Proposed Budget: Access to Care
For the fourth consecutive biennium, Medicaid expansion is the cornerstone of the budget proposal for DHS. Expanding health care coverage and access lowers costs, boosts Wisconsin’s economy, and supports the state’s workforce.
Increased access to quality health care services makes it easier for enrollees to afford other expenses like food, housing, and paying down their debts. Forty other states have already expanded their Medicaid programs and experienced positive outcomes as more people gain access to needed treatment and care, hospitals stay open, and jobs and the economy grow.
Expands BadgerCare Plus
The budget proposal for DHS is, once again, anchored by the expansion of BadgerCare Plus, which would provide high-quality, low-cost Medicaid coverage to Wisconsinites up to 138 percent of the federal poverty level. This would give affordable health care coverage to 95,800 low-income Wisconsinites and lower state health care costs by $1.9 billion over the biennium.
Wisconsin is one of only 10 states in the country and the only state of its Midwest neighbors that has not yet expanded Medicaid. States that have expanded experienced positive outcomes as more people gain access to needed treatment and care, hospitals stay open, and jobs and the economy grow.
This budget proposal is also good for Wisconsin’s workforce by increasing the number of people who can find and maintain full-time employment and helps prevent medical bankruptcies.
Supports hospitals and clinics
Gov. Evers’ budget supports the state’s hospitals by raising hospital reimbursement by $3.2 billion, with a $15 million supplement for hospitals that treat kids. The budget also addresses the critical need created by the closing of two hospitals in Western Wisconsin by providing $15 million to support patients in that area access care.
To ensure Wisconsinites can access care they need, the budget provides $71 million in targeted payment increases for rural health clinics, childbirth, certain opioid use disorder treatment, autism treatment, and tube-feeding.
Supports frontline workers
Wisconsin’s health care system depends on the dedication and compassion of those working on the frontlines of our hospitals, nursing homes, and in emergency medical services who help achieve positive health outcomes for patients throughout the state, support residents, and deliver quality care. Gov. Evers’ budget invests in the health care workforce through Medicaid coverage of community health workers, doulas, and certified peer specialists, as well as $7.5 million for recruitment and retention grants, and $2.5 million for health care provider training. It also provides support for the WisCaregiver Careers program and recent graduates of mental health provider programs.
Gov. Evers’ budget makes investments in our health care workforce to:
- Help health care providers implement best practices and innovative solutions to increase worker recruitment and retention.
- Update and strengthen the health care provider training grant program.
- Support health care focused registered apprenticeships.
- Enhance licensure opportunities in Wisconsin through health-related multi-state compacts and reciprocity agreements.
- Create a pilot program to provide tuition reimbursement for former nurses who are not actively practicing but wish to participate in a refresher course at a technical college.
Supports patients with enhanced services
Gov. Evers’ budget makes investments in the state’s health care system to ensure Wisconsinites can access care when and where they need it - quickly and close to home by:
- Establishing standards to improve access to services by requiring in-network services to be within set travel times and distances from the plan holder.
- Exploring standards for appointment wait times, making sure people get access to services within a reasonable number of business days.
Holds insurers accountable
In addition to expanding health care access, Gov. Evers’ budget takes steps to hold health insurers accountable in order to lower costs and improve transparency, in turn, protecting consumers, preventing price gouging, and helping Wisconsinites afford every day, out-of-pocket costs. The budget calls for auditing insurers who deny too many claims, reining in excessive prior authorization of services, and creating an office devoted to holding health insurers accountable.
Other initiatives in the governor's budget to expand access to health care and coverage
- Easy Enrollment Program
- Medicaid Community Support Funding
- Medicaid Coverage for Continuous Glucose Monitoring Devices and Insulin Pumps
- Nursing Home Bed Access
- Home- and Community-Based Services Reestimate
- Pre-Release Medicaid Authority Waiver Authority
- Medicaid School-Based Services - 100% Revenue Pass Through to Schools
- Medicaid Social Determinants of Health Waiver Authority
- Health Care Entity Ownership Regulation Statutory Language