Here & Now

Budget Watch: Medicaid

Zac Schultz:

Weekends are about the only time Beth King and her husband, Justin, get to be together with their daughters.

Beth King:

How come Barbie's never have socks?

Zac Schultz:

Justin and Beth run a small business specializing in property management and home remodeling. The long hours working on someone else’s home means less time in their home. But the business is starting to be more successful.

Beth King:

A little too successful, a little too out of poverty, you know?

Zac Schultz:

They’re still finishing up their tax returns, but they expect to be above the federal poverty level for a family of four, which is $23,550. That means they will lose their Badgercare coverage under Governor Walker's new Medicaid proposal.

Scott Walker:

I want to have fewer people in the state who are uninsured, but along with that, I’d like to have fewer people in this state who are dependent on the government.

Zac Schultz:

Through the Affordable Care Act, the federal government would pay 100% of the costs of expanding Medicaid to cover all people up to 133% of the federal poverty level. A family of four could earn $31,000 a year and still receive coverage. Eventually the federal government would only pay 90% of the costs, leaving the state with the other 10%. Over the objections of Democrats, Governor Walker chose to reject the expansion, and change Wisconsin’s eligibility limits for Badgercare.

Beth King:

I was pretty upset about it.

Zac Schultz:

Starting next year, only those earning less than the poverty level will qualify, leaving people like Justin and Beth to find their own plan through the federal health care exchange.

Justin Robbins:

It didn’t make sense to me, because it’s money we’ve already paid into the federal government.

Zac Schultz:

Beth’s health history makes her even more concerned about moving to a new insurance plan. Three years ago, she went to the emergency room with stomach pains.

Beth King:

I had a congenital defect where my intestines were twisted and the blood supply was cut off. So I had surgery, like, that day.

Zac Schultz:

Beth forced herself back to work in a week, but last fall the pains came back.

Beth King:

I was admitted a few times to the hospital with a NG tube, and in and out, and then I finally had the surgery and things– I had complications. I ended up in the hospital for a month.

Zac Schultz:

It was a stressful time, and she fears having to go through it again, this time worrying if they can afford larger co-pays and deductibles.

Beth King:

And you feel guilty because what if something happens to you and you’re not there? I mean, Justin said, you know, I’m half the business and all the mom.

Zac Schultz:

What makes things even more complicated is Wisconsin is not changing the eligibility standards for kids, so Helena and Isla will still be covered by Badgercare, while Beth and Justin find their own plan.

Beth King:

That’s why I’m worried about this exchange, because I don’t know what it’s going to look like. And if we’re moved on to it, which very well may happen, it’s like, okay, well, the kids will be on Badgercare and we’ll be on the exchange, but, you know, what’s covered under who and

Scott Walker:

The system will work that way if they can get better care for their children, which our thresholds are higher for children and for needy individuals, so we still cover at a higher level.

Bobby Peterson:

parents being split from their children’s coverage. And I’m not sure why we’re doing that, because we don’t have to, you know.

Zac Schultz:

Bobby Peterson is the executive director of ABC for Health. It's a small nonprofit that helps people figure out their health insurance problems. He says they spend a lot of time dealing with people who are confused by health insurance, putting parents and children on separate plans will only complicate things.

Bobby Peterson:

It's making parents run through the maze, figuring out coverage for themselves, for their kids, premium payments for themselves and for their children.

Zac Schultz:

Justin and Beth say it’s hard to plan for business growth because they’re not sure how much extra it will cost for insurance next year.

Beth King:

There is a lot of frustration and fear because it’s like, here we are, finally we’ve built and built and built, and becoming successful and we're talking about possibly even hiring someone because we have so much work and so many clients.

Justin Robbins:

It just throws a lot of uncertainty into the mix because we don’t really know what those premiums are going to be, we don’t know what the co-pays are going to be.

Zac Schultz:

Governor Walker describes the shift to exchanges as empowering for people like Justin and Beth.

Scott Walker:

The more people we get in the private insurance and into the exchanges, the more latitude they have over what happens in their lives and the lives of their families.

Zac Schultz:

After a full day of work, Justin doesn’t want that latitude or empowerment.

Justin Robbins:

1:00 rolls around. It’s like, oh, crap, I’ve got to go to bed. I don’t time to think about, you know, what kind of insurance policy I want.

Beth King:

It isn’t like a normal marketplace. It’s not like I can you know, like buying a rug. You can shop around, right? You can shop around. You can go to this store and see the same rug and it’s $30 cheaper, and you know what rug you’re getting. It’s not the same for health insurance. You have no idea what you’re getting. You have no idea what it covers, and you have no idea what you need.

Zac Schultz:

While Governor Walker won’t extend Medicaid, he does want to help small business owners like Justin and Beth, but with a tax cut.

Scott Walker:

One of the best ways to grow our economy is to put more money back into the hands of the people and small businesses of the state.

Beth King:

Tax cuts are wonderful, but they don’t fund my insurance plan.