Insuring Already-eligible Kids Is Critical for Improving the Health of WI Children

Wisconsin is no longer the leader it once was in getting children insured. A new WCCF report examines how Wisconsin lost its national prominence in insuring children and how our state could regain its leadership in that important area.

Census Bureau figures show that Wisconsin went from having the 6th highest rate of insurance coverage for kids in 2008 to the 16th best in 2014. Our analysis of the 2014 data found that there would have been about 11,800 fewer uninsured children in Wisconsin if our state achieved the average coverage rate for kids in the four neighboring states (3.5 percent).

A recent study by the Urban Institute regarding participation of eligible children in Medicaid and the Children’s Health Insurance Program (CHIP) helps explain why other states have been climbing ahead of Wisconsin in the insurance rate for children. Wisconsin used to be far ahead of most states in the percentage of children who are eligible for Medicaid or CHIP and are actually participating; however, that’s no longer the case. The Urban Institute analysis found that in 2014 Wisconsin dropped slightly below the national average in the percentage of eligible kids who are participating in Medicaid or CHIP.

2_Child HealthOther states have surpassed us on that measure because they are taking advantage of provisions in the Affordable Care Act that enable them to sign up and maintain coverage for a higher percentage of the children who meet Medicaid or CHIP eligibility standards. A key part of that is expanding Medicaid eligibility of parents.

Almost 20 years ago, when Governor Thompson and the legislature created BadgerCare, Wisconsin demonstrated that covering parents improves the participation rate of their children. However, in 2014 when many other states were expanding Medicaid eligibility of parents, Wisconsin cut it in half. It appears that many of the children of parents who were terminated from BadgerCare have lost their coverage as well (even though they are still eligible), and some of those children almost certainly became uninsured.

Another reason that other states have been climbing ahead of Wisconsin is that they have done a much better job of utilizing federal options for streamlining Medicaid and CHIP enrollment processes and annual renewals of coverage. For example, they use income data already available in the state’s computer system in order to expedite enrollment and renewals, and to avoid inefficient and unnecessary churning of families into and out of Medicaid coverage.

Health insurance for children is an extremely cost-effective investment because it is relatively inexpensive, and providing kids with access to quality preventative care can significantly reduce more expensive interventions like hospitalization for asthma. Giving children access to preventative care also removes a barrier to learning, and it enables kids to grow up to be productive adults.

In related news, the Department of Health Services announced early this month that state spending for Medicaid is now expected to be almost $176 million (3.1%) less than the 2015-17 budget bill set aside. As I explained last week in a Wisconsin Budget Project blog post, the primary reason for the underspending is that the May BadgerCare enrollment was about 27,600 people (3.3%) below the average that the budget bill assumed for the 2015-16 fiscal year.

In light of the substantially lower estimates of Medicaid enrollment and spending, it’s time for state policymakers, health care providers and advocates to rededicate themselves to making Wisconsin once again a national leader in ensuring that children have access to quality, affordable health insurance.

There is no reason that we should trail all of our neighbor states because there are easy ways to increase the number of BadgerCare eligible children who sign up and stay enrolled. A great place to start would be to tap the tools that many other states are using to make enrollment and renewal processes more efficient and less burdensome for families.