Federal Approval of BadgerCare Plus Core Plan for Childless Adults

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Adults who are chronically uninsured and who do not have children under their care may now have access to primary and preventive care. Wisconsin Governor Doyle announces an agreement with Federal Government to offer Health Care to childless adults.

Governor Jim Doyle announced today that his administration has reached an agreement in principle on the next important component of his BadgerCare Plus plan to expand health care in Wisconsin. Under the proposal, those who are uninsured and who do not have children under their care may now have access to primary and preventive care. The five-year federal waiver proposal builds upon Wisconsin’s existing BadgerCare Plus program.

“Today we cleared one of the final hurdles on the way toward my goal of providing access to health insurance for 98 percent of Wisconsin residents,” Governor Doyle said. “However, the significant downturn in the national economy, and its effect on the state’s fiscal situation, will challenge our ability to quickly extend this program.”

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Governor Doyle thanked U.S. Rep. Paul Ryan, U.S. Rep. Tammy Baldwin, U.S. Sen. Russ Feingold, and U.S. Sen. Herb Kohl, along with the rest of the Wisconsin delegation, for their bipartisan work to encourage the federal government to support this new health care plan that will benefit some of the state’s hardest working residents.

The state and federal government are currently working to finalize the waiver. Once the plan is finalized, the state will use federal funding that previously supported uncompensated care to provide health insurance coverage to low-income adults. Income-eligible adults, from age 19 through 64 who do not have children or do not have dependent children under age 19 living with them, may be able to enroll in the BadgerCare Plus Core Plan. This health insurance plan is for adults who were previously not eligible to enroll in state and federal health programs. In addition, individuals who have had health insurance or had access to employer subsidized health insurance during the previous 12 months are not eligible for the Core Plan.

The BadgerCare Plus Core Plan for Childless Adults is not a standard Medicaid benefit nor an entitlement program, and will be a limited benefit due to strict state and federal budgetary limits. The program will cover basic health care services, including primary and preventive care as well as generic drugs. Every adult who applies to the program will have to complete an online health needs assessment before the application can be submitted for approval, and all members must receive a comprehensive physical exam within the first year of being enrolled in the program.

After final federal approval, the state will develop an enrollment plan based upon available state resources. Adults who may be able to enroll can make no more than 200% of the Federal Poverty Level ($20,800 each year for a single person and $28,000 for a married couple) each year. These amounts are based on federal guidelines which increase by a small amount each year. For current federal poverty level guidelines, go to badgercareplus.org/fpl.htm. For more information about the BadgerCare Plus Core Plan, go to BadgerCarePlus.org.

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