Frederica Freyberg:

Under the Affordable Care Act states were given the choice to beef up their Medicaid coffers with additional money from the federal government. In Wisconsin’s case this could have meant more people covered on the state’s BadgerCare program. Governor Scott Walker turned the money away saying he didn’t believe the feds could sustain those funds over time. 19 Wisconsin counties, however, have sent a letter to state health secretary Kitty Rhoades requesting state approval for the counties themselves to obtain the federal money on their own. Eau Claire County was among them. Colleen Bates is the first vice chair of the Eau Claire county board and joins us now from the campus of UW-Eau Claire. Supervisor, thanks very much for doing so.

Colleen Bates:

You’re welcome.

Frederica Freyberg:

What have you heard from the secretary’s office concerning this request that the feds allow Medicaid expansion for counties?

Colleen Bates:

Well, first of all I want to clarify something. The particular letters that have gone out have gone out from individual supervisors. They are not letters that have gone from the whole of the county board. Nor has action been taken by the whole of the county board. I believe that’s true in every one of these cases. But certainly it’s indicative of the uncertainty that counties are feeling in regard to what is going to happen to the individuals that we have been responsible for, those who are very often the most vulnerable in our state as far as their access to quality health care? And will it be something that they are able to maintain over time?

Frederica Freyberg:

And has there been response, to your knowledge, to any of these individual letters sent out by supervisors in these counties?

Colleen Bates:

No, I don’t believe so. I do think that certainly, if you look and have read the print, that the governor has rather dismissed this effort. I do think, however, though there is enough frustration, enough uncertainty, that it does seem to be getting some momentum in the state. Now, whether or not that will change the way that we do business is difficult to say. But obviously, it’s probably not going to go away as long as the current uncertainties continue to exist.

Frederica FReyberg:

How much would Eau Claire County’s cut of the expanded Medicaid money that would have come to Wisconsin, what would Eau Claire County’s cut of that have been?

Colleen Bates:

I can’t give you that exact figure. I can tell you that if the funding were to be restricted to those individuals that are at 100% of poverty rather than 133% of poverty, already we know that between the three counties Eau Claire, Chippewa and Dunn, that that would impact about 10,000 people. Some of them being denied access, others simply because of the fact they’re not of that 100% level. And others who simply don’t qualify.

Frederica Freyberg:

What about the opportunity for those people to get into the healthcare exchanges?

Colleen Bates:

Well, there is some concern there as well. There are a lot of unknowns in this. One of those unknowns is who will participates in this? Right now, we know that most of the major insurance companies are not stepping up and saying, I want to be a part of this. So basically there appear to be some that are interested but it certainly is not the big providers. What will that mean for the individuals seeking affordable healthcare? Likely, if we were to project what would happen is these policies are likely to be high deductibles. They're likely to have more co-pays, simply because that will make them affordable. For individuals already living right on the edge of what they are able to bear in their budgets, this could mean that basically they wouldn’t be looking to accomplish preventive care, nor would they likely have early intervention care. Because they’ll be watching those dollars so closely that we’re more likely to see them with advanced diseases. We're more likely to see them in emergency rooms. And that’s going to have an impact, again, on total cost, not only to them, but to the system as well.

Frederica Freyberg:

And yet the governor says that under Wisconsin’s new kind of revised healthcare plan going forward without the expansion of this Medicaid money, that he would cut the number of uninsured by nearly 225,000 statewide. So there must be some good in this for your county.

Colleen Bates:

It isn’t a question of whether or not they have insurance. For some individuals, it’s a question of whether or not that insurance is actually going to provide them the type of care that they really need. Again, you have to look– They will have insurance, but they will also, I’m quite certain, have co-pays and high deductibles. So the type of insurance that you have enters into this picture as well. I do think that this is a particular effort that is going to bear watching. Obviously, the Wisconsin Counties Association has not taken a position on this as yet. Nor have the individuals who are in the Human Services director’s group. So it’s sort of like wait and see and see what is happening, and it is that wait/see issue that is actually sparking interest in looking to see whether or not you can have the money come direct to counties. That would do something. It would indeed keep the level of funding at 130, 33%, rather than bringing it down to 100% as has been proposed in the state legislature and governor’s effort.

Frederica Freyberg:

We need to leave it there. Supervisor Bates, thank you very much. We will be watching.

Colleen Bates:

Thank you.