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It’s a complicated job: About 1.4 million low-income, elderly and disabled Wisconsin residents who rely on Medicaid for health care — and whose eligibility for the program went unchecked for more than three years because of COVID — must reapply for those benefits.
Reviewing whether about one in four Wisconsin residents still qualify for Medicaid is so complex that the state Department of Health Services (DHS) will do it over a 12-month period. The snail-mail and outreach process started in June and will run through May 2024.
June results are in, and they can be interpreted in different ways.
DHS Secretary-designee Kirsten Johnson called the June totals “preliminary” but, “We’ve seen at least 60% of Medicaid members who were scheduled to renew their coverage in June take action to start the process.”
The June numbers: Of the 99,037 residents who get care through a Medicaid program who DHS asked to reapply that month, 61,057 — or 62% — “took some action to initiate the renewal process,” Johnson said.
And the 37,980 — or about 38% — who were asked to reapply and didn’t? Is that a discouraging number?
It’s too soon to tell, officials said.
“Some of those who did not initiate the renewal process may already have other coverage or may have known they were above the income limit for their program,” DHS said in its July 20 update.
And, someone now on Medicaid who “missed their renewal window can still submit their information up to three months past their renewal month to see if they are still eligible for coverage and get it reinstated.”
In March 2020, when the COVID pandemic closed schools, businesses and governments and threw millions out of work nationally, the federal government ordered states to stop forcing those on Medicaid to reapply. The federal government could issue that order because it pays more than half of Medicaid costs.
During that three-year suspension, the number of Wisconsin residents on Medicaid went up by 14% — from 1.2 million to 1.4 million.
One of state government’s most critical — and expensive — programs, Medicaid especially helps minorities.
Consider:
*Medicaid is projected to cost $14.2 billion this year, with $7.7 billion (54%) from the federal government and $4.2 billion (30%) from the state’s general fund. Almost 20% of all state general-fund taxes this year will go to pay for Medicaid.
*In June, 51% of all Medicaid enrollees were white; African-Americans, 15% and Hispanic or Latino, 11%. Overall, Wisconsin’s population is about 86% white; Hispanic or Latino, 7.6%, and African-American, 6.6%.
*In May, almost half of all Wisconsin children relied on Medicaid for health care.
*In 2022, 35% of births were covered by Medicaid.
One Medicaid budget analyst advised not paying too much attention to the June failure of 38% of those eligible to reapply for Medicaid.
Why? Several factors — including getting a new job or old job back with an income that makes you ineligible for Medicaid, someone turned 65 and now qualifies for Medicare, recipients have moved or died — will determine how many eventually reapply for Medicaid.
The more important numbers will be what percentage of Medicaid recipients fail to reapply in July, August and September — when widespread job losses caused by COVID forced the unemployed to seek health care, the analyst added.
The Republican-controlled Legislature made “significant investments” in the state’s Medicaid program in the 2023-25 budget, Assembly Speaker Robin Vos said.
For example, Vos said, the Legislature raised “Medicaid reimbursement rates across several health services — including hospital base payments, primary care rates, emergency department physicians, chiropractors, and behavioral health in general medical hospitals.”
Urban “disproportionate share hospitals” serving “a large number of Medicaid and uninsured individuals” will get $124 million more, and rural hospitals $11.6 million more, the Republican leader added.
But Republican legislators have repeatedly killed the request of Democratic Gov. Tony Evers to apply for federal aid to expand Medicaid.
“Expanding affordable healthcare will help our families, our farmers, our rural communities, our small businesses and Main Streets, and our state’s biggest employers,” Evers said in his budget, which estimated that 90,000 more would get coverage under Medicaid expansion. “Access to quality, affordable healthcare is workforce and economic development.”
Republicans have a three-word explanation — “no welfare expansion” — for their refusal to expand Medicaid coverage.
Steven Walters started covering the Capitol in 1988. Contact him at stevenscotwaltes@gmail.com.
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