Filed Under:Health Insurance, Individual Health

Drop in Claims Helps Wisconsin Medicaid Program

MADISON, Wis. (AP) — A reduction in per-enrollee health care costs should help Wisconsin Medicaid programs cut their projected budget shortfall to $232 million, from an estimate of $554 million made in September 2011, an Wisconsin official said in a letter released Tuesday.

State and federal agencies have been spending a total of about $7.5 billion per year on Wisconsin Medicaid programs. The programs provide coverage for 1.2 million of Wisconsin's 5.7 million residents.

Many are hoping the state can use any Medicaid savings to re-open Family Care, a Medicaid community support program that tries to keep disabled people and elderly people who need long-term care (LTC) services out of nursing homes.

Wisconsin Department of Health Services (DHS) Secretary Dennis Smith said in his letter about the latest budget shortfall projection, which was addressed to the co-chairs of the Wisconsin Legislature budget committee, that the Medicaid budget numbers have improved for a number of reasons, including lower-than-anticipated increases in people enrolling in the Medicaid programs, less costly Medicare Part B payments and an overall drop in costs per enrollee.

Wisconsin is still planning to move ahead with Medicaid program cuts that could result in about 65,000 poor adults and children losing coverage, Smith said.

Wisconsin lawmakers already have approved the cuts, but the state needs approvalfrom the U.S. Department of Health and Human Services to implement them.

Smith said even minor changes in enrollment or billing patterns can have a dramatic effect on Medicaid's bottom line given the size of the program, and that is why the department plans to proceed with its cost-savings plan.

But Democrats and advocates for Medicaid recipients are pointing to the news that the Medicaid shortfall may be lower than expected to press for the Walker administration to scale back the proposed reductions.

"I once again call on Gov. Walker to slow down and sincerely work with all stakeholders in order to achieve nece

ssary savings without seriously risking the health of our most vulnerable individuals," said state Rep. Sandy Pasch, D-Whitefish Bay.

A spokesman for Walker declined to comment and referred questions to DHS.
 
While the new numbers are good news, they do not mean that the cost-savings being proposed by DHS should be dropped, said Sen. Rob Cowles, R-Green Bay. However, if the savings as projected in the new forecast do pan out, that money could be used to help pay for a planned re-opening and expansion of the popular Family Care program as announced last week, Cowles said.

The Walker administration imposed a cap on Family Care enrollment in July 2011.

The enrollment cap was scheduled to result in about $106 million in savings over two years. The cost of reopening the program, which the federal government ordered Walker to do, and expanding it to 15 counties will depend on when those changes are implemented, Smith said.

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