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There has always been an initial check to make sure people’s incomes are below the threshold that qualifies for BadgerCare before they can be enrolled, according to the Wisconsin health department.
But during the pandemic, federal law mandated that states could not perform typical checks to ensure that people’s incomes hadn’t risen to a point that would disqualify them.
That law is still in effect for all states, not just Wisconsin. It ends March 31, after which states will need to start checking the qualifications of their enrollees, which number millions more in total than three years ago.
As a new year and a new legislative session begin, Wisconsin Republicans are looking to place limits on government benefits 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 benefits.
It also arose on the Assembly floor 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 benefits from the state. How is that right? It’s not."
There are a couple of 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 benefits? Is he right about that, too?
Let’s take a look.
One important point that Vos’ statement doesn’t quite make clear: There is always an initial check of people’s incomes to make sure they fit within the program’s requirements before they can enroll in BadgerCare.
Proof of income has always been required, Elizabeth Goodsitt, a state Department of Health Services spokesperson, said in an email.
A spokesperson for Vos said the speaker’s phrasing, "Day One, you qualify," referred to that first check.
Fair enough. So what if the next day, a person gets a large influx of money and moves above the program’s income limits?
What happens next changed as a result of the COVID-19 pandemic.
Before the pandemic, people were required to report an income change that could disqualify them from receiving benefits, and there were other external checks to ensure 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 people 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. This will 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 all members 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.
Vos argued that even a multimillionaire could receive BadgerCare benefits 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 end this spring.
So, the overnight millionaire scenario Vos describes could theoretically happen — and individuals, because of a new job or other more modest income gains, could rise above the threshold.
But Vos skirts past this not being something the state initiated, nor something the state can avoid. And it will end soon.
We rate a statement Mostly True if it is accurate, but needs clarification or additional information.
That fits here.
Legislative Fiscal Bureau memo, "Federal requirements regarding Medicaid eligibility redeterminations following the end of COVID-19 public health emergency," Jan. 3, 2023
Milwaukee Journal Sentinel, "Wisconsin Republicans are voting to place a welfare work requirement on the April ballot. Here's why it's all about the Supreme Court election," Jan. 16, 2023
Wisconsin Department of Health Services, BadgerCare Plus information page, accessed Feb. 1, 2023
PolitiFact Wisconsin, "Kleefisch off the mark with claim linking worker shortage and medical assistance enrollments," Aug. 2, 2022
Email with Elizabeth Goodsitt, spokesperson, Wisconsin Department of Health Services
House Resolution 6201, Families First Coronavirus Response Act, accessed Feb. 1, 2023
Kaiser Family Foundation, "10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision," Jan. 11, 2023
Georgetown University Health Policy Institute Center for Children and Families, "Unwinding Wednesday #15: Congress proposes to end Medicaid continuous coverage protection in early 2023; Adds transparency and accountability requirements," Dec. 20, 2022
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