CMS Approves BadgerCare Waiver

November 06, 2018

On October 31, the Centers for Medicare & Medicaid Services (CMS) approved the BadgerCare Reform Medicaid demonstration waiver, which provides health care coverage for childless adults with income up to 100% of the federal poverty level (FPL) in Wisconsin. The program was scheduled to expire December 31, 2018, but this new approval extends the program through December 31, 2023. The Wisconsin Department of Health Services (DHS) indicated it will take at least one year to implement the changes.

The approved waiver makes the following changes to the program:

$8/month premiums for those 50-100% of the FPL
$8 co-payment for non-emergency use of the emergency department (ED)
80 hours/month work, training, or community engagement requirements 
Required completion of a health risk assessment (HRA)
Premium reductions based on responses to the HRA
Allowing termination for non-payment of premium or failure to meet work requirements

The most significant change to the original proposal was the removal of drug screening requirements.

The final proposal reflects changes supported by WHA in our submitted comments, including a narrower focus for co-pays (non-emergent ED visits only) and the drug screening change.

WHA will proactively engage with DHS in the weeks ahead as they work with stakeholders to get feedback on plan implementation.

This story originally appeared in the November 06, 2018 edition of WHA Newsletter