An additional 180,000 people in five other states could lose coverage because they are in experimental versions of Medicaid that expire this year and may not be renewable under the new law.
Wisconsin’s Gov. Scott Walker (R) says his approach would restore Medicaid as a program that exclusively serves people in poverty, while enabling the near-poor to make the transition from “government dependence.”
“We’re not talking about pushing people out onto the streets,” he said during his budget address to the legislature Feb. 20. “We are talking about empowering people to control their own destiny.”
Wisconsin’s Medicaid program is among the most expansive in the nation, in some respects even more generous than the higher standard envisioned in the health-care law. Adults with children are eligible if they earn up to twice the federal poverty level — or up to $47,100 for a family of four — as are some childless adults in that income range.
Walker’s proposal to the Republican-led legislature would set the cutoff at the federal poverty line — $23,550 for a family of four — but cover all adults, including those without children, with incomes up to that point.
As a result, tens of thousands of childless adults would gain Medicaid coverage. But many more Wisconsin residents who have Medicaid would lose it: 95,000 adults, nearly all of them parents, whose incomes are above the officially defined poverty level.
Those people with incomes a few notches above poverty will be able to use new subsidies provided by the law to buy private plans on insurance marketplaces — called “exchanges” — that the law sets up in each state starting in 2014. And Walker’s staff projects that, once the subsidies are taken into account, the premiums that the poorest families would pay would be as low as $19 a month.
However, consumer advocates contend that the private plans are likely to charge co-pays and deductibles that will prove out of reach for many low-income families.
“It’s extremely disappointing and surprising that while other states are making progress toward improving access to health coverage for low-income people, we would decrease their options,” said Jon Peacock, research director for the Wisconsin Council on Children and Families.
Bethany King worries about the impact on her family. King, 31, who launched a handyman business with her husband several years ago in a Madison suburb, said they have struggled to support their two young children on their erratic earnings.
Her client base is growing, and King said she expects the enterprise to be in good shape in a few years. But she estimated that her family’s income will barely top $25,000 this year. And month-to-month revenue has been so variable, she said, there have been times, “we’ve literally had to sell our things to make ends meet — you know, eBay-ed off our TV set.”