Here & Now

Tammy Baldwin Discusses ACA Changes and BadgerCare Delay

Barack Obama:

That’s on me. I mean, we fumbled the rollout on this healthcare law, and we should have done a better job getting that right on day one, not on day 28 or on day 40.

Frederica Freyberg:

Also, President Barack Obama announces a fix to a problem getting a lot of negative attention. He says cancelled insurance plans can now be renewed for one year. I’m Frederica Freyberg. Tonight on “Here and Now,” more on that with US senator Tammy Baldwin. Plus, a check-in with a state healthcare navigator, and a Wisconsin company develops a flu vaccine that protects against all influenza strains. A so-called universal vaccine.

But first, if the big mess with the flawed healthcare.gov web site wasn't enough, the plans that could not be extended due to non-compliance with the Affordable Care Act resulted in cancellation notices, and the president had to admit his pledge that if you like your plan, you can keep it, was not accurate. He’s also admitting the administration fumbled the rollout of the healthcare law. What’s more, the enrollment numbers are tepid. To date, 106,000 nationwide. Fewer than 900 people in Wisconsin have been able to enroll through the healthcare marketplace, putting tens of thousands of people on BadgerCare in danger of not finding coverage by the time their plans were set to end December 31st. Governor Scott Walker made his own announcement on that late this week.

Scott Walker:

So because we don’t want anyone in this state to fall through the cracks, we’re going to be asking the legislature to act on is two particular changes. One would delay by three months, so through March 31st of 2014, we would delay the transition for the implementation of people moving in to the healthcare plans under the exchanges at the federal level, here in the state of Wisconsin. The other part of that plan would be delayed by three months in a similar pattern, delay the changes and keep intact people who are in our state’s high-risk insurance plan.

Frederica Freyberg:

The governor says he’s calling a special session to effect the changes. Wisconsin Democratic US senator Tammy Baldwin had asked the governor to extend BadgerCare coverage to the 77,000 recipients expected to lose it by the end of the year. Senator Baldwin joins us now from Washington with her reaction to him doing just that. Senator, thanks for joining us.

Tammy Baldwin:

It’s a pleasure. Thank you.

Frederica Freyberg:

So this is what you called on the governor to do, extending this coverage for these recipients of BadgerCare, and also this high-risk plan. What’s your reaction to it?

Tammy Baldwin:

Well, let me start with a little broader context on it, because I called on Governor Walker many, many months ago to create a state-based exchange, state-based insurance marketplace, and to take the federal government up on its offer to extend Medicaid with 100% of the cost being picked up by the federal government, and he said no to both of those, which I think has been unfortunate for the state, and particularly challenging for the 77,000 Wisconsin-ites who are estimated to lose their BadgerCare because of the refusal to extend Medicaid. That said, as the web site problems that the healthcare.gov has been experiencing unfolded, I did call on the governor this week to help ease the transition for those 77,000 Wisconsin-ites, who will lose their BadgerCare, and to align their transition time with those of others shopping in the marketplace till the end of March. I am pleased that he decided to move in that direction and is asking the legislature to follow suit. Although, I do have a very sharp criticism of how he’s choosing to do so because it appears in this rollout that he’s putting another roughly 85,000 Wisconsin-ites, keeping them on a waiting list for BadgerCare when they don’t have to– That shouldn’t have to be the way. There’s an easier way to do this, and I hope when the legislature meets to review this plan that they, instead, choose to provide coverage for all of those Wisconsin-ites.

Frederica Freyberg:

And the way that they would do that, in your mind, is to accept the federal expansion of Medicaid?

Tammy Baldwin:

Yes. And they can do so at any time, and on a temporary basis. So even if the governor wants to keep this limited to the end of March, this would really help tens of thousands of Wisconsin-ites with a much smoother transition, so he do hope that he adjusts his plans. But I do want to say that I’m pleased that he is trying by extending the BadgerCare for the 77,000 through the end of March.

Frederica Freyberg:

Now, in terms of kind of the difficult healthcare.gov web site and people’s difficulty enrolling in the marketplace, there’s another prong to Governor Walker’s response to what he calls the, failure of the federal government. Take a listen.

Scott Walker:

We’re asking President Obama’s administration to allow individuals who qualify for subsidies to be able to use them under any qualified healthcare plan. Not just plans they can purchase under the exchanges in the future, but under any qualified plan. If they’re eligible for the exchange, our belief is that they should be ultimately eligible to get those subsidies no matter where they purchase their plan.

Frederica Freyberg:

Senator, what about that proposal, allowing subsidies for plans outside the exchange?

Tammy Baldwin:

Well, I think it’s really important to understand why the marketplace was created in the first place. It was created to help those people who were unable to get any insurance at any price, perhaps because of preexisting medical conditions or other reasons of self-employment, or time away from employment. It was also meant to give quality options to people who have so-called junk plans. When I say that, I refer to plans that don’t have very basic consumer protections, like, you know, inadequate coverage, say, if somebody developed cancer that doesn’t cover their treatment, and then they face a debt and bankruptcy. We don’t want to have incentives for those junk policies to have equal footing with the programs that have enrolled, or have signed up, to offer health insurance in the marketplace. We want subsidies for Americans to have high-quality healthcare so that we close the long-standing problem that we’ve had with un-insurance and under-insurance in America.

Frederica Freyberg:

How disappointed, Senator, are you, in the enrollment numbers that show fewer than 900 people in Wisconsin have actually been able to sign up in the healthcare marketplace?

Tammy Baldwin:

You know, I’m disappointed. It’s beyond words. This is very frustrating, and the administration has to fix the problems with this web site. You know, the marketplace, the underlying marketplace is there. It’s available for sign-up. But it’s a marketplace that was created, assuming that the main door of entry was going to be online, through this web site. There are other doors of entry. There’s an 800 number. There’s a navigators who can sit down and actually do a paper application, but the clear intent was that the web site, healthcare.gov, be the main door of entry. And for this to work as effectively as possible, that door has to be wide open. So I continue to call on the administration, you know, fix it yesterday, fix it today. Get this up and running, working flawlessly for Wisconsin-ites and the American people.

Frederica Freyberg:

Speaking of the administration, what is your reaction to President Obama’s administrative fix that he announced Thursday, allowing formerly cancelled plans to be renewed for a year?

Tammy Baldwin:

You know, I think that it was something that the moment forced him to do. I think that it will ease transition for some who are getting cancellation notices. But I do want to stress what I said before, is the idea of a marketplace, whether it’s a state-based marketplace, as I wish Wisconsin had, or a federal marketplace, the idea behind it is that people have adequate consumer protections against insurance abuses that they have adequate and comprehensive coverage, including preventative care. A lot of aspects that these other policies don’t have. And so I want to really hope that the focus is on getting people enrolled in the marketplace.

Frederica Freyberg:

Now, apparently, this administrative fix, so-called by the president, is not a major deal in Wisconsin, won’t have major effect because people were allowed to renew their existing policy in this state. But in terms of the Affordable Care Act itself, do you worry that this somehow damages that because it kind of becomes a pool of the sick?

Tammy Baldwin:

You know, I really think that, you know, the president was sort of forced to make this policy because of the problems that we’ve had with the web site and additional factors. What I hope is that we get that web site fixed, and that the vast majority of people who are uninsured, who are underinsured, instead shop for insurance through the marketplace where they’ll have choices among policies that are guaranteed to cover preventative care, to have comprehensive benefits, and to protect Wisconsin-ites from the potential of insurance abuses, like being kicked off their plan when they become sick, or having annual or lifetime limits that still expose them to the possibility of bankruptcy should they develop a serious illness or have an injury.

Frederica Freyberg:

What’s your position on legislative fixes to the issue of keeping insurance policies?

Tammy Baldwin:

You know, I don’t think that they’re going to be necessary given the action that the president announced yesterday. And some of the plans that go under the guise of being promises to keep your health insurance are actually serious erosions of the consumer protections, including– included in the Affordable Care Act. For example, the bill being considered in the house would once again expose people to the risk of bankruptcy in the event of a serious illness. And it erodes the other important protections that we think ultimately as people do enroll in the healthcare exchanges and the healthcare marketplaces, you know, that will lead to higher quality healthcare and well-being and health among the American and Wisconsin population.

Frederica Freyberg:

Senator, how damaging, in your mind, for Democrats, politically, is the administration’s fumbled– his words– rollout of the Affordable Care Act?

Tammy Baldwin:

You know, I have to say that I am hugely critical of the web site problems. But I don’t believe that the underlying marketplace is flawed. In fact, I think it’s a huge step forward for so many Wisconsin-ites and Americans who were left out before, perhaps because of a pre-existing health condition, were never even able to shop for insurance. And I don’t think this is about scoring political points. I think it ultimately will be about how many people have new coverage that they couldn’t acquire before on January 1st, and in the months that follow. That’s what really matters to me is how many people are able to, for the first time in their lives, have health insurance, or, for the first time in their lives, have quality coverage that really will be there if they have a time in need. That, to me, is how we should rate the ultimate effectiveness of the Affordable Care Act. It’s not about putting partisan points on the scoreboard right now.

Frederica Freyberg:

Senator Tammy Baldwin, thank you very much for joining us on this.

Tammy Baldwin:

Thank you.

Frederica Freyberg:

We spoke to Republican US senator Ron Johnson on the issue of cancelled plans two weeks ago on this program.