With federal health care reform hitting obstacles, Gov. Jim Doyle on Thursday proposed a stripped-down health plan to cover tens of thousands of financially struggling state residents.
But a Republican lawmaker immediately attacked the proposal aimed at 21,000 childless adults, saying the state was backing into a government-run health plan similar to the controversial public option being debated at the federal level.
The proposed BadgerCare Plus Basic Plan would serve as a stopgap for qualifying childless adults in the state on a waiting list to enroll in the state’s swamped Core Plan, Doyle said. The new plan would be funded by a $130 monthly premium paid by participants, not taxpayers, the Democratic governor said. It will require lawmakers’ approval but could be up and running by April.
“This is not a Cadillac plan,” Doyle said, speaking at the UW Health Clinic on Odana Road. But “my hunch is we’re going to find a huge demand for this out there.”
The announcement comes as federal health care reform has been thrown into doubt by the Democrats’ loss in Tuesday’s U.S. Senate election in Massachusetts, which will make it harder for lawmakers to reach the needed votes in the Senate.
State Sen. Alberta Darling, R-River Hills, questioned whether the state would be able to run the Basic Plan on the monthly premiums alone and said the program should have been left to the private sector.
“We are getting as close to a government-run health-care system as Massachusetts,” Darling said.
The Core Plan and the proposed Basic Plan are limited to childless individuals making up to $21,660 a year and couples making up to $29,140. Eligibility standards are the same for the Basic program.
As outlined by Doyle, the Basic Plan would provide annually for:
• Up to 10 doctor visits.
• One inpatient hospital visit, five outpatient visits and up to five emergency room visits.
• Some generic medications and discounts on other drugs.
In October, Doyle announced the state was suspending enrollments in the Core Plan only months after its debut because unexpectedly high demand had caused it to blow its budget. The program now has 64,000 enrolled participants with nearly 21,000 people on a waiting list. Doyle acknowledged that even more people might sign up for the Basic Plan once it’s launched but didn’t provide an estimate.
Mary Tree of Sparta could be one of them. Tree, 58, lost her social work job and health coverage one year ago and since then has been working a part-time job with no health benefits. The Basic Plan could ease worries that she’ll be devastated financially by an illness, she said.
“Uncertainty and stress should not be my constant companions,” Tree said.
The Core Plan is a part of the Medicaid program, which is jointly funded by state and federal money. The Basic Plan would not be part of Medicaid and would not use any taxpayer money. It would be much more limited in coverage, allowing only emergency dental services, for example, and no mental health or chiropractic coverage.
Darling said the Basic Plan could undermine private health insurers.
That’s because the Basic Plan won’t have to follow state mandates on private insurance plans such as the requirement to cover treatment of children with autism, she said. Also, the Basic Plan would pay the same rates to clinics and hospitals as the Medicaid program does, rates that are widely acknowledged to be less than the treatment actually costs the providers, she said.
That could shift more costs onto those with private insurance, she said.