BadgerCare Plus, known informally as BadgerCare, is a public healthcare coverage program for low-income Wisconsin residents created by former governor Tommy Thompson and modified by former governor Jim Doyle. The Wisconsin Department of Health Services oversees the program's implementation.
Before the implementation of the federally-funded State Children’s Health Insurance Program (SCHIP) initiative, Governor Tommy Thompson had wished to create a state-level family healthcare plan that used both Medicaid and SCHIP funds since his days in the state legislature.
BadgerCare was passed in the wake of the Clinton administration's social service overhaul (when Aid to Families with Dependent Children was replaced by Temporary Assistance for Needy Families) and launched in July 1999. The goal was to provide coverage to families with uninsured children who were transitioning from welfare to the workforce. The program's initial enrollment was 3,400 adolescents, but the total number of individuals covered by BadgerCare increased to 51,172 by November 2000. [1]
Under the original conditions of BadgerCare, families could enroll if their net incomes were up to 185% of the federal poverty level (about $31,000 for a family of four in 2000) and could remain on BadgerCare as long as their incomes did not exceed 200% of the federal poverty level. [1] Unlike Medicaid, a family applying for BadgerCare did not have to pass any sort of "asset test" to qualify.
In 2006, the Democratic-controlled Wisconsin Senate passed a bill nicknamed the "Healthy Wisconsin proposal" [2] that would have created a near-universal health care system in Wisconsin similar to the Massachusetts health care reform of 2006 implemented by then-governor Mitt Romney. Like the Massachusetts plan and the Affordable Care Act, the Healthy Wisconsin proposal would have mandated insurance coverage for any individual not on Medicare or BadgerCare. [2] The proposed plan would not cover dental or eye care, long-term care, nor unnecessary cosmetic surgery. [3] The plan was to have been paid for by a $15 billion payroll tax, making it incredibly unpopular among the Republican-controlled Wisconsin Assembly, and Democratic governor Jim Doyle. [4]
Since Governor Doyle opposed the Senate's mandate plan, he chose instead to expand BadgerCare, claiming that 98% of Wisconsinites would have some form of health insurance under his expansion. [4] Doyle called the revised program BadgerCare+ and included it in his 2007-2009 biennial budget. BadgerCare+ began functioning on February 1, 2008.
According to a state document [5] sent to healthcare providers in January 2008, BadgerCare+ expanded enrollment to:
The revised plan also covered tobacco cessation products such as nicotine gum.
The extremely high number of applications for the BadgerCare+ Core plan put undue stress on the program's budget, and Doyle suspended enrollments for that program in October 2009 [6] with 21,000 individuals still on the waiting list. To assuage the thousands of Wisconsinites still seeking coverage, Doyle proposed an additional plan named BadgerCare+ Basic, targeted at childless adults. The income stipulations for BadgerCare+ Basic were $21,660 a year for a single childless individual and $29,140 for a childless couple. In contrast to Badgercare+ Core, coverage would be funded by a $130 premium to be paid by the policyholder, rather than taxpayers, and would cover up to 10 doctor visits, one inpatient hospital visit, five outpatient visits, and up to five emergency room visits in addition to some generic medications and discounts on other drugs. [6] Signing the BadgerCare+ Basic bill into law in May 2010 was one of Doyle's last major acts as governor, [7] [8] as he did not seek re-election in the 2010 Wisconsin gubernatorial election.
Soon after taking office in 2011, Governor Scott Walker began pursuing large funding cuts to BadgerCare as a government deficit reduction measure. [9]
In 2013, Governor Scott Walker rejected federal money that would have ben made available under the Affordable Care Act, and 92,000 people were told that their health insurance through BadgerCare Plus would end and that they would consequentially be required to buy potentially more costly commercial health coverage under the Affordable Care Act's individual mandate. [10] [11]
After taking office in 2019, Governor Tony Evers began pushing to expand BadgerCare Plus by about 76,000 participants, which Republican opponents argued would "shift costs to the private sector." [12]
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding.
The Children's Health Insurance Program (CHIP) – formerly known as the State Children's Health Insurance Program (SCHIP) – is a program administered by the United States Department of Health and Human Services that provides matching funds to states for health insurance to families with children. The program was designed to cover uninsured children in families with incomes that are modest but too high to qualify for Medicaid. The program was passed into law as part of the Balanced Budget Act of 1997, and the statutory authority for CHIP is under title XXI of the Social Security Act.
TennCare is the state Medicaid program in the U.S. state of Tennessee. TennCare was established in 1994 under a federal waiver that authorized deviations from the standard Medicaid rules. It was the first state Medicaid program to enroll all Medicaid recipients in managed care. When first implemented, it also offered health insurance to other residents who did not have other insurance. Over time, the non-Medicaid component of the program was significantly reduced. Today TennCare offers a large variety of programs to better serve the citizens of Tennessee.
Dr. Dynasaur is a publicly funded healthcare program in the U.S. state of Vermont, created in 1989. Vermont had an estimated 140,000 people under age 18 (90,000 under 300% above the Federal Poverty Level. Dr. Dynasaur covered 56,000 of these uninsured. After adding the coverage of this program to those already covered by private health insurance, Vermont had achieved a virtually universal health insurance for children. As a result, the state was regarded as having the best healthcare program in the United States.
The Massachusetts health care reform, commonly referred to as Romneycare, was a healthcare reform law passed in 2006 and signed into law by Governor Mitt Romney with the aim of providing health insurance to nearly all of the residents of the Commonwealth of Massachusetts.
The Balanced Budget Act of 1997 was an omnibus legislative package enacted by the United States Congress, using the budget reconciliation process, and designed to balance the federal budget by 2002. This act was enacted during Bill Clinton's second term as president.
The Oregon Health Plan is Oregon's state Medicaid program. It is overseen by the Oregon Health Authority.
In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.
Healthcare reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, which amended the PPACA and became law on March 30, 2010.
In the United States, health insurance coverage is provided by several public and private sources. During 2019, the U.S. population overall was approximately 330 million, with 59 million people 65 years of age and over covered by the federal Medicare program. The 273 million non-institutionalized persons under age 65 either obtained their coverage from employer-based or non-employer based sources, or were uninsured. During the year 2019, 89% of the non-institutionalized population had health insurance coverage. Separately, approximately 12 million military personnel received coverage through the Veteran's Administration and Military Health System.
Healthy San Francisco is a health access program launched in 2007 to subsidize medical care for uninsured residents of San Francisco, California. The program's stated objective is to bring universal health care to the city. Healthy San Francisco is not a true insurance program, as it does not cover services such as dental and vision care, and only covers services received in the city and county of San Francisco. The program itself acknowledges its limitations, and has stated that "insurance is always a better choice." Healthy San Francisco represents the first time a local government has attempted to provide health insurance for all of its constituents. The program is open to low-income city residents over the age of 18 who do not qualify for other public coverage, and who have had no insurance for at least 90 days. Eligibility is not conditional on citizenship, immigration, employment or health status. The program covers a range of services, but only pays providers within San Francisco. By July 2010, almost 90% of the uninsured adults in San Francisco — over 50,000 people — had enrolled in Healthy San Francisco.
In the United States, health insurance marketplaces, also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection and Affordable Care Act at ACA health exchanges, where they can choose from a range of government-regulated and standardized health care plans offered by the insurers participating in the exchange.
The Oklahoma Health Care Authority (OKHCA) is an agency of the government of Oklahoma responsible for providing health insurance benefits for the state's SoonerCare members. The authority is the state-level counterpart to the federal Centers for Medicare and Medicaid Services.
Members of the United States population between the ages of 18 and 29 who decide that it is in their financial best interest to forgo health insurance are sometimes referred to as young invincibles by the insurance industry, a term coined to express the idea that the young demographic perceives themselves as immune to sickness and injury. The argument is that these individuals are young and in good health, so they have a low risk of experiencing substantial health issues that would lead to large amounts of spending on health care. Further, this group tends to have a mentality of “it won’t happen to me” with regards to most causes of injury. Together, these beliefs lead to the young invincibles not purchasing insurance.
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965.
Following the signing of the Children’s Health Insurance Program (CHIP) into law on August 5, 1997, as Title XXI of the Social Security Act, Utah started looking at how to implement the Federal program under the Center for Medicare and Medicaid Services.
Health care finance in the United States discusses how Americans obtain and pay for their healthcare, and why U.S. healthcare costs are the highest in the world based on various measures.
The Affordable Care Act (ACA) is divided into 10 titles and contains provisions that became effective immediately, 90 days after enactment, and six months after enactment, as well as provisions phased in through to 2020. Below are some of the key provisions of the ACA. For simplicity, the amendments in the Health Care and Education Reconciliation Act of 2010 are integrated into this timeline.
In the context of American public healthcare policy, the Medicaid coverage gap refers to uninsured people who do not qualify for marketplace assistance under the Affordable Care Act (ACA) and reside in states that have not adopted Medicaid expansion under the ACA. People within this categorization have incomes above the eligibility limits for Medicaid set by their state of residence but fall below the federal poverty line (FPL), resulting in deficient access to affordable health insurance. As of March 2023, an estimated 1.9 million Americans in 10 states are within the Medicaid coverage gap according to the Kaiser Family Foundation. Approximately 97 percent of this cohort lives in the Southern U.S., with a majority living in Texas and Florida; Texas has the largest population of people in the cohort, accounting for 41 percent of people in the coverage gap.
The Healthy Montana Kids Plan Act (HMK) is a program that expanded the Children's Health Insurance Program (CHIP) and Medicaid eligibility for children in the state of Montana. The effort to codify HMK was spearheaded by then state auditor John Morrison. HMK was passed by Montana voters in 2008 under Ballot Initiative 155, and then implemented the following year. After the adoption of HMK, children of families with a household income of up to 250 percent of the federal poverty level were eligible for CHIP coverage. Children of families with incomes up to 185 percent of the federal poverty level were eligible for Medicaid coverage, removing the requirement for clients to make a copay upon receiving treatment. Under HMK, efforts to enroll children in CHIP and Medicaid have increased significantly. HMK also helps to cover the costs of adding children who would be eligible for CHIP or Medicaid to their parents’ existing private insurance plans, thereby saving state funds. The insurance provided under HMK covers medical, dental, and vision care.