How to prepare and what to know

MADISON, Wis. – It was the unexpected blessing of a pandemic baby that moved Kathryn, a Dane County mother, back to BadgerCare early on in the pandemic.

She had just gotten a new, higher-paying job at a small firm (News 3 Now is not using her last name to protect her employment), but the job didn’t offer health insurance and she knew she’d need to buy a public health care plan through the federal health insurance marketplace. The baby forced her back to BadgerCare, the state’s Medicaid program, which was welcome – at first.

“I didn’t have to pay for insurance, I got prenatal visits covered,” she explained. “But I also knew, because this was not my first child, that it was going to end.”

Except – the coverage continued. Thanks to one of the earliest coronavirus-related federal mandates, no one across the country could be kicked off their Medicaid plan as long as the federal public health emergency was in place.

“It was nice, I saved money,” she said. She would have bought a public plan sooner, but she wasn’t able to get off. While she’s grateful for the coverage, she’s also in need of a medical procedure she says it currently doesn’t cover. Now, as an end to the public health emergency looms, she’s expecting to lose coverage – and not unprepared.

“It’s scary,” she said, “But it’s also a relief.”

Thousands could lose coverage

A few hundred thousand Wisconsinites across Wisconsin could lose their access to federally-funded health care coverage this summer, including at least 10,000 in Dane County, according to state health officials and health care attorneys.

The federal public health emergency, declared early on in the pandemic and periodically renewed ever since, stopped states from taking anyone off Medicaid for the duration of the emergency, in exchange for expanded Medicaid payments from the federal government.

As the Biden Administration decides when to lift that emergency, Wisconsin’s top health official warned this week that at least a “few hundred thousand” people could lose their benefits in the state. Before the pandemic, an average of 1 to 1.1 million used the program; today, that number has soared to 1.5 million amid paused renewals and eligibility determinations. The state has also received an added $ 1.2 billion beyond what was expected in federal payments.

“We are ready for it,” Department of Health Services interim secretary Karen Timberlake said. The agency will begin sorting out renewals and determining eligibility over a 12-month timeframe once the emergency lifts, meaning not everybody will have to submit for renewal at the same time. Timberlake said the Biden Administration has told them they’ll get a 60-day notice before the federal emergency is lifted; the current emergency runs through mid-April, and it’s renewed every 90 days.

“At that point, we will need to begin the process of redetermining Medicaid eligibility for 1.5 million people,” Timberlake said.

If you’re on BadgerCare, here’s what to do

Everyone currently using BadgerCare in Wisconsin will have to submit for renewal once the federal public emergency lifts, regardless of whether they will be ultimately found eligible or not.

“Even if your situation hasn’t changed, you’ll have to complete that renewal,” Courtney Harris from the nonprofit Covering Wisconsin explained. It will start with a letter from the state.

The state and health care advocates are urging the public to make sure that their contact information – address, email, phone number – are updated in their account so that they will receive the notice once it goes out announcing renewals have started. Once the public health emergency lifts, it won’t all happen at once: the Wisconsin Department of Health Services said it will kickstart a 12-month process, where a twelfth of everyone on Medicaid will be alerted to renew their coverage each month.

Secondly, don’t throw out mail from the state. Anyone on BadgerCare will get a letter from the DHS announcing the change, so it’s important for a person to make sure they’re opening their mail.

Finally, it’s not required but could be helpful to download the MyACCESS Wisconsin app from the DHS, available through your phone’s app store. Turning on push notifications will help be alerted when that change goes out; plus, a person can upload documents and do other work through the app to help process their renewal.

People who may need to change coverage

While everyone currently on Medicaid in Wisconsin will need to go through the renewal process, the majority will likely be able to continue their coverage once their eligibility is redetermined.

But throughout the pandemic, the number of people in Wisconsin using Medicaid benefits has swelled to 1.5 million, above the 1 to 1.1 million that was average before the pandemic. Once renewals kick back in and the state must redetermine eligibility, state health officials estimate at least a few hundred thousand will be losing their eligibility.

Bobby Peterson, executive director for ABC for Health in Dane County, estimates that could amount to more than 10,000 people in Dane County.

“If you’ve had changes in terms of your income – your income has gone up significantly, your family size has decreased – those would be some of the situations,” Peterson explained. “You may have your coverage reevaluated.”

For health care advocates like Peterson, who helps the low income population as an attorney get access to health care, the goal is to help people transition to other plans – in many cases, that could be the marketplace, where some Medicaid providers often have very similar plans.

“What we want to do is make sure no one loses coverage, but people transition to more appropriate coverage,” he said. Stay alert, but no reason to panic. At this point, it’s just being prepared for when that public health emergency ends. “

But some could still be lost in the gaps, as anyone who doesn’t submit for renewal risks losing their coverage, even if they would ultimately be found eligible.

There’s always a concern that people could be dropped entirely from health care coverage when administrative changes occur, Harris from Covering Wisconsin explained. The non-profit helping people navigate health insurance is based at the University of Wisconsin-Madison, and has received federal Covid relief funds from Gov. Evers to assist in helping people navigate the upcoming Medicaid changes.

“It’s always a place where folks fall off of coverage,” she explained. “That’s really what our navigators are here to help support.”


Resources & Information

Need help sorting out your coverage? Reach out to:

  • Covering Wisconsin: Non-profit based at the University of Wisconsin-Madison, state’s health insurance navigator agency. From CW: Covering Wisconsin’s expert Health Insurance Navigators provide free help any time. You can contact a Covering Wisconsin Navigator by calling 608-261-1455 or 414-400-9489 or schedule an appointment online at www.coveringwi.org/enroll. You can also call the 2-1-1 Helpline to find a Navigator or other health insurance enrollment assister near you.
  • ABC for Health: Non-profit law firm specializing in health care access
  • Department of Health Services

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