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State issues enrollment freeze, premium increase for BadgerCare Basic health coverage

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Premiums will rise and some families will be denied coverage under state Medicaid program changes sought by the Walker administration.

The state is freezing enrollment in the BadgerCare Basic plan, which started in July and offers limited health coverage to about 5,300 childless adults with low incomes.

The program, supported by enrollees' premiums of $130 a month, lost $1.6 million in its first nine months, the state Department of Health Services said Friday. The deficit could be up to $5.7 million when delays in claims are factored in, the health department said.

Coverage will remain for those in the program, but the premium will increase in May to $200 a month.

"Unfortunately, the design of the program and the decisions made by the previous administration were unsustainable," Dennis Smith, health department secretary, said in a news release. "In order to prevent a cost shift to the state taxpayers we must suspend enrollment and increase premiums."

Bobby Peterson, executive director of ABC for Health, a non-profit law firm in Madison that helps uninsured and underinsured people get health care, said the move is unfortunate.

"Access to basic, affordable health care is hard enough," he said. "They're making it more difficult and more expensive."

The basic plan was designed for people on the waiting list for the BadgerCare Plus Core plan, which started in January 2009 for low-income adults without children. After enrollment in that plan was capped in October 2009, a waiting list was started that swelled to more than 80,000 people. The core plan currently covers 42,500 people.

Unlike the core plan and other parts of BadgerCare Plus and Wisconsin's overall Medicaid program covering 1.2 million residents, the basic plan was designed to operate with no support from taxes.

But monthly costs have ranged from averages of $190 to $290 per person, significantly more than the $130 premium, said health department spokesman Seth Boffeli.

Department officials said people on the waiting list for the core plan can try to enroll in the state's Health Insurance Risk-Sharing Plan, a similar new federal plan, private plans or COBRA insurance offered to workers when they leave jobs.


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