Wisconsin Faces Cuts in FoodShare Funding

Wisconsin is one of only four states nationwide that is enacting cuts to the food stamp (FoodShare) program. The food stamp cuts were passed as part of the massive Federal Farm Bill in February. The intent of the legislation was to save money by clamping down on states that were using certain provisions of a federal heating assistance program to increase food stamp benefits.

The Associated Press found that governors of 12 states have taken steps to avoid the cuts. In some cases, states are using their own money, saying they’re preserving benefits for their most vulnerable residents. The AP review said Wisconsin, Michigan, New Jersey, and New Hampshire are the only ones that did not try to work around the federal cuts.

But how does this affect our work at CKF? FoodShare eligibility is one of the federal benefits that qualifies school-age children for Free and Reduced Lunch as part of the National School Lunch Program. CKF has been working with Wisconsin’s Department of Public Instruction to connect children to free lunch via direct certification since 2011. Cuts to FoodShare mean fewer students are eligible for the healthy, nutritious meals they need to remain productive at school.

The good news is that students that were eligible for FoodShare at the start of this school year will remain eligible for free lunch for the rest of this academic year and the first month of school in 2015, regardless of whether or not they lose their FoodShare eligibility. The bad news is that unless Wisconsin leaders step in to avoid these cuts, untold numbers of kids will not be eligible for FoodShare and free lunch for next year.

For some kids, school is the only place they can get a fulfilling and nutritionally balanced hot meal.

Learn more about CKF’s Direct Certification Project at the webpage Questions about Direct Certification or how FoodShare relates to free lunch? CKF’s Direct Certification Specialists, Nikki and Helena, are happy to answer your questions. Please contact them at directcert@ckfwi.org.

New Special Enrollment Period for Former BadgerCare+ Members

Today, the Centers for Medicare and Medicaid Services announced a Special Enrollment Period for consumers who lost their BadgerCare+ coverage in April due to the Department of Health Services eligibility changes. This means those consumers have an opportunity to enroll in Marketplace coverage now, and do not have to wait until the next Open Enrollment period.  The Special Enrollment Period for those who lost their BadgerCare+ is available today, September 4th through November 2nd.

For applications made before the 15th of the month, coverage will begin on the first day of the month immediately following. For applications made after the 15th of the month, coverage will begin the next month. The next Open Enrollment period begins November 15th, 2014 with coverage starting no sooner than January 1, 2015.

An estimated 62,000 people throughout the state lost BadgerCare+ coverage in April, and approximately 60% of them did not re-enroll into Marketplace coverage, likely remaining uninsured and without access to compensated care.

If you know uninsured consumers and clients who lost their BadgerCare+, please spread the word and encourage them to apply for coverage in the Marketplace. These consumers are likely eligible for financial assistance to help pay the cost of premiums, co-payments and deductibles. Remind them there are many plans available in the Marketplace to choose from, and all plans cover essential health benefits like prescription drugs, preventive care, hospital stays and more.

Consumers should apply for this Special Enrollment period by calling 1-800-318-2596. Consumers looking for in-person enrollment assistance can dial 211 to find local help.

It can still be special! (Enrollment, that is.)

Even though the first open enrollment period is closed and the second is just about 3 months away, there are many situations that still allow someone to enroll in coverage for the first time or change coverage for very specific reasons.

Known as Special Enrollment Periods or SEPs, CKF has developed a handy Special Enrollment Summary chart that guides assisters through the essentials of determining if someone might be eligible for a SEP, and how to undertake gaining coverage.

And, here’s a handy flyer to remind people that they may still be special. Special enough for a SEP.

Courts Weigh In on ACA and Premium Subsidies – But Nothing Changes (Yet)

Earlier this morning, the DC Circuit Court of Appeals released a decision saying that the Affordable Care Act (ACA) only authorized health insurance subsidies for state-based Marketplaces, essentially rendering subsidies invalid in the 36 states with federally-facilitated and state-partnership Marketplaces. Just a few hours later, the Virginia Circuit Court of Appeals upheld the subsidies in federally-facilitated and partnership Marketplaces.

So, what does this mean for subsidies in Wisconsin, a federally-facilitated Marketplace?
Nothing, for now.

More on the cases:

Halbig v. Burwell (Decision here): Three-judge panel of the DC Circuit Court of Appeals: This panel voted 2-1 against the subsidies, agreeing with the plaintiffs that the text of the ACA does not permit federal subsidies outside of state-based Marketplaces. The federal government has stated that it will request an “en banc” review of the decision – meaning all eleven DC Circuit Court judges would review the decision, potentially reversing the decision of the three-judge panel.

King v. Burwell (Decision here): Three-judge panel of the Virginia Fourth Circuit Court of Appeals: This panel voted 3-0 to uphold the subsidies, agreeing with the Obama Administration that the law does not limit the subsidies to state-based Marketplaces. The plaintiffs could request an “en banc” review of this decision as well, to have all judges in the Circuit Court review and rule.

These cases are, indeed, contradictory.

And there are more cases on the legality of subsidies still pending: Pruitt v. Burwell (US District Court Eastern District of Oklahoma) and Indiana v. IRS (US District Court Southern District of Indiana).

Next Steps:

These cases will likely both be heard and decided by all eleven judges in each jurisdiction, and could result in reversal or upholding of the three-judge panel decisions. Cases that have differing and contradictory rulings at the District Court of Appeals levels are more likely to be reviewed by the Supreme Court – however, the Supreme Court could decide to hear the case regardless of Court of Appeals’ opinions. Whether or not the Supremes hear this issue is unclear.

Why this Matters:

In our Federally-Facilitated Marketplace in Wisconsin, subsidies make a difference in people choosing to purchase health insurance through the Marketplace. According to the Summary Enrollment Report Addendum, 91 percent of Wisconsinites who selected a Marketplace plan had financial assistance through the subsidies. Avalere Health estimates Wisconsin consumers would see a 70-74 percent increase in premiums if the subsidies were deemed invalid outside of state-based Marketplaces. These cases could potentially have big consequences on the ACA – but not yet.

Want to read more? Vox.com is providing great news coverage and analysis of the decisions, as well as the National Health Law Program., and the Kaiser Foundation offers this Q&A.

Coverage to Care- New Resources!

Thousands of Wisconsinites signed up for health insurance coverage during the first Open Enrollment period and more are continuing to enroll in BadgerCare+ or in the Health Insurance Marketplace through a special enrollment period. Many of these consumers are accessing insurance coverage for the first time. A recent study by the Kaiser Family Foundation reported that nearly 60% of new enrollees were previously uninsured. With an influx of newly insured individuals into the health care market, many are confused about using their coverage.

How do I find a provider? How much does my insurance cover for my doctor’s visits? What is a deductible? Are my prescriptions covered? When should I use the Emergency Room?

Oftentimes consumers will seek out assistance from advocates, providers or enrollment assisters they have trusted in the past, meaning they will be coming back to you with their questions. Before they do, make sure you are prepared by exploring new resources from the Centers for Medicare and Medicaid Services, Coverage to Care (C2C).

C2C is a new initiative launched to answer questions consumers have about using their new health insurance. Check out their Roadmap to Better Care and a Healthier You, a comprehensive 8 page brochures which shares consumer friendly information on understanding an insurance plan, finding a provider, scheduling an appointment, and other resources to make health insurance more understandable. Additional publications and videos can be accessed here. And, if you want to order material, free of charge, do so here.

For more information and materials about health insurance access and additional outreach materials, visit http://www.ckfwi.org.

BadgerCare+ Enrollment Numbers Released

The Department of Health Services released April’s BadgerCare+ enrollment numbers today. The release of these numbers has been anticipated because the numbers reflect the effect of the April 1 BadgerCare+ eligibility changes.

Remember, the April 1 changes modified eligibility for BadgerCare+ to 100% FPL, providing access to coverage for many, but eliminating access to coverage for some.

So, what story do the numbers tell? Are more people insured? And, who’s left out?According to DHS’s data (found here), as of April 2014, 81,731 Wisconsin childless adults now have health insurance coverage through BadgerCare+. These are the childless adults who were previously ineligible, many who were uninsured and on a waitlist for coverage.

The April 1 changes ended the waitlist and opened up coverage to anyone with an income below 100%FPL ($11,670/year) for parents or for childless adults. It’s important to remember that these numbers may increase throughout the year because BadgerCare+ has continuous enrollment – meaning a person can apply for and enroll in BadgerCare+ any time throughout the year, not just during Open Enrollment.

Though good news to many new enrollees, the eligibility changes also resulted in some parents losing coverage. Because the new income limit is 100% FPL, adults with incomes between 100-200% FPL were removed from their BadgerCare+ coverage April 1. DHS reported 62,776 parents lost their BadgerCare+ coverage.

Because losing coverage is considered a qualifying event, those parents were informed they had 60 days (until May 30) to apply for new coverage in the Health Insurance Marketplace. These individuals will be eligible for financial assistance when purchasing their new plans if their income is still below 400% FPL.

There is some concern about whether these parents will apply for new coverage and whether it will be considered affordable. If you are working with individuals who lost their coverage and are looking for assistance, encourage them to seek out a Certified Application Counselor or Navigator to discuss their options. Local help can be found by dialing 2-1-1 in most parts of the state, or by contacting the National Call Center at 1-800-318-2596.  Applications can be completed online at http://www.healthcare.gov.

Check out CKF’s Fact Sheets for more information, also found at www.ckfwi.org.


Community Eligibility: Free Lunch and Breakfast in Eligible Wisconsin Schools

CKF has been working with Wisconsin’s Department of Public Instruction (DPI) to connect children to healthy, free school meals via direct certification (DC) since 2011. Direct Certification is the web-based process by which children are deemed eligible for free meals under the National School Lunch Program without paper applications. Now, a new and exciting opportunity called Community Eligibility is on the horizon for high poverty schools and districts in Wisconsin that will connect even more children to healthy, free school meals. 

 The Community Eligibility Provision (CEP) allows high poverty schools and districts to offer breakfast and lunch to all students at no charge. CEP was piloted in 2011-2012 and is now available to schools in all states for the 2014-2015 school year.

 CEP is a 4-year reimbursement option for eligible schools participating in both the National School Lunch Program (NSLP) and School Breakfast Program (SBP) that wish to offer free school meals to all children in high poverty schools without collecting household applications. To participate in CEP, schools or districts must have a student population where at least 40 percent are eligible for free school meals without an application. Those eligible without an application include students that are in Head Start, students classified as homeless or migrant, and students directly certified for free meals because they are living in a household that receives FoodShare or W-2 cash assistance or based on their status as a foster child. 

 Schools or districts have until June 30, 2014, to apply for CEP for the 2014-2015 school year.

 Here’s a list of Wisconsin schools eligible to participate in CEP: 

 For further information and to download the CEP Application Form, please visit DPI’s Community Eligibility webpage http://fns.dpi.wi.gov/fns_cep.

CEP Report.

Small Doses About the Role of Tax Credits When Obtaining Health Insurance on the Markeplace Seen on IRS YouTube Videos

The Internal Revenue Service (IRS) has posted four Tax Credit videos on YouTube – three explain the Advanced Premium Tax Credit (APTC) in English, Spanish and American Sign Language, in under 2 minutes. If you purchase health insurance through the Health Insurance Marketplace, you may be eligible for the tax credit. The fourth video explains the Small Business Tax Credit in English in 2 1/2 minutes.

Premium Tax Credit – IRS English YouTube Video

Premium Tax Credit – IRS Spanish YouTube Video

Premium Tax Credit – IRS ASL (American Sign Language) YouTube Video

Small Business Health Care Tax Credit

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 info@ckfwi.org.

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 www.mkehcp.org/mken. 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.