Open Enrollment Ends But the Work Continues…

It’s been a very busy three months for us at Covering Kids & Families- so busy that we have neglected our blog! Although we’ve posted through our Facebook and various other project list serves, we wanted to make sure we keep you all connected through this tool as well. We’ll be back to posting regularly so be sure to send any requests for additional information to

This is Danielle writing, so I’m going to give you a quick update on outreach, education and enrollment assistance efforts through the Milwaukee Enrollment Network (MKEN),  MKENa regional collaboration of 100+ organizations focused on health insurance enrollment. Stay tuned next week for an update on a different topic from one of my colleagues.

On March 31st (or April 15th, depending on how you look at it), we saw an end to the first Health Insurance Marketplace Open Enrollment period. Covering Kids & Families, one of the co-conveners MKEN, was busy providing training, event coordination, resources and materials to local organizations in order to ensure consumers were connected to coverage. Other MKEN member organizations including local Navigators, Certified Application Counselor agencies, agents, brokers and other public benefit assisters spent the last six months trying to put a dent in Milwaukee’s 13% uninsured rate and enroll eligible consumers into Marketplace or BadgerCare+ coverage. MKEN members met regularly to share updates, discuss strategies and best practices, and plan outreach events and enrollment activities.

So, we are still waiting on Wisconsin-specific data, but nationwide, Health and Human Services reported that roughly 7.5 million people signed up for health insurance coverage in the Marketplace as of the end of March, and that that millions more signed up through private plans or through their state’s Medicaid program. Also, because some consumers will be eligible for Special Enrollment Periods and BadgerCare+ enrollment is year-round, we hope to see the insured rate increase over time. We will be sure to pass along the most recent data on the number of Wisconsin’s successful enrollments as they are made available – so stay tuned!

If you are interested in learning more about or getting involved in MKEN, check out For folks outside of Milwaukee, check out the Department of Health Services’ website for contact information on your regional enrollment network. Efforts are already underway to prepare for the next Open Enrollment period which begins November 15th!

Wisconsin BadgerCare+ Waiver Approved: An Update on BadgerCare+ Policy

Waiver Approval

Today, the Department of Health Services (DHS) announced a final agreement with the federal Centers for Medicare and Medicaid Services (CMS) on the waiver to make changes to BadgerCare+. Though the state changes to the program were proposed and enacted through the biennium budget in June 2013, BadgerCare+ is a joint state and federal program, so all changes had to be negotiated and approved by CMS.

Three-Month Delay

Due to technical issues with the federal Marketplace website, the changes to BadgerCare+ coverage have essentially been delayed for three months through state legislation passed in December. We blogged in December about the delay in coverage of childless adults under BadgerCare+ and the transition of parents/caretakers with income above 100% FPL to the Marketplace as it was passed into law. The waiver language confirms this- that childless adults with incomes below 100% FPL will be eligible for BadgerCare+, without an enrollment cap, on April 1, 2014.

CKF’s 10 Things to Know document summarizes the effects of the 2014 changes to BadgerCare+.


The waiver also ensures that all BadgerCare+ enrollees (including children) will have access to the full Standard Plan benefit package, which is more robust than the current Benchmark and Core Plan benefits.


The agreement between the state and federal government also updates progress on the state’s transition to assessing eligibility under the new Modified Adjusted Gross Income (MAGI) standard – which will apply to BadgerCare+ enrollees, and not the Elderly, Blind, and Disabled Medicaid population. The MAGI system will be operational February 1, 2014. In order to assess currently eligible BadgerCare enrollees for future eligibility using the new standard, the state is asking all current BadgerCare enrollees to complete this form and return it by January 17, 2014. This will take an amendment to state law that has been approved by the Wisconsin Joint Finance Committee, and will need full legislative approval.

Here are a couple things to know about the MAGI transition and key eligibility dates:

·        January 17th – Current BadgerCare+ enrollees who received this letter should return the tax filer information form to have their eligibility reassessed under MAGI.

·         February 1st – MAGI will be implemented and all newly enrolling adults/caretakers will be assessed under MAGI with the BadgerCare+ adult income standard at 100% FPL instead of the current 200% FPL.

·         March 15th – Currently enrolled BadgerCare+ parents/caretakers with incomes above 100% FPL should enroll in a Marketplace plan with federal subsides to help afford coverage. If these individuals fill out the tax filer information form and are found to have income above 100% FPL under MAGI rules, their information should have been automatically transferred to the Marketplace.

·         April 1st – Currently enrolled BadgerCare+ parent/caretakers with incomes above 100% FPL will no longer be eligible for BadgerCare+.

·         April 1st – Newly eligible childless adults with income less than 100% FPL will be eligible to start BadgerCare+ coverage. Current BadgerCare+ Core Plan members with incomes below 100% FPL will be automatically transferred to the full Standard Plan.

More details about the MAGI transition and agreement can be found in the Legislative Fiscal Bureau papers on the technical bills currently before the legislature.

Further Waiver Policy – Transitional Medical Assistance (TMA)

Wisconsin currently charges premiums to TMA adults with incomes above 133% FPL, and requested, through the waiver, to charge premiums to all TMA adults above 100% FPL. However, the final agreement allows Wisconsin to charge scaled premiums to adults between 100% and 133% FPL only after six months on TMA. This may become a moot point if congress doesn’t reauthorize the option of providing TMA to some adults for 12 months (as Wisconsin currently provides). To learn more about that federal discussion, see the Center on Budget and Policy Priorities recent report.

If you want to read more on the technical details of the waiver agreement, the special terms and conditions can be found here.


State and Feds Approve BadgerCare+ Effective Date Changes

2014 marks significant changes to health insurance options for Wisconsin residents – including those who use BadgerCare+ (Wisconsin’s Medicaid program) for coverage. Wisconsin did not accept funding for Medicaid expansion as part of the Affordable Care Act’s implementation. Instead, the original state proposal was to change BadgerCare+ eligibility, sending some currently eligible BadgerCare+ enrollees to the Health Insurance Marketplace, where they could ideally receive subsidies to purchase insurance and opening BadgerCare+ enrollment to adults living at 100% or below the federal poverty level – including those without dependent children. These changes were originally slated to take effect January 1, 2014.  

In response to issues with Health Insurance Marketplace’s initial functionality, the governor and state legislature proposed changing the effective date of these changes to April 1, 2014. This proposal has been accepted and the changes are now in force.

The changes are summarized in this CKF 10 Things to Know document. 

The health insurance changes over the past year have kept consumers, advocates, assistance professionals, agents, brokers and providers on their toes as everyone seeks to provide accurate and timely advice. Insurance is not an easy topic to understand, despite its key link to health. It can be especially difficult with the many changes that have taken place as the nation undergoes the first year of health reform.

We’re encouraging anyone who interacts with people who are insured through BadgerCare+ now, or may be in the future, to pay close attention to all communications from the Wisconsin Department of Health Services as it seeks to inform BadgerCare enrollees and provide them with key instructions to maintain BadgerCare+ coverage or seek insurance on the Marketplace. 

Keep an eye on the DHS website and Covering Kids & Families website to stay informed about these changes – and others that may come in 2014.

NEW! Milwaukee Area Events and Enrollment Directory Published




MILWAUKEE (December 11, 2013) – The Milwaukee Enrollment Network (MKEN) is promoting almost daily education and enrollment events this month to build awareness and assist with reviewing insurance options available through the Health Insurance Marketplace.  While open enrollment will continue through March 31, 2014, December 23 is the last day individuals can enroll to ensure insurance coverage by January 1, 2014.

Open to the general public, the enrollment events include information, education and often, assistance enrolling in BadgerCare Plus or the Health Insurance Marketplace.  For the most up-to-date list of enrollment events and assistance locations, individuals should dial 2-1-1.

Statewide events 

(click list to see full list of events by date)

Milwaukee area events

MKEN is a consortium of more than 100 organizations committed to promoting adequate and affordable health insurance coverage, with a focus on low-income uninsured and underinsured people in Milwaukee County. Its members are implementing a number of strategies to help individuals understand, buy and keep health insurance.  The consortium includes federally funded Navigators as well as Qualified Health Plans, insurance agents and Certified Application Counselors.  It has helped recruit, train and deploy more than 120 enrollment assisters in the community.  MKEN recently published the Milwaukee County Enrollment Directory, which lists more than 36 organizations that provide in-person or over the phone enrollment assistance for patients, clients and the public.  MKEN members and Qualified Health Plans have already hosted more than 100 outreach and education events across the community since August and will continue to coordinate enrollment activities in the New Year.

Milwaukee Enrollment Directory

Milwaukee Marketplace Assistance fact sheet

MKEN is co-convened by Covering Kids & Families Wisconsin, the Milwaukee Health Care Partnership and the Wisconsin Department of Health Services.  Significant funding for MKEN’s outreach efforts has been provided by the Greater Milwaukee Foundation, the United Way of Greater Milwaukee and the Milwaukee County Department of Health and Human Services.

BadgerCare+ and Health Insurance Marketplace Updates (11/27/13)

downloadMany changes are coming in the way individuals and families access health care in our community due to the Affordable Care Act and changes to Wisconsin’s BadgerCare+ program. Covering Kids & Families (CKF) joins many other local, state and national organizations working to inform the community about these changes to ensure residents have appropriate access to coverage and care.

BadgerCare+: Governor Walker has proposed delaying changes to the BadgerCare+ program from January 1st, 2014 to April 1, 2014.  If approved, this would mean:

  • individuals who are currently enrolled in BadgerCare+ would maintain their eligibility and enrollment in the program until April1st,
  • childless adults (many of whom were on the BadgerCare+ Core waitlist) would not be able to access BadgerCare+ benefits until April 1st, and
  • individuals in HIRSP plans will have the option to continue in their current plan until April 1st, or transition to a new plan through the Health Insurance Marketplace (see the HIRSP FAQ here).

This delay is not effective until approved by Wisconsin State Legislature and the Centers for Medicaid and Medicare Services.  The Legislature will hold a special session on this topic December 2nd, 2013 at 11:00 am.  Interested individuals can attend and testify at this public hearing held in room 412 East at the State Capitol building.  More information on the proposed changes can be found at the Department of Health Services website:

Marketplace Coverage Deadline: In order for coverage selected in the Marketplace to begin January 1st, 2014, the application must be submitted and the first premium paid by December 23rd.   Originally the date was December 15, 2013.  Applicants can also apply for coverage through the Marketplace by calling 1-800-318-2596.

Uninsured individuals and families and those seeking new coverage should continue to apply at the Health Insurance Marketplace at  For in-person application assistance, check out the enrollment directory at  Residents in Milwaukee and southeastern Wisconsin can also call 2-1-1 for a list of local supports.

Please visit the CKF website, blog and Facebook at  or email us at for more resources and training material.

BadgerCare+ Members Notified of Changes; Now What?

The Department of Health Services (DHS) recently released data on the informational letters mailed to Wisconsin residents potentially affected by the January 1, 2014, BadgerCare+ changes.  The data outlines the number of parents/caretakers, children and childless adults in each county who were mailed one of four letters.  DHS released the following descriptions of each letter and the criteria used to select the member/individual:

·         Letter 1 – includes those transitioning adults (parents/caretaker relatives and childless adults) whose household income exceeds 100% of the federal poverty level (FPL), and transitioning children in households whose income exceeds 300% FPL.

·         Letter 2 – includes those parents/caretaker relatives who are currently in transitional medical assistance (TMA) and eligible for BadgerCare Plus+ for 12 months, also called an extension, whose household income is between 100% and 133% FPL. They will be required to pay premiums starting January 1, 2014.

·         Letter 3 – includes those childless adults that are currently enrolled in the BadgerCare Plus Basic Plan.

·         Letter 4 – includes those childless adults that were on the Core Plan waitlist as of September 20, 2013.

The letters can be viewed at the DHS website:

A total of 257,434 individuals statewide may be impacted by the BadgerCare+ changes.  Beginning January 1, 2014, individuals below 100%FPL will be newly eligible for BadgerCare+, individuals above 100%FPL will lose their BadgerCare+ and a third group of individuals will be required to pay premiums to retain their BadgerCare+ coverage.  Individuals transitioning off of BadgerCare+ are advised to go to the Health Insurance Marketplace at to apply for new coverage.

Covering Kids & Families, in partnership with the Wisconsin Primary Health Care Association, the Department of Health Services and Regional Enrollment Networks throughout the state, is working hard to ensure that residents affected by the changes in BadgerCare+ understand them and know what to do next to secure healthcare coverage for their families.  A website called Enrollment for Health Wisconsin ( was created to keep the community informed.  The e4health website houses a calendar of over 200 informational sessions, trainings, and enrollment events for consumers, enrollment assisters and health care professionals and has a downloadable directory of enrollment supports ( to inform consumers where to go locally for application assistance.  Additionally, the Wisconsin Office of the Commissioner of Insurance has provided a list of licensed agents ( who have received training to assist transitioning BadgerCare+ members in selecting health insurance from the Marketplace.

CKF is furthering its educational and outreach efforts in the community – training community-based organizations on the basics of the health care reform, distributing information to consumers affected by the Medicaid changes, informing school district staff of new health care options available to families and providing technical support, referrals and resources to those calling or emailing us.

For more information or to request CKF assistance, contact us at

Enrollment 4 Health Wisconsin website opens Event and Training Calendar

Learning to be an enrollment assister? Mobilizing your community? Educating consumers? Learn how to do it best by attending one of the many trainings and events listed on the E4Health Wisconsin Website calendar.

The new E4Health Wisconsin website is the central resource for the Affordable Care Act in Wisconsin with quick links to essential tools, helpful organizations, and policy notices from the responsible agencies, in addition to a searchable calendar with events for enrollers and consumers.

Look there first to increase your knowledge and send your events for posting through the contact us form.



January 1, 2014 BadgerCare+ Changes

With the opening of the Health Insurance Marketplace on October 1st and impending changes to the state’s Medicaid program coming January 1st, it’s an interesting time for consumers looking for health care in Wisconsin.

Though a majority of Americans who access healthcare coverage through their employer or through Medicare will not experience any changes, many consumers who are currently uninsured or have coverage through BadgerCare+ will have new options for coverage.

Beginning this month, BadgerCare+ members will be receiving letters in the mail, notifying them of potential changes to their eligibility for coverage.  Wisconsin’s administration has requested a waiver from the Department of Health and Human Services to make changes to the BadgerCare+ program, which would begin taking effect January 1st, 2014.

The most significant request is a change in eligibility for BadgerCare+ adults from 200% of the federal poverty level (FPL) to 100% FPL.  Currently parents and caretaker relatives are eligible for BadgerCare+ but most childless adults remain on waitlist for coverage.  Beginning January 1, 2014, parents with incomes over 100% FPL who currently have coverage through BadgerCare+ will no longer be eligible.   This is expected to impact 17,000 Milwaukee County residents.  Residents who will lose their BadgerCare+ coverage will be encouraged to apply for private coverage on the new Health Insurance Marketplace at

At the same time, childless adults with incomes less than 100% FPL who were previously on a waitlist for coverage will now be able to apply for BadgerCare+ coverage, also at  This change will allow nearly 44,000 uninsured Milwaukee County residents to access the BadgerCare+ program for coverage.

To further explain the changes proposed to the BadgerCare+ program, Covering Kids & Families created this “Top 10 things to Know” factsheet.  The goal of this factsheet is to inform stakeholders who will be working with consumers that may be impacted by these changes.  We want to make sure consumers are equipped with the knowledge, resources and assistance to connect to the healthcare coverage for which they are eligible- whether through BadgerCare+ or the Health Insurance Marketplace.


More information is available at from the Covering Kids & Families, the Department of Health Services, and Enrollment for Health Wisconsin.

Supplemental Nutrition Assistance Program (SNAP) Benefits Cut in November 2013

All participants of SNAP, also known as FoodShare in Wisconsin, will see a decrease in their monthly benefits come November 1, 2013. The American Recovery and Reinvestment Act of 2009 (ARRA) responded to the country’s economic struggles with an increase in SNAP benefits for all participants. This temporary increase will end on November 1st, and a family of three will see a monthly cut of $29 from their FoodShare benefits.  With these cuts, SNAP benefits will average less than $1.40 per person per meal in 2014 (further details of benefit cuts can be found in an article by the Center on Budget and Policy Priorities).

In preparation for the cuts, states need to determine how they will notify households participating in SNAP that they will see a decrease in their monthly benefits. It is likely that there will be some confusion and disappointment among participants.  Cuts will likely cause hardship for these families and reduce their ability to purchase food.  As of June, 2013, 15% of the 5.7 million people in Wisconsin were receiving FoodShare. Fifty percent of these recipients are 23 years old or younger (taken from the WI Department of Health Services- FoodShare Wisconsin at-a-Glance). These cuts can be likened to taking away 16 meals a month for a family of three.  Notifying SNAP participants as far in advance as possible that these cuts are coming may help them prepare and find other resources that can help them access consistent meals for their families.

Although these cuts may be detrimental to families, FoodShare participants with school-aged children should still be aware that when they receive FoodShare benefits in Wisconsin, their children are eligible to receive free meals while they are at school. Schools participating in the National School Lunch program in Wisconsin are required to provide free meals to children living in households that participate in FoodShare or W-2 cash benefits, or who are in the state foster care system. Families not participating in FoodShare or W-2 may be eligible for free or reduced price meals based on their income and they may complete an application at their school.

CKF’s Direct Certification Specialists, Marisa and Abby, are happy to answer questions about these school meal benefits in Wisconsin. Please contact them at

Navigator Grants Awarded in Wisconsin

Last week the Department of Health and Human Services announced the organizations awarded funding to implement Navigator programming in Wisconsin.  Navigators will be one piece of the consumer support network charged with outreaching to and enrolling eligible individuals and families into appropriate health insurance when the Marketplace opens on October 1.

Organizations who are not housing Navigators but wish to provide enrollment assistance support can apply to become Certified Application Counselors (CACs).  For more information on becoming a CAC organization, visit

Both Navigators and CACs will be required to go through training and certification processes.   An inventory of available CAC organizations will be made available after they are identified so local organizations know where to refer consumers in need of assistance.  Organizations who will house Navigators are listed below.

For more information on who’s doing what in your community and how to get involved, feel free to contact us here at CKF – 608-261-1455.


Navigator Grants Awarded in Wisconsin

Partners for Community Development, Inc.
Anticipated grant amount: $315,720
Partners for Community Development will facilitate the enrollment of the uninsured with
emphasis on reaching out to Hispanic and Hmong families and other hard-to-reach eligible consumers in Door, Kewaunee, Manitowoc, Ozaukee, and Sheboygan Counties in Wisconsin. It will focus outreach and enrollment efforts in its service area on hard-to-reach consumers and families with limited English proficiency.

Northwest Wisconsin Concentrated Employment Program, Inc.
Anticipated grant amount: $285,035
The Northwest Wisconsin Concentrated Employment Program will help lead a Navigator project in their region to promote accessibility to health insurance Marketplace and the health care system in Wisconsin. The cooperative agreement will be used to provide Marketplace Navigator services at 21 Wisconsin Job Centers without reach provided at libraries, Senior Centers and college campuses by existing staff that have experience working with diverse populations.

Legal Action of Wisconsin, Inc./SeniorLAW
Anticipated grant amount: $70,000
SeniorLAW is a community and consumer-focused nonprofit located in Milwaukee that
provides a variety of services to individuals age 60 or over, mostly related to health insurance and public benefits. This group will conduct outreach to the 60-64 population in Wisconsin, using community education, client contacts and agency relationships that SeniorLAW has established throughout Southeastern Wisconsin.

National Council of Urban Indian Health*
Anticipated grant amount: $35,000
National Council of Urban Indian Health is the only national, membership-based organization dedicated to outreach and education on behalf of Urban Indian Health. It provides training, technical assistance, outreach, and education to Urban Indian Health Programs.

National Healthy Start Association
Anticipated grant amount: $191,667
The National Healthy Start Association is a non-profit organization that works to improve birth outcomes and health disparities across the country through the federal Healthy Start programs. They will reach out to the uninsured population and provide education and assistance services for Marketplace enrollment.

R&B Receivables Management Corporation DBA R&B Solutions
Anticipated grant amount: $104,520
R&B Receivables Management Corporation currently works to connect uninsured and
underinsured individuals with coverage options to help them afford health care. They will expand their services to connect with a broader range of underserved populations, and leverage their experience screening people for eligibility for medical assistance programs to connect people with coverage.