December 6, 2011

A New Definition of Family

By Senator Lena C. Taylor

As we all know by now, there will be big changes for BadgerCare and other state Medicaid programs in 2012. The GOP members of the Joint Finance Committee, who comprise the majority, granted the Department of Health Services permission to submit to the federal Centers for Medicare & Medicaid Services the state’s request to change the state Medicaid program’s eligibility and income requirements. One of the most alarming changes to the eligibility requirements is the new method for calculating family income.

Under the already-approved proposal, eligibility will now be based on the combined income of everyone living in the household, not merely the applicant’s income and perhaps that of their spouse or partner. To demonstrate just how detrimental this change will be for some enrollees, I will give you an example of how this provision will apply. Jane Doe is a single mother of two who is struggling to make ends meet. To ease some of her financial burdens, she decides to move in with her friend, Judy, who for Private Company. Her decision to move in with Judy drastically impacts her eligibility for state Medicare because now, Judy’s income will be added to Jane’s income, and Jane’s eligibility will be determined based on that figure. With eligibility based on the combined income of Jane and her friend Judy, it will be more difficult for Jane to qualify. To add insult to injury, because there is no familial relationship between Jane and Judy, Jane and her children will not be covered under Judy’s health insurance through her employer.

One of the biggest indirect consequences of this combined income approach is a decrease in willingness to help others. If allowing a family member or close friend to live with you would jeopardize access to health insurance for yourself and your children, would you be more or less likely to offer a helping hand?

This new eligibility plan is supposed to be a trial implementation of Obamacare, but there is a distinct difference between Wisconsin’s family income eligibility and Obamacare’s family income eligibility. Under the terms of Obamacare, family income is determined using only the income of the immediate family, excluding grandparents. Wisconsin is using different standards, so this certainly cannot be considered a test of Obamacare.

The plan that DHS has adopted is an effort to shift costs, not reduce costs. Although there was inadequate time for public input (the two public hearings held by DHS provided insufficient information about the proposals and their effects), we must make sure that we remain informed about what these plans mean for our families and communities. If you have any questions or concerns, do not hesitate to contact my office at (414) 342-7176 or me at sen.taylor@legis.wisconsin.gov.

As always, I will do my utmost to ensure that those affected by these plans understand the changes and that their responses are based on solid, reliable information.