The federal government has announced it supports proposed changes to Wisconsin’s Medicaid program but needs further details before it can officially approve them.
In a letter sent Wednesday to Wisconsin Medicaid Director Brett Davis, Centers for Medicare and Medicaid Services Director Cindy Mann said while the federal government agrees with many aspects of the plans, it needs clarification on a few issues before it can approve them.
“We agree that much progress has been made and that with some additional discussions the outstanding items can be resolved in an expeditious manner,” Mann said.
The letter approves of many of the changes to Medicaid the Wisconsin Department of Health and Human Services has proposed to make. For instance, Mann said CMS agrees families that are eligible for employer-based health care plans with minimum benefits should not be eligible for Medicaid if their premium contribution is less than 9.5 percent of their household income.
However, Mann said CMS needs clarification on many items such as what the definition of minimum benefits would be.
Wisconsin Department of Health Services Secretary Dennis Smith lauded the decision of the government and said he looked forward to working with the federal government on fulfilling their recommendations in a statement.
“We’ve made significant progress in negotiations, […] which will allow us to fulfill [Gov. Scott] Walker’s vision of making fair, common-sense reforms to the Medicaid program,” Smith said in a statement. “We will continue to work with them on the outstanding items and are confident we will reach a final agreement soon on our request.”
While at one point Smith proposed cutting Medicaid funding by $550 million, Donna Friedsam, a health policy director for the Population Health Institute and an expert on state Medicaid programs, said the budget estimates have changed for the program.
Friedsam said Smith is no longer proposing to cut as much as he had proposed, but the cuts would still amount to millions of dollars.
Beth Kaplan, spokesperson for the Department of Health Services, said negotiations are still continuing with CMS and the final amount of budget cuts may still be in flux since they still have not addressed everything.
Friedsam said at this point nobody knows how these cuts could affect Wisconsin families, but she said the changes would alter eligibility for adults. She said some adults would have to pay higher premiums.
While some would remain eligible for Medicaid programs, she said others would have to go to private employees to become insured and that it was still unknown how many would participate in the cost-saving plans.
Friedsam said DHS is asking adults who make over 130 percent above the poverty line to pay more in contributions of a premium and to contribute more in co-payments.
“This would lead to adults contributing more in co-payments, which would make the program more similar to private coverage,” she said.
Friedsam said the federal government must give approval to the program since it provides 60 percent of funds for the state and is thus in a partnership with the program.
She said the state has to change a number of rules to match coverage requirements put forth in a Medicaid reform bill passed by congress, which relates to coverage and affordability.