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Health Care Insurance Opportunity For Door County

On August 9, 2013, Wisconsin submitted a request to the federal government to renew its five-year BadgerCare adult insurance demonstration project expanding coverage to 98,000 adults by 2015, but reducing the eligibility limit from to 100% of the federal poverty level from 200%.  

Wisconsin’s decision means that, on January 1, 2014, both a single individual working more than 30 hours per week at $7.25/hr and a single mother with two children, working for $10/hr ($20,800/yr) will be dropped from BadgerCare. The insurance premium for the single mom will rise to $460/yr on average. Her co-pays and deductibles could reach $2,250/yr.  

Because of this impact on the low-income adults and families in their communities, as of August 26, 2013, thirty Wisconsin counties had asked the state to waive their participation in Wisconsin’s Medicaid (MA) demonstration project (BadgerCare) and to be allowed to submit their own request to the federal government. This approach was successful in Cuyahoga County, Ohio.

Door County should examine this strategy immediately. A large drop in Door County’s uninsured population would save lives by enabling early access to health care and reduce reliance on emergency rooms for primary health care.   

In addition, it would improve access to health care for low income, mentally ill and substance-dependent individuals, thereby reducing the number of these individuals inadvertently housed in our expensive penal system due to the lack of affordable mental health care services.   

If it operates its own Medicaid project at 133% of the federal poverty level, the County will receive 100% reimbursement for the next three years. Subsequently, the County’s contribution rises slowly reaching 10% of the cost by 2020. Part of this 10% can be offset by the reduction in unreimbursed ER visits and the productivity gains and community benefits from employees’ and residents’ improved health.  

By distributing administration across a group of cooperating counties, expenses can be further reduced. As a member of the state-mandated Bay Lake Consortia, the Door County Department of Social Services shares administration of health and food related services with four nearby counties. The County is convinced that this approach is more effective for revolving loan funds, so why not for the low income residents who will be ineligible for BadgerCare in 2014?

Door County must not delay in securing these benefits for the low-income, uninsured workers in our community. On January 1, 2014, at least 1,372 of our neighbors and friends will lose access to health care when BadgerCare drops 643 people and 729 people lose their eligibility.

And, small business owners in Door County, those with fewer than 25 employees that pay minimum or low wages and who cannot afford to provide insurance to their employees, often family members, need your help.

Door County should submit its own Medicaid (MA) demonstration project to the federal government and if accepted, then submit a request to the state to remove itself from BadgerCare. Please act now for all of us.  

Respectfully submitted, 

Victoria L Cerinich and Peter L Wyatt
Co-owners of Wyatt’s Gallery in Sevastopol
4145 Cherry Road
Sturgeon Bay, WI  54235-8978
920-559-3686

Sources:
A calculator

Web:
insuranceproviders.com
ehealthinsurance.com
dhs.wisconsin.gov/badgercareplus/waiver081513.pdf
wisconsinbudgetproject.org
citizenactionwi.org
dhs.wisconsin.gov/forwardhealth/imagency

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