State could miss out on federal stimulus Medicaid payments if Legislature doesn't act
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State could miss out on federal stimulus Medicaid payments if Legislature doesn't act


Wisconsin won’t miss out on Medicaid payments approved in one of the recent federal coronavirus relief bills — for now.

But U.S. Rep. Mark Pocan, D-Madison, warned last week that recent changes in state law will make the state ineligible for future rounds of funding and the Wisconsin Legislature must act in order to get additional funds going forward.

U.S. Rep. Mark Pocan


Wisconsin was initially slated to miss out on a 6.2% increase in Medicaid funding because the state was not compliant with conditions laid out in the second of three recent coronavirus-related relief packages passed by Congress. The bill dictates, among other things, that premiums for Medicaid members were not increased after Jan. 1 and there are no cost-sharing requirements for COVID-19 testing and treatment.

On Feb. 1, Wisconsin made a series of changes to BadgerCare Plus for childless adults, including adding monthly premium payments and copays for emergency room visits. These policy changes violate the legislation’s conditions.

The 6.2% bump could save $150 million in state spending per quarter, according to the Legislative Fiscal Bureau.

Pocan said “one of the last changes to happen” to the third relief package, the $2.2 trillion stimulus bill colloquially known as the CARES Act and signed into law last month by President Donald Trump, allows Wisconsin to receive the increased funding in the first quarter despite the state’s changes to its Medicaid program.

Pocan warned the Wisconsin Legislature would have to take steps in order to get additional funds in the future. Wisconsin will become ineligible for the increased federal funding on April 17 if lawmakers do not make necessary changes to the state’s Medicaid program.

“We were able to get the Wisconsin fix (in the bill), but it’s for the first quarter,” Pocan said. “The legislature will have to deal with (making additional changes).”

The additional Medicaid funds have also caught the attention of Wisconsin Department of Health Services Secretary Andrea Palm. In a letter sent to the Legislature’s Joint Finance Committee on Tuesday, Palm wrote the COVID-19 pandemic “is likely to significantly increase Medicaid expenditures for the remainder of the biennium.”

Palm said Medicaid members will require additional health care services due to the pandemic. She also wrote, due to the outbreak’s effect on the economy, that Medicaid enrollment will likely increase as people lose coverage from employers.

In the letter, Palm wrote that DHS is working with legislators “to make temporary program changes to qualify for the enhanced” federal funding. She said the funding will help offset increases in service utilization and Medicaid enrollment.

Assembly Speaker Robin Vos, R-Rochester, did not reply to a request for comment about potential changes to Medicaid or whether they would be enacted by the deadline.

Palm also wrote that DHS is “working with the legislature” on federal waiver approval for more flexible requirements in responding to the pandemic.

“These measures will help providers respond more effectively to patient care needs while also boosting the volume of provider claims submitted to the Medicaid claims system,” Palm wrote.

During last year’s budget negotiations, Gov. Tony Evers vowed to “fight like hell” to expand Medicaid in Wisconsin, which DHS said would have brought in an additional $1.6 billion in federal funding for the program.

Expanding Medicaid in Wisconsin has long been opposed by Republican lawmakers, and was stripped from the budget by the Legislature’s budget-writing committee. Vos declared last year that expanding Medicaid in Wisconsin is a “massive welfare expansion” that GOP lawmakers cannot support.

There were 776,581 Wisconsinites enrolled in BadgerCare Plus in February, according to available DHS data.

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