Most childless adults in Medicaid would have to pay monthly premiums and some would get drug tested under changes for which the Department of Health Services is seeking federal approval.
The plan is facing criticism from liberal-leaning groups, which say the changes would push people off Medicaid and lead to more uncompensated care at hospital emergency rooms.
But DHS says the plan would strengthen the program and help people get substance abuse treatment and job training.
Lawmakers approved the changes as part of the 2015-17 budget, though DHS Monday released more details on the specifics of the plan it’s asking the Trump administration to approve. DHS plans to submit its application May 26 after the public comment period wraps up.
DHS said the changes it’s seeking for childless adults include:
*screening recipients for substance abuse and testing some individuals. Those who test positive for drugs will have the option to enter a treatment program, though they’ll become ineligible for Medicaid for six months if they don’t participate in the program. Those who refuse to take the screening assessment or drug test would be ineligible for Medicaid until they complete them.
*adding monthly premiums ranging from $1 to $10 per household, which DHS says will “help to increase the sustainability and value of health care in the state.” Those between 0 and 20 percent of the federal poverty level would be exempt from paying premiums. That means that individuals would be subject to premiums if they make between $2,412 a year and the federal poverty level of $12,060 a year.
*conducting a health risk questionnaire and reducing the monthly premiums by half if people engage in healthy behaviors.
*setting a 48-month Medicaid eligibility limit for those who are 19 to 49 years old, though if they spend at least 80 hours a month working or in a job training program, that time wouldn’t count toward the limit. If people hit the 48-month limit, they lose eligibility for Medicaid for six months. There are several exemptions, though, such as those for students and people with mental illness or disabilities.
On a media call Monday, UW-Madison professor Richard Brown criticized the drug screening and testing plan.
Brown, the director of the Wisconsin Initiative to Promote Healthy Lifestyles, said the money the state would spend on administering drug tests would be better used to boost treatment programs. He also said the plan is “doomed to fail,” as various websites give people instructions on how to pass a drug test and the tests often show false positives.
Jon Peacock, research director of the Wisconsin Council on Children and Families, raised concerns about adding premiums to Medicaid enrollees, saying studies have shown that has led to low-income people losing health coverage.
“For many of those people, they don’t have checking accounts, they don’t have credit cards, and it’s going to be very difficult just as a practical matter for them to pay monthly premiums,” he said.
DHS is accepting written comments on the plan for 30 days starting Wednesday. It’s also holding two public hearings, one in Wausau on April 26 and the other in Milwaukee on May 1.
See more on the DHS plan: https://www.dhs.wisconsin.gov/badgercareplus/waivers-cla.htm
See the Citizen Action of Wisconsin release on today’s call: http://www.citizenactionwi.org/public_health_experts_challenge_gov_walker_s_forced_drug_testing_for_badgercare