies play an important role in those improvements. If Wisconsin were to improve to the level of the top performing state, 9,542 more low- or moderate-income adults with activity of daily living disabilities would be covered by Medicaid and 6,057 more new users of Medicaid LTSS would first receive services in home and community based settings, instead of nursing homes.

A Wisconsin Patients’ Bill of Rights

This afternoon, WCCF was pleased to participate in the announcement of the WI Patients’ Bill of Rights. Sponsored by Rep. Jon Richards and Sen. Jon Erpenbach, this bill looks for common ground around health care reform by addressing the pro-consumer measures from the Affordable Care Act (ACA), on which there is very broad public support, and on which there should be broad bipartisan agreement in the Legislature.

New Report Examines Joblessness in Wisconsin

The Center on Wisconsin Strategy (COWS) has released a report called The State of Working Wisconsin -- Update 2011, which examines the increased rates of unemployment and underemployment in Wisconsin and the disparate impact those problems on particular sectors of the workforce. Read more in the Wisconsin Budget Project’s Labor Day blog post.

Jon Peacock

Health Care Advocates Call for More Balance on Health Reform Working Groups

Two consumer advocacy groups issued a press release this afternoon calling Insurance Commissioner Ted Nickel’s newly identified membership of the health insurance exchange work groups “unacceptable.” Under the Affordable Care Act, states are required to establish health insurance exchanges as an important tool for consumers of all abilities to get health insurance and certain Medicaid/BadgerCare Plus services.

GOP Governors Renew Push for More Authority to Restrict Medicaid

The Republican Governors Association (RGA) released a report Tuesday (Aug. 30) detailing 31 recommendations for loosening federal Medicaid standards, in order to give states far more autonomy in determining who is eligible and what they are eligible for. The report, titled A New Medicaid: A Flexible, Innovative and Accountable Future, has been endorsed by 30 GOP governors and territorial leaders, including Governor Walker.

As an Associated Press/ Washington Post article reported Wednesday, the RGA report says that “Medicaid should be custom-designed by each state to best provide care to children, the poor and disabled without federal rules and the waivers required to get around them.” The recommendations include longtime GOP priorities such as repealing the health care reform law's “maintenance of effort” requirement that places restrictions on the ability of states to cut their Medicaid rolls.