Additional Resource: The Kaiser Family Foundation Medicaid and Long Term Services Fact Sheet

What is Medicaid?

• A safety-net program for health and long-term care financed by the state and national governments for people with low incomes, including seniors and people with disabilities.
• A program that expands to cover more people during economic downturns.
• The main source of long-term care coverage and financing in the U.S.

Who receives Medicaid in Wisconsin?

• People who are age 65 or older.
• People of any age who are blind or have a disability.
• Families with incomes at or below the monthly program limit.
• United States citizens or legal immigrants.

About 45% of the Medicaid budget goes to providing care for older adults and people with disabilities.

How can I apply for Medicaid services in Wisconsin?

Please visit the Wisconsin Department of Health Services website.

How does Medicaid impact the Wisconsin economy?

• Each dollar of state money Wisconsin spends generates $2.40 in additional federal funds flowing through the Wisconsin economy this year.
• This creates / maintains jobs and generates income within the health care sector and throughout the economy, due to the “multiplier effect.”
• Payments to providers for services delivered funnel through local economies, supporting employment, business income, consumer spending, and state tax revenue.

What happens when the state cuts Medicaid funding?

• People don’t receive needed services.
• Federal Medicaid dollars are decreased, the flow of dollars to health care providers is interrupted, and economic activity at the state level declines.
• If state Medicaid spending is cut by $1 then Wisconsin would lose $3.00 in business activity.

What Medicaid programs are funded by the state of Wisconsin?

• Elderly, Blind or Disabled Medicaid is a health care program for people who are age 65 or older, blind or disabled.
• Community Waivers help the frail elderly, people who are blind, and people with disabilities live in their own homes or in the community, rather than in a state institution or a nursing home.
• Family Care is a managed care program for the frail elderly, people with physical disabilities or with developmental disabilities.
• Medicaid Purchase Plan provides health care for people with disabilities who work.
• Medicaid Deductible Plan helps people who have high medical bills and whose income is over the Medicaid program income limits.
• Medicare Savings Plans helps some people pay their Medicare Part A and B premiums, coinsurance and deductibles.

How many people in Wisconsin use Medicaid?

Across all programs, Wisconsin Medicaid provides health care services for 20% of Wisconsin residents (1.1 million).  Along with private insurance plans, these publicly-funded programs provide access to health insurance for 98% of Wisconsin residents.

• July 2010 Statewide Enrollment in Badger Care Plus - 771,784
  • July 2008 comparison - 561,796 (State)
  • Increase of 37% due to the economic recession

• July 2010 Statewide Elderly & Disabled Coverage - 278,323
  • July 2008 comparison - 263,786 (State)

What promises have been broken due to the 2009 - 2011 Medicaid budget cuts in Wisconsin?

• Providers of long-term care services have not received funding increases needed to keep pace with inflation and adjust wages to attract and retain a quality workforce.
• The Family Care program (now in 55 counties) has not been adequately funded to serve older adults and people with disabilities and is currently being audited by the Legislative Audit Bureau.
• Payments to nursing homes for skilled long term care are not sufficient, as measured by the disparity between actual costs and Medicaid payments for care.
• Two-thirds of the 33,047 residents receiving care in Wisconsin’s 400+ nursing facilities are dependent on Medicaid as the source of payment for the care they require and receive.
• Medicare is the source of payment for just 11% of these residents; private payers represent just 23% of the nursing home resident census.
• 43% of actively practicing dentists participate in the program, which is a higher percentage than other states, but Medicaid only pays dentists one third of what they get from private insurance.
• Only 1% ($38 million of the state’s $4.4 billion annual Medicaid budget), is spent on oral health programs. By comparison, 80% of other states spend a greater percentage of their Medicaid budgets to deliver dental care.

So, are there any ideas to protect Medicaid and find a long term funding solution?

Not yet.

Federal economic recovery funds are dwindling, and Wisconsin has already cut $633 million from the Medicaid program.

If a solution is not found by June 30, 2011, the state economy stands to lose 9,100 jobs; 394 million in income; and $30 million in state and local tax revenue for every 10%  of the Medicaid budget that is cut further. Read more.