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Affordable Care Act Implementation in Wisconsin

Affordable Care Act Implementation in Wisconsin. Covering Kids and Families Annual Conference October 3, 2012. Decline in Employer-sponsored Insurance ( CPS data for non-elderly population: 2000 to 2011 ) .

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Affordable Care Act Implementation in Wisconsin

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  1. Affordable Care Act Implementation in Wisconsin Covering Kids and Families Annual Conference October 3, 2012

  2. Decline in Employer-sponsored Insurance (CPS data for non-elderly population: 2000 to 2011)

  3. Uninsured Non-Elderly Wisconsinites(2010 SAHIE data: 518,246 uninsured, or 10.8%)

  4. Uninsured Wisconsin Children(2010 SAHIE data: 72,800, or 5.3% of WI kids)

  5. Trend in BadgerCare Core Coverage for Non-Custodial Adults

  6. 2 Times Lambeau on the BadgerCare Core Plan Waiting List

  7. Unsubsidized (No Income Limit) Limit) Net Family Income as a Percent of Poverty Level 300% Evolution of Family Health Coverage Reaching More Wisconsinites Self-Employed / Farmers BadgerCare Plus Expansion 200% 185% Medicaid & Healthy Start BadgerCare (July ‘99- January ‘08) BadgerCare Plus Expansion (2008) 100% 44% Pregnant Women Children (ages 0-5) Children (ages 6-18) Parents Caretaker Relatives Youth (exiting foster care) Childless Adults (enrollment 7/09-10/09) Challenges and Opportunities You Can Help

  8. Net Family Income as a Percent of Poverty Level 400% Health Insurance Exchanges Potential BadgerCare & ACA Coverage in WI in 2014 300% Protected by MOE (until 2019) ??? 200% Basic Health Plan Option 138% Supreme Court 100% BadgerCare Foundation of Coverage Parents Children Pregnant Women Adults without Dependent Children Challenges and Opportunities You Can Help

  9. Decision Points: ACA Implementation March 2010: Affordable Care Act Becomes Law • Pre-existing condition protections for children, expanded coverage for young adults, small business tax credit, discounted drugs in donut hole June 2012: SCOTUS Upholds Majority of ACA July 2012: Wisconsin increased premiums and tightened crowd-out restrictions for adults in BadgerCare over 133% of the poverty level (FPL) • As allowed under ACA if state certifies a budget deficit (WI did so) September 30, 2012: State Essential Health Benefit Benchmark Decisions November 16, 2012: State Exchange Authorization and Blueprints due to HHS January 2013: HHS Certifies and Approves (or conditionally approves) State-Based Exchanges October 2013: Open Enrollment for Exchange Coverage Begins January 2014: Exchange Coverage Begins in Every State & Filling the Gap in BC+ • States can shift BadgerCare adults over 138% FPL into Exchanges or Basic Health Plan • States can begin receiving enhanced federal funding if participate in the Medicaid expansion • Further insurance protections go into place No Deadline: Using the ACA to fill the gap in BadgerCare, 100% federal funding until 2016, phases down to 90% from 2020 onward. State can also expand now, and restrict coverage in the future.

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