innerViews_summer2013 - Wheaton Franciscan Healthcare

Advocacy Overview
Medicaid coverage changes
The passage of the Affordable Care Act (ACA) in 2010 and
subsequent Supreme Court ruling in 2012 forced states to
make decisions about the future design of their Medicaid
programs. One of the core decisions relates to whether or
not a state will choose to expand coverage and receive
additional federal support for doing so. In many states
around the nation, this decision has triggered some changes
to current eligibility levels, which will lead to a transition in
coverage options for many patients.
What are Illinois, Iowa, and Wisconsin doing
Illinois and Iowa
The state legislatures in both Illinois and Iowa have
approved bills that will take advantage of federal funds to
expand Medicaid to cover non-pregnant individuals up to
133% Federal Poverty Level (FPL). Pregnant women and
children are covered at a higher level. Governor Quinn in
Illinois is expected to sign the bill soon, which means
Medicaid coverage for approximately 500,000 new
individuals in 2014.
In Iowa, Governor Branstad signed legislation in June that
allowed for coverage of individuals up to 133% FPL under a
hybrid program that will expand coverage for approximately
150,000 individuals. Residents up to 100% FPL will be
covered under Medicaid; those with incomes between 101%
and 133% will be eligible for a new plan: the Iowa Health
and Wellness Plan. Under this plan, Medicaid will pay the
premiums for individuals between 101% and 133% FPL,
provided they participate in certain wellness-related
activities that are designed to help keep them healthier.
Both Illinois and Iowa will receive federal funding to cover
100% of the Medicaid expenses for these newly covered
individuals.
Wisconsin
On June 30, Governor Walker signed the biennial state
budget into law which provides significant changes to
Wisconsin’s Medicaid program. Currently, the program
covers non-pregnant individuals with incomes up to 200%
FPL. The proposal sent to the Governor decreases the
eligibility for Medicaid to 100% FPL. Wisconsinites making
more than 101% FPL will be eligible to seek subsidized
coverage in the Health Insurance Marketplace, sometimes
referred to as an Exchange. These changes mean that
approximately 87,000 Wisconsinites will move off Medicaid
into the Marketplace, and approximately the same number
will become newly eligible for Medicaid. Wisconsin will not
receive additional federal funding for its Medicaid program
under this plan.
Because there are significant concerns regarding the ability
to effectively transition patients from one program to
another, as well as the concern that the Marketplaces may
not be fully functional from day one of operation, Wheaton
and other area hospitals lobbied the Governor and Legislature
to make no changes to the current program this year.
While we were not successful at convincing policy makers
to delay changes, they did include some modest funds
targeted to assist hospitals in caring for patients who may
find themselves uninsured because of the transition period.
Rest assured, we will be keeping a watchful eye on the
program and doing our part to help individuals get enrolled
to maintain their coverage in one program or another.
What does Federal Poverty Level mean in dollars
Below is a chart showing the annual income in 2013 that
represent 100% and 133% of the Federal Poverty Level.
Household Size 100% 133%
1 $11,490 $15,282
2 15,510 20,628
3 19,530 25,975
4 23,550 31,322
6 (inner)Views • Summer 2013