The non-partisan Legislative Audit Bureau does a wonderful job auditing state agencies. Two recent audits by the Bureau suggest major issues with government entitlement programs. If the state of Wisconsin is subsidizing health care, it should make sure the people reaping the benefits are citizens.

According to a Legislative Audit Bureau report about BadgerCare Plus Basic Plan, citizenship verification for enrollees does not always occur. In addition to not verifying BadgerCare Plus Basic enrollees are Wisconsin residents, the audit reveals major issues with the cost-effectiveness and sustainability of the health care program.

The BadgerCare Plus Basic Plan was to be a self-funded health insurance program for childless adults without access to health insurance through their employer. Enrollee premiums were to offset the full cost of the program.

Unfortunately, from July 2010 through December 2010 the program ran a $140,300 deficit. A $1.1 million federal grant prevented a larger deficit. The federal grant may or may not be available during the future. BadgerCare Plus Basic expenditures are the drain on taxpayer resources Republicans anticipated at the time Governor Doyle and the Democrats created the program during 2009.

The audit reveals other problems. Monthly premium payments by BadgerCare Plus Basic enrollees failed to offset service and administrative costs. People not enrolled in BadgerCare Plus Basic received services. People enrolled in BadgerCare Plus Basic received services not covered by the program. The Department of Health Services did minimal verification of the eligibility of applicants and enrollees.

BadgerCare Plus Basic is under justifiable scrutiny, and reforms are underway since Governor Walker’s term began January 2011. The Department of Health Services suspended program enrollment during March. Monthly premium payments for current enrollees will increase from $130 to $200 beginning June 2011. Even with these changes, “… concerns remain regarding the Basic Plan’s sustainability… ,” the audit reports.

The BadgerCare Plus Basic Audit comes on the heels of a Legislative Audit Bureau Audit of another Medical Assistance program. The Family Care Program provides long-term care for elderly and low-income adults with disabilities. The state contracts with private managed-care organizations to deliver services to Family Care enrollees.

Family Care expanded from five counties to 53 counties since 2005, and costs increased nearly $700 million dollars. During the 2009-10 fiscal year, Family Care was a nearly billion-dollar program.

Is the money well spent? Unfortunately, the Audit Bureau “… could not definitively determine [Family Care’s] cost-effectiveness, in part because the type and quality of services available under Family Care may be prompting enrollment by some individuals who would otherwise not seek public assistance.” Governor Walker’s budget includes a provision to cap Family Care enrollment.

Medical Assistance programs rapidly expanded during the last five years. Difficult economic times led more people to turn to government assistance programs. Enrollment for all Medical Assistance programs increased 25 percent from the 2005-06 fiscal year to the 2009-10 fiscal year. During that same time, expenses increased nearly 50 percent. Governor Walker’s budget contains real reforms to Medical Assistance programs. With Medical Assistance reform and expansion, the work of the Legislative Audit Bureau remains paramount. Legislators must keep close tabs on taxpayer money and must do a reality check about the sustainability of the myriad of government programs.

If you have comments on this or any other issue, please contact me at Sen.Lazich@legis.wisconsin.gov, www.senatorlazich.com, Senator Mary Lazich, State Capitol, P.O. Box 7882 Madison, WI 53707 or 1-800-334-1442.