"Waiving" Goodbye to Medicaid??

In this Issue...

Wisconsin's Joint Finance Committee gives a "thumbs up" to Wisconsin Department of Health Services proposed Medicaid cuts, Health Reform suit goes before the US Supreme Court, and HealthWatch Wisconsin sets the date for its 5th Annual Conference! Read more...

Party Line Vote By Joint Finance Approves Medicaid Cuts

On Thursday, November 10, the Joint Finance Committee met to discuss and vote on the Wisconsin Department of Health Services proposal to gut BadgerCare and Medicaid. The Joint Finance Committee was comprised of 11 Republicans and 4 Democrats (Sen. Luther Olsen was absent). Secretary Dennis Smith was invited to present his proposal to the Committee.

Recall that the Committee’s approval is all that is required to set the waiver request in motion to the federal government (CMS) for review. Act 32, the Wisconsin State Budget, delegated authority to Department of Health Services Secretary Smith to create changes in BadgerCare and Medicaid laws, needing only a "passive review" of the Joint Finance Committee, not a review by the full legislature.

By a party-line vote, 11-4, the Committee approved the Department's proposal with no changes. Therefore DHS will forward aspects of the plan that require federal approval to CMS. HealthWatch Wisconsin staff observed the Committee meeting, and will continue to analyze the comments made by both the Department of Health Services and the Committee members. Watch for the next edition of the HealthWatch Reporter to cover more analysis of this process and vote.

Share your BadgerCare and Medicaid Story:

In Wisconsin, about 1.2 million people rely on BadgerCare and Medicaid programs to provide essential, affordable, and effective health care services. And the impact of these programs reaches thousands more--our friends, neighbors, grandparents,  colleagues, and health care providers large and small in every county of Wisconsin. Tell your BadgerCare or Medicaid Story! Why is BadgerCare or Medicaid important to you and your family? What would happen if BadgerCare or Medicaid ended? CLICK HERE to complete a story form!

Vol. 7, No. 21
November 15, 2011

In This Issue:

Party Line Vote by Joint Finance Approves Cuts

Share Your BadgerCare Story!

ABC Presents Pathway Plan for 2012 at Dem Public Hearing

Health Reform Suit Before the Supreme Court

HealthWatch News

NEW! Core Plan Waiting List Counter!

Case Tip

Ops Memo

Coalition Roundup

3 C's for CYSHCN!

State & National News

On our Website:
HealthWatch Membership
Upcoming Coalition Meetings

Footage of Public Hearings: The Human Impact of BadgerCare Plus

ABC for Health Presents"The Pathway Plan for 2012" to Democratic Legislators in Special Hearing

As the Joint Finance Committee was meeting on November 10, so too were Democratic members of the Wisconsin Legislature. Their intent was to hear about the impact of the proposed BadgerCare and Medicaid cuts on the people of Wisconsin--the same people not allowed to testify at the Joint Finance Committee meeting. During his comments, ABC for Health public interest attorney and Executive Director Bobby Peterson identified the Pathway Plan for 2012 as an alternative to the draconian cuts of the Health Secretary. “Mr. Smith proposes to model BadgerCare on a free market system that is badly misaligned with Wisconsin’s values. Despite strong bi-partisan roots of BadgerCare Plus, the program is now in the hands of highly partisan ideologues. The proposed cuts will force thousands into emergency room care and could lead to the largest redistribution and socialization of uncompensated care and medical debt I have seen in over 20 years of patient advocacy. Smith proposes a bailout to a failed small group and individual marketplace and must be stopped,” Peterson continued.

Read the Pathway Plan for 2012, a working document. Share your feedback!

Health Reform Suit Before the Supreme Court

The Supreme Court announced yesterday that it will hear arguments on the Affordable Care Act. The Court allocated five and a half hours for oral argument--setting the stage for one of the longest oral arguments in US history. Only Brown v. Board of Education and a challenge to the voting rights act in 1965 involved longer debate periods. News outlets including NPR are calling this an "election year showdown." The court will have four issues to decide:

1. Did Congress exceed its constitutional authority in requiring virtually all Americans to have basic health care coverage?
2. If the individual mandate is unconstitutional, does the rest of the law stand?
3. Does the law impose unconstitutional conditions on the states by requiring them to pay 5 percent more into Medicaid by 2017 to cover the increased number of people under the program?
4. Is it is premature to decide the first three?

None of the nine Supreme Court justices have recused themselves from hearing the case. The argument will likely take place in March 2012.

HealthWatch News

Save the Date! HealthWatch 5th Annual Conference

February 27 & 28, 2012!

Madison will be the place to be this spring! As a Presidential primary approaches and "recall fever" is in the air, we'll gather elected officials, candidates, experts and more to discuss our featured topic "Waive Goodbye to Medicaid?" and get perspectives on the future of health coverage in Wisconsin! Mark your calendar for Monday and Tuesday, February 27 & 28 for the 5th Annual HealthWatch Wisconsin Conference!  Watch your inbox in the coming weeks as registration for the great event will open December 1st.

5 Things to Watch Workshop a Success!

Thank you to everyone who made our November 3rd HealthWatch Wisconsin "5 Things to Watch" workshop a success! Guest Speakers Jon Peacock, David Riemer, Bruce Speight, Meghan Pesko, and ABC for Health attorneys and advocates presented up to the minute information on the DHS waiver request, insurance exchange implementation in Wisconsin, birth cost recovery's impact on infant mortality and more! If you missed the workshop but would like more information or want to purchase the workshop CD, contact HealthWatch Wisconsin.

Do You Know the Advocate of the Year?? Help with the HealthWatch Annual Awards!

HealthWatch Wisconsin is currently accepting nominations for the Third Annual HealthWatch Awards to be presented at the HealthWatch Wisconsin annual conference luncheon on Tuesday, February 28, 2012. The Health Watch Wisconsin council seeks to recognize outstanding work in healthcare advocacy and service in four categories. Click on the category you wish to nominate someone for to download a nomination form!

• Advocate of the Year
• Elected Official of the Year
• Outstanding Outreach Effort Award
• Outstanding Media Coverage Award

To nominate someone for an award, complete the appropriate nomination form, found by clicking on the award names above. Return your form to HealthWatch Wisconsin by email, FAX: 608-261-6938 or US Mail: 32 N. Bassett St., Madison, WI 53703. To view last year’s winners, Click Here.

Join the Leadership of HealthWatch

Nominate a friend, colleague, public health hero of yours (or yourself) for the HealthWatch Wisconsin Council, the leadership committee of HealthWatch Wisconsin! We will compile nominations and prepare a ballot for the Annual HealthWatch Wisconsin conference February 27 & 28, 2012. To make your nomination, please email HealthWatch Wisconsin with your nominee's name, workplace, email and phone number.

NEW: Core Plan Waiting List "Counter"

One hundred twelve thousand, six hundred and five people, and counting

This number represents the number of childless adults in Wisconsin sitting on the BadgerCare Plus Core Plan Waiting List as of the early afternoon on October 31, 2011. These individuals should be effectively screened by the Department of Health Services/Enrollment Services Center upon entering the abyss of the waiting list for different health coverage programs, including, but not limited to, Elderly, Blind and Disabled Medicaid, Medicaid Assistance Purchase Plan, HIRSP, or SSI/SSDI.

Core Plan Enrollment May-October 2011

Keeping Count: The BadgerCare Plus "Counter"

When the BadgerCare+ Express traveled Wisconsin educating families and advocates on BadgerCare Plus, we did a lot of "myth-busting!" One of our main messages was "BadgerCare Plus for Children, Families and Pregnant women is still an option for families," despite frozen enrollment for the Core and Basic Plans. The HealthWatch Update staff is keeping an eye on BadgerCare Plus enrollment for children, adults/caretakers, and pregnant women. As numbers are made available, we will update them here:

Seven hundred forty eight thousand and ninety nine children, adult/caretakers and pregnant women are enrolled in BadgerCare Plus as of the end of October 2011. (This number does not include adults on the BadgerCare Plus Core Plan.)

BadgerCare Plus Enrollment May-October 2011

The enrollment data does not include those individuals in the BadgerCare Plus Core Plan (charted above in blue).

Case Tip

Baby, It's Cold Outside!

As Wisconsinites brace for winter, families concerns turn to heating costs in addition to medical expenses. While meeting with families to discuss their health care coverage options, take a few moments to discuss that family’s eligibility for heating assistance, too!  The Wisconsin Home Energy Assistance Program provides assistance for heating costs, electric costs and energy crisis situations. For heating assistance in particular, families may be eligible for a one-time payment between October 1, 2011 and May 15, 2012. Click Here to see application information, and the income eligibility chart below. Applicants will be asked to provide:

• Verification of household income for the three month period prior to the month of application. (Individuals receiving Social Security or SSI will need a letter from Social Security with information about their benefits.)
• Social Security cards and Birth Dates for everyone in the household
• A copy of the rental agreement (if heat is included in the rental amount)
• A recent utility bill.

The assistance payment will not cover the entire heating bill, but will pay a portion of the heating costs. Factors that determine the amount of assistance a family will receive include: household size, income, and energy costs. Further, the family will not see a check; the benefit is paid directly to the energy supplier and then the family receives a notice that a benefit was paid.

Ops Memos

Ops Memo 11-55: The Centralized Document Processing Unit (CDPU)
Released November 11, 2011
New Policy: Effective January 1, 2012, DHS will administer a Centralized Document Processing Unit (CDPU or DPU) to scan and validate documents belonging to non-MilES cases. The purpose of the CDPU is to perform many of the tasks that local agency staff currently perform. This includes receiving, routing, scanning, manipulating and validating documents for Income Maintenance (IM) cases. The CDPU staff will initially be located in Madison and will be comprised of scanning and document validation staff using multiple scanners. The CDPU is required to be moved out of Dane County prior to July 1, 2012. The final location is yet to be determined.

A pilot program testing limited CDPU functions is planned to start on November 28, 2011. An email will be sent to CARES Coordinators when the pilot agencies are selected.

Coalition Roundup

Click here for a list of upcoming coalition meetings.

The Chippewa County HealthWatch Coalition met last Tuesday, November 8 at the Chippewa County Courthouse. Jaime Lawrence-Olson, Assistant Executive Director and Prevention Services Program Coordinator for Positive Alternatives, Inc., a multi-service nonprofit serving youth and families in Wisconsin presented on at risk children and related issues. The next coalition meeting isn't until January 10, 2012, but mark your calendars now! For more information about the Chippewa County HealthWatch Coalition, please contact Rose Marsh.

The Dane County HealthWatch Coalition met last Monday, November 7, when Meghan Pesko of ABC for Health presented on Infant Mortality, with Birth Cost Recovery as a potential missing piece of the puzzle--the same topic explored at the recent HealthWatch Wisconsin "5 Things to Watch" workshop. Coalition members also brought in canned goods and non-perishables for Dane County HealthWatch's annual Thanksgiving food drive. Participants did an outstanding job, collecting 187 lb of food! The group decided to donate the haul to Second Harvest Food Bank. Thanks to everyone who participated! Also at the meeting, Brenda Stamstad of St. Mary's Dean Ventures was elected to the Dane County HealthWatch steering committee. The next Dane County HealthWatch meeting will be Monday, December 5 with an as yet to be determined speaker. For more information about Dane County HealthWatch, please contact Adam VanSpankeren.

The Eau Claire County HealthWatch Coalition met on November 3 at the Luther Hospital Cafeteria, welcoming Kari Francois, the Community Relations Coordinator for Heritage Senior Living as a speaker. She presented on the Chippewa Valley Assisted Living Association (CVALA), a collaborative group of area professionals committed to providing education, resources and tools to help folks simply the search for assisted living in Eau Claire, as a one stop shop for information on assisted living facilities. The next Eau Claire County HealthWatch meeting is on January 5, 2012. For more information on the Eau Claire County HealthWatch Coalition, please contact Lou Kelsey.

The Milwaukee HealthWatch Coalition convened Wednesday, November 9 at Aurora Family Service. joined by speakers Bob Waite from 211 Impact and Adam VanSpankeren from ABC for Health. The group also received an update from DHS about the proposed Medicaid changes and developments with LogistiCare. The steering committee did not meet this month. The next Milwaukee HealthWatch meeting will be Wednesday, December 14. If you would like more information on Milwaukee HealthWatch, please contact Julie Dixon-Seidl or (414) 773-4646.

The Pierce County HealthWatch Coalition next meets on January 19 at the Crossroads Community Church in Ellsworth, when a panel of service providers from the area will be presenting on a number of topics and initiatives, from homelessness to mental health to combating hunger. To RSVP for that meeting, please contact Lisa Raethke (email below). Despite a short break between meetings, the Pierce County HealthWatch Coalition has been very productive, and the Pierce County Health Department has managed to secure a Medicaid overmatch contract, in addition to becoming an Express Enrollment Provider. Both of these developments came after nearly a year of arduous efforts by Lisa and others, and were well earned. Great job Pierce County! Stay tuned to the HealthWatch Wisconsin Update for more details. For more information about the Pierce County HealthWatch Coalition, please contact Lisa Raethke.

The Tri-County HealthWatch Coalition will meet Tuesday, November 22 at the Goodwill Community Center in Menasha. At their October meeting, group discussed the "5 Things to Watch" workshop, as well as recent Medicaid news for Wisconsin. The Coalition has identified a pocket of people interested in women's health initiatives; Susan Garcia Franz will follow up on behalf of the coalition. Tri-County HealthWatch is also taking a look at charity care programs offered by hospitals in their area. At the next meeting, the coalition will be deciding how to focus their efforts to make the most of 2011 and how to proceed into 2012. For more information about the Tri-County HealthWatch Coalition, contact Susan Garcia Franz or Connie Raether.

3 C's for CYSHCN!

Ask a Good Question...

I recently received a denial for Katie Beckett Medicaid for my 12 year old daughter. What is the first thing I should do?

...Get a Good Answer!

Public health insurance benefits through Medicaid, including BadgerCare Plus and Katie Beckett, provide for an appeals process for families. Yet this process varies from the process for requesting a grievance with a private insurance company or challenging a private insurance denial in court. The Medicaid appeals process provides for an administrative review and a chance for the family to be heard by an independent hearing officer, called an “Administrative Law Judge.” The two appeals processes are alike in one respect: the family should not delay!

• The first step in appealing a denial for Katie Beckett Medicaid involves requesting a fair hearing. A fair hearing gives the family an opportunity to tell why they feel the decision about their application or benefits was wrong.
• The family must request the fair hearing within 45 days of receiving their denial letter.
• Keep a more urgent deadline in mind: If the child is already receiving benefits, the family must request a fair hearing within 10 days, to continue to receive benefits until the hearing officer makes a final decision on the matter.

Individuals may file for a fair hearing by writing directly to the Department of Administration, Division of Hearings and Appeals at: PO Box 7875, Madison, WI 53707-7875 or by completing the Fair Hearing Request Form.

In the request for a fair hearing, be sure to include the following key pieces of information:

• The Child’s name and Social Security Number.
• The Child’s Address
• The Benefits program the child received a denial from
• Brief description of the problem/reason you feel the denial is incorrect

If possible, help the family begin gathering relevant documentation to help support their claim that the denial was incorrect. Look for medical documentation, ask for doctor’s letters of support, read therapist notes, request copies of the most recent IEPs from school, and any other information the family has in support of benefits for their child.

Questions on this Answer?

Still not sure? Have another question? Send us an email! We may address emailed questions in the next edition of the Update Newsletter.

Events of Interest:

Is there an event missing from our list? Let us know! Email us with events, directions and details other collaborators may like to attend.

Finding Your Way: A Navigation Guide for Wisconsin Families Who Have Children and Youth with Special Health Care Needs and Disabilities has been published. Download a pdf version of the booklet here.

The National Youth Leadership Network announces their new curriculum: Reap What You Sow: Harvesting Support Systems Curriculum Training Packages. Reap What You Sow brings youth and adults together to build support systems. For more information, click here.

December 2-3, January 20-21, February 17-18, March 30-31. Parents in Partnership: A Leadership Development Opportunity for Parents of Children with Disabilities. 4:30 to 8:30 p.m. on Friday and 9 a.m. to 3:30 p.m. on Saturday at Paradise Shores Conference Center, 26364 County Hwy. M, Holcombe, WI. Parents and guardians must attend all five sessions. For more information, contact Ruth Adix at 715-864-3014 or raadix2@yahoo.com.

January 13-14, February 24-25, April 20-21. Youth in Partnership with Parents for Empowerment. 5 p.m. Fridays ending by 3 p.m. on Saturdays at the Tundra Lodge Resort & Conference Center, Green Bay, WI. Youth, parents and guardians must attend all five sessions. For more information, contact Martha DeYoung at 800-862-3725 or deyoungm@cesa5.k12.wi.us.

A Training Announcement for All CYSHCN Collaborators: The Next CYSHCN Live Web Cast is Thursday, November 17, 2011 at 10:00am

While many of you working with families will not challenge a denial or go to a fair hearing, you surely have had families ask you about the process! Fair hearings are designed to give individuals an opportunity to challenge the explanation of their denied service, coverage reduction or coverage termination. But, how do you get from the denial of BadgerCare Plus or Medicaid to the actual fair hearing? What is a fair hearing like? Is there a judge? In this webcast, we will start with a few simple examples of conversations you can have with families so they know what to expect and what it's like to go through a public coverage program appeals process. Learning objectives for this training include, how to:

• Learn some conversation starters and tips for talking to a family about fair hearings
• Understand some common scenarios and examples of fair hearings to make the process more approachable
• Become more familiar with the Medicaid Handbook and some of the rules that govern fair hearings
• Help communicate a reasonable expectation of goals to families interested in fair hearings
• Locate appropriate assistance as necessary, including community referral sources for additional information, resources and guidance on laws and statutes.

This web cast training was selected by YOU! Thank you! Through the competency self-assessment survey, you indicated that you wanted to learn more about state Medicaid benefits and programs, challenging denials and other communications with families about health coverage programs for children.

Watch your inbox for a confirmation of the date and time, future instructions, and login information! This is a live web cast, so you are able to participate, ask questions, and answer polls. Not able to join the live web cast? Don't worry, we'll share the archive link with you, and hope that you can join us again in the future.

State & National News

Headlines

HealthWatch Wisconsin is saddened by the news of Dick Wheeler's passing. Wheeler operated his own news service, extensively covering legislative events in Wisconsin. We began each day by checking "The Wheeler Report," for news, legislative schedules, press releases and more. His news service was efficient, accurate, non-partisan, and reliable. A memorial service for Dick Wheeler will take place today, November 15 at 4:00pm in the capitol rotunda.

Whatever Court Rules, Major Changes in Health Care Likely to Last
New York Times, Nov. 14, 2011
For the nation’s health care system, there may be no going back.

Obama Administration Launches $1 Billion Healthcare Drive
Reuters, Nov. 14, 2011
The Obama administration on Monday said $1 billion of federal funds allocated in last year's health reform law will go toward innovation programs designed to boost jobs and improve patient care.

Comparative Summary of the DHS Proposal
WCCF, Nov. 14, 2011
The Wisconsin Department of Health Services (DHS) recently submitted a request to federal officials for approval of proposals that would make sweeping changes in the BadgerCare program.

Medicaid changes to hit community centers first
Journal Sentinel, Nov. 14, 2011
Community health centers, which provided care to 271,000 patients statewide and almost 78,000 in Milwaukee last year, would be among the first to see the effects of the proposed changes to BadgerCare Plus and other state health programs.

Chris Rickert: Rate hike for the holidays
Wisconsin State Journal, Nov. 13, 2011
Competition for market share by health care service providers and reduced enrollment in Medicaid and BadgerCare Plus, resulting in reliance on costly emergency care, will result in increasing costs for the insured overall.

Where city factories, and now babies, die
Journal Sentinel, Nov. 12, 2011
The southern Chinese city of Guangzhou has mastered many of the trades Milwaukee championed in the last century: machinery, motors, metalworking.

Consumer advocates ramp up pressure on health insurers
The Hill, Nov. 9, 2011
Consumers Union on Wednesday sent the White House a letter signed by more than 50 organizations demanding that the administration require simple, standardized health insurance forms starting next year, as called for in the law.

Peterson Weighs in on the Dire Straits for BadgerCare Plus and Health Reform Funds [Audio]
WORT, Nov. 8, 2011
In Our Backyard featured Bobby Peterson, ABC for Health, reacting to recent health coverage decisions in Wisconsin

Social Security Launches New Spanish Online Services
Social Security, Nov. 15, 2011
Michael J. Astrue, Commissioner of Social Security, announced that the agency’s most popular online services, the applications for retirement and Medicare and for Extra Help with Medicare prescription drug costs, are now available in Spanish.

Will Partisanship Shape the Health Care Ruling?
Los Angeles Times, Nov. 15, 2011
Not surprisingly, the Supreme Court on Monday agreed to decide the constitutionality of the individual mandate in the Affordable Care Act, the health care reform package passed in 2010.

Improving Adherence-Money Isn't the Only Thing
New England Journal of Medicine, Nov. 14, 2011
Value-based insurance design may be a useful complement to the health savings accounts and consumer-driven health plans that are increasingly being offered in the market.

The Time is Not Right for Supreme Court to Review Health Care Law
Washington Post, Nov. 14, 2011
The court battle over President Obama's signature health-insurance reform law seems to be going his way.

Supreme Court will hear health care case this term
Associate Press, Nov. 14, 2011
The justices announced they will hear an extraordinary five-and-a-half hours of arguments from lawyers on the constitutionality of a provision at the heart of the law and three other related questions about the act. The central provision in question is the requirement that individuals buy health insurance starting in 2014 or pay a penalty.

Thinking Our Way to Better Treatments of Chronic Pain
The Archives of internal Medicine, Nov. 14, 2011
Despite being the backbone of therapy for chronic nonmalignant pain, there is little evidence that long-term opioid use is efficacious in reducing pain, much less in restoring function, the true goal of treatment.

Critics question speed, completeness of health department merger plan
The Northwestern, Nov. 13, 2011
The merger would reduce tax burdens in Neenah and rural Winnebago County, while taxes would increase slightly in Oshkosh. The added Oshkosh tax costs would be offset and offset by reduced inspection fees for Oshkosh businesses.

Commentary: Balancing budget doesn’t have to be done on the backs of workers
Journal Times, Nov. 13, 2011
Rep. Cory Mason (D, Racine): Let's not pile on to an already tough economy by telling tens of thousands of working Wisconsinites and their children they will have to go without health care because Scott Walker decided we need more tax breaks for the wealthy.

Billions wasted on billing [Opinion]
New York Times, Nov. 12, 2011
Ezekiel J. Emanuel supports electronic billing which would reduce costs in administration and errors in medical billing processes.

State awards $850,000 to increase access to dental care
DHS, Nov. 11, 2011
Nine safety net dental clinics will receive $850,000 as part of a state budget initiative to increase access to oral health care, allowing clinics to increase staffing and expand services to more individuals in need.

Gov. Walker’s War on Children
Rep. Chris Taylor, Nov. 11, 2011
According to the non-partisan Legislative Fiscal Bureau, as a result of the Governor’s proposal a total of 120,000 children will see their health care coverage severely reduced. In addition, according to the Wisconsin Council on Children and Families the state will no longer use express enrollment to expedite coverage for urgently needed care to kids whose applications are held up by red tape.

Democratic Weekly Radio Address: "Walker Administration Retreats on Health Care for Wisconsin Families"
Rep. Jon Richards, Nov. 9, 2011
Life-altering decisions to cut more than $550 million from health care are now being made with almost no legislative oversight and little public input because Gov. Walker gave this power to one of his political appointees.

Milwaukee sets goal to reduce infant mortality
Journal Sentinel, Nov. 8, 2011
Officials aim to reduce black infant mortality rate by 15% and the city's overall rate by 10% by 2017

Healthier Wisconsin awards $4.8 million
Journal Sentinel, Nov. 6, 2011
The investment income from the endowments must be used to fund research, education and community projects to improve public health, with 65% going to research and education and 35% to community projects.

Medicaid cost cuts planned
Journal Sentinel, Nov. 6, 2011
Every state plans to implement at least one policy to control Medicaid spending this fiscal year, according to a survey by the Kaiser Family Foundation.

Wisconsin Legislature Considers Medicaid Cuts [Audio]
Wisconsin Public Radio, Nov. 4, 2011
If a federal waiver is granted, state could charge Medicaid participants higher premiums; it would also tighten up eligibility and suspend health coverage for missed premium payments. ABC for Health’s Bobby Peterson opposes the measure and proposed an alternative, private-public partnership plan.

GOP lawmakers in tough spot on health care exchange idea
MPR News, Nov. 4, 2011
On one hand, they don't want to do anything to show support for what they term "Obama-care." On the other hand, the concept of an insurance exchange is an idea they've embraced in the past. Gov. Tim Pawlenty proposed one for Minnesota long before Congress passed the federal health care law.

ABC for Health plan would expand BadgerCare while reducing Medicaid expenses
Wisconsin State Journal, Nov. 3, 2011
ABC for Health's Pathway Plan for 2012 would expand BadgerCare to people who make three times the poverty level or more. It would be paid for by matching funds from the federal government and cost sharing by enrollees

Opinion: Make Insurance Understandable
Politico, Nov. 3, 2011
Lynn Quincy voices support for the new health insurance disclosure form, called the Summary of Benefits and Coverage, which would standardize how consumers view health plan information — like premiums and deductibles. It would also include a new feature, called Coverage Examples, that illustrates complicated health plan provisions using hypothetical medical scenarios.

Insurance exchanges could harm US states' autonomy
Reuters, Nov. 3, 2011
Exchanges where individuals can purchase health insurance are key to the healthcare reform plan championed by President Barack Obama. States can create exchanges alone, band with neighboring states or opt out entirely and have the federal government establish exchanges within their borders.

Insurers Seek to Avoid ‘Worst of All Worlds’ in Health-Care Case
Bloomberg, Nov. 3, 2011
States filed a challenge to health care reform’s Individual Mandate, but removing the mandate would undermine other provisions, including a requirement that insurers issue a policy to anyone who applies and a ban on higher premiums for people with preexisting conditions. Without the premiums of healthy people, insurers would raise their prices as more high-cost patients enrolled, driving away low-cost policyholders.

Health Insurers Plan to Pass Along New Tax to Patients
NationalJournal, Nov. 3, 2011
A report financed by American’s Health Insurance Plans predicts that premiums will increase by about 2 percent in 2014, and 3 to 4 percent by 2023, once insurance companies pass along a federal tax that will hit in 2014.

The Birth Control Solution
New York Times, Nov. 2, 2011
There is a solution to many of the global problems that confront us, from climate change to poverty to civil wars, but it is starved of resources. It’s called family planning, and it has been a victim of America’s religious wars.

Hospital group sues over cuts to Medi-Cal program
LA Times, Nov. 2, 2011
The trade group for California’s hospitals has sued state and federal officials to block a 10% cut in government reimbursements for healthcare providers who treat low-income patients which will threaten the ability of many hospitals to continue operating skilled nursing facilities.

Senator plans to pull plug on health care reform
Wisconsin Radio Network, Nov. 2, 2011
The bill (AB 210) has passed the state Assembly, but now state Senator Frank Lasee says he’ll kill it in his Senate committee.

Grading Docs with Electronic Medical Records
Kaiser Health News, Nov. 2, 2011
The Obama administration is giving clinics and hospitals millions to give them an incentive to use electronic medical records, generating mounds of data that can be mined to both save money and improve a doctor's performance.

Stimulus funds will build state health exchanges but might not sustain them
iWatch News, Nov. 2, 2011
Federal stimulus funds are paying to build or expand systems enabling health care providers within each state to share patient information, but state officials are concerned about how to keep paying for the programs once the federal money runs out, an iWatch News survey reveals.

Gov. Walker creates rules office
The Northwestern, Nov. 2, 2011
Walker issued an executive order Wednesday creating the Office of Regulatory Compliance. The office would accept agencies' rule scope statements and economic impact studies and inform agencies of whether their proposals have the green light.

Health insurer rebate exemptions would cost consumers
Journal Sentinel, Nov. 1, 2011
The request by the state's insurance commissioner to exempt health insurers from having to spend 80% of premiums on medical care could cost consumers an estimated $14 million over three years.

Copyright © 2011 ABC for Health, Inc. All rights reserved. No reprint without permission.

HealthWatch Wisconsin is a project of ABC for Health, Inc.
Update Staff:
Bobby Peterson, Executive Director
Brynne McBride, Assistant Director
Adam VanSpankeren, Education and Outreach Coordinator
Evan Benner, Publications Assistant