The Centers for Medicare and Medicaid Services approved Gov. Scott Walker’s new healthcare reforms, which includes a work requirement for some eligible members of the BadgerCare Plus program.

According to the Wisconsin Department of Health Services, the reform will affect the 148,156 childless adult members of BadgerCare Plus, Wisconsin’s largest Medicaid program.

According to DHS, members will now be required to either work or participate in worker training programs, or community engagement programs for at least 80 hours a month. If members do not meet this requirement for four years, they will lose eligibility for six months. After six months, they can apply again.

As stated in a press release from Walker’s office, this requirement is a part of the DHS Section 1115 BadgerCare Reform demonstration waiver amendment. It “establishes policies that will promote improved health outcomes, increase participants’ ability to obtain and maintain employment and employer-sponsored healthcare, and familiarizes individuals with private health insurance practices.”  

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Opponents of the waiver include the American Lung Association, which released a statement describing perceived shortcomings of the waiver.

The ALA argued in a press release that struggling families should not have the additional burden of proving they meet requirements in order to maintain health care coverage.

“Additionally, Wisconsin has not expanded its Medicaid program, giving this waiver the unfortunate distinction of being the first waiver with a work requirement for the non-expansion population, a particularly vulnerable group,” the association said.

Arkansas, Indiana and New Hampshire have received approval to impose work requirements for Medicaid eligibility since 2018 under the Trump administration, according to a report by MAPAC, a nonpartisan agency that advises Congress, the Department of Health and Human Services and state governments on Medicaid.

According to MAPAC, Kentucky also received approval, but the approval was blocked in June by a federal judge.

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In addition to the work requirement, the waiver also:

  • Institutes monthly premiums of $8 per household
  • Establishes an $8 copayment if member uses an emergency department for care in a non-emergency situation
  • Requires members to complete a health and wellness questionnaire, including any drug use
  • Allows for full coverage of residential treatment for substance use disorder for all Medicaid and BadgerCare Plus members
  • Members can now reduce the premium they have to pay by making “healthy lifestyle choices,” such as wearing a seatbelt

The implementation of these new policies will take about a year, according to Walker’s press release.