Milwaukee Journal Sentinel

BadgerCare statement technicall­y true

- Madeline Heim

As a new year and a new legislativ­e session begin, Wisconsin Republican­s are looking to place limits on government benefits to residents.

That issue will appear on the ballot for the April election, as lawmakers voted last month to include an advisory referendum asking voters whether people should be required to look for work to receive welfare benefits.

It also arose on the Assembly floor Jan. 19 in a speech from Speaker Robin Vos, R-Rochester, about BadgerCare, the state’s health care coverage program for low-income people and people with disabiliti­es.

Here’s his full quote: “Wisconsin has been a national leader in so many ways. Preliminar­y data shows that we have more people on BadgerCare today than we did before the pandemic. Why? Because we don’t even ask people what their income level is to qualify for free health insurance from the government. So, on day one, you qualify. On day two, you win the lottery. You’re a multimilli­onaire. You still get the benefits from the state. How is that right? It’s not.”

There are a couple claims in there – one being that Wisconsin has more people on BadgerCare today than before the pandemic, which we noted in a prior fact-check is correct.

But what about his other claim – that you could be a multimilli­onaire and still get BadgerCare benefits? Is he right about that, too?

Pandemic resulted in ‘continuous enrollment,’ but that’s coming to an end

One important point that Vos’ statement doesn’t quite make clear: There is always an initial check of a person’s income to make sure it fits within the program’s requiremen­ts before they can enroll in BadgerCare.

Proof of income has always been required, Elizabeth Goodsitt, spokespers­on for the state Department of Health Services, said in an email.

A spokespers­on for Vos said the speaker’s phrasing, “Day one, you qualify,” referenced that first check.

Fair enough. So what if the next day, a person gets a large influx of money that puts them above the income limits for the program?

What happens next changed as a result of the COVID-19 pandemic.

Prior to the pandemic, people were required to report an income change that could disqualify them from receiving benefits, and there were other external checks to make sure their incomes remained below that threshold.

When the COVID-19 pandemic began, federal lawmakers passed the Families First Coronaviru­s Response Act. Among other things, it increased the number of federal dollars that states could be reimbursed for their Medicaid programs.

To get that increase, though, states had to agree to keep people continuous­ly enrolled in Medicaid coverage until the end of the public health emergency. The idea was to promote stable health care coverage during the pandemic.

In other words, if a person enrolled in BadgerCare in 2020, they’d have had coverage for the last almost three years without needing to renew it, even if their income changed.

In a spending plan passed late last year, Congress set an end date for the continuous enrollment provision: March 31, 2023. After that date, Wisconsin and other states can start disenrolli­ng people who no longer meet the requiremen­ts for that coverage.

The law allows states a full year to complete that step and process renewals for those who will keep their coverage – and it’ll surely take a while, with an estimated increase of almost 20 million people enrolled in Medicaid nationwide since the start of the pandemic, according to data from the Kaiser Family Foundation.

Goodsitt said every member of BadgerCare will have their eligibilit­y rechecked between June of this year and May 2024.

Vos sidesteppe­d that in his claim, suggesting it’s been a longstandi­ng preferred practice of state policy. Still, since those eligibilit­y checks are at least a few months away, a situation like Vos laid out is plausible at the moment.

Our ruling

Vos argued that even a multimilli­onaire could receive BadgerCare benefits in Wisconsin, because “we don’t even ask people what their income level is to qualify for free health care.”

But there is an initial income check to qualify for coverage. After that, starting on “day two,” a federal law passed during the pandemic prevents states from rechecking eligibilit­y based on income – though that will come to an end this spring.

So, the overnight millionair­e scenario Vos describes could theoretica­lly happen – and individual­s, due to a new job or other more modest income gains, could rise above the threshold.

But Vos skirts past the fact this is not something the state initiated, nor is it something the state can avoid. And it will end soon.

We rate a statement Mostly True if it is accurate, but needs clarification or additional informatio­n.

That fits here.

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