Medicaid Enrollment Trends
The CCF Enrollment Tracker uses the most recent monthly administrative data from state websites and the Centers for Medicare & Medicaid Services (CMS). State administrative data is often the quickest way to assess what is happening in a state’s Medicaid program.
Wisconsin operates a partial Medicaid expansion, approved under the BadgerCare waiver, that offers coverage to childless adults up to 100% federal poverty level. The state must implement work reporting requirements for the adults enrolled in the BadgerCare waiver.
Wisconsin posts monthly state administrative data, including Medicaid enrollment. Timely administrative data is useful for early identification of potential problems in administering eligibility and enabling rapid response before more people are impacted. Seeing rapid declines in enrollment, which we expect to see with implementation of work reporting requirements, won’t help identify the root of the problem. More detailed data disaggregated for the expansion population, including ex parte rates for verifying compliance or exemption, procedural disenrollments, and disenrollment reasons, are important for understanding what’s happening in a state’s systems and processes. Read more here about ways states can collect and report data to monitor implementation and impact of work reporting requirements.
(Click here to see examples of data reported by Arkansas – including data on disenrollment reasons – during the state’s Medicaid work reporting rollout in 2018 and 2019.)
Parents and Children
In all states, the overwhelming majority of parents should be exempt from work reporting requirements. Parents living with their child and who have income below the state’s “Section 1931” income eligibility level are not subject to work reporting requirements regardless of the age of their children. Section 1931 parent/caretaker relative Medicaid is a mandatory coverage group in all states. The minimum income eligibility level for Section 1931 coverage varies by state and is based on a state’s 1988 cash assistance rules, but many states have adopted higher levels. Read more here to learn about this coverage category, find each state’s specific 1931 income limit, and see how it interacts with Medicaid work reporting requirements.
In Wisconsin, almost all parents should not be impacted by work reporting requirements. Adults enrolled in Wisconsin’s BadgerCare waiver must meet work reporting requirements. They are mostly childless adults. Low-income parents living with their child in Wisconsin would be covered under the state’s Section 1931 parent/caretaker relative Medicaid, not the BadgerCare waiver. In Wisconsin, the upper income threshold for partial Medicaid expansion is the same as that for the Section 1931 parent coverage group (100 percent federal poverty level). As a result, almost all low-income parent/caretaker relatives would qualify for Section 1931 Medicaid coverage and therefore not subject to work reporting requirements. For a family of three, that’s an income below around $27,320 annually or $2,277 per month.
Additionally, any woman who is pregnant when she applies for Medicaid and becomes pregnant while covered by Medicaid is exempt from work reporting requirements. The exemption is extended through the entire postpartum period during which the woman is continuously eligible regardless of changes in circumstances. All states cover postpartum care for women whose pregnancy is covered by Medicaid for a full 12 months, except Arkansas.
Since many women in the adult expansion group become pregnant after enrolling, it will be critical for states to take steps to identify pregnant and postpartum women to ensure they receive continuous coverage and are excluded from work reporting requirements. Read more from CCF here about risks posed by H.R. 1’s new requirements for pregnant and postpartum women.
State Policy and Implementation Decisions
State Administration and Operation
Eligibility and Enrollment System Readiness
As states implement work reporting and six-month renewal policies, many may struggle to keep up with the administrative workload – workloads that already strain state systems and staff. Tracking metrics such as call center wait times, application processing times, and renewal outcomes can provide insight into system strain and a state’s readiness to implement data matching and other necessary system changes. Read more about these eight state-reported metrics in the report and the blog. See the 50-state tracker here, updated for the most recent quarter.
Click on the tabs below to see the different metrics.
State Websites and Beneficiary Materials
Click here for information about Medicaid from Wisconsin’s Department of Health Services. State residents can apply or renew coverage through the online portal here.
Wisconsin’s webpage has information about federal changes under HR 1, including Medicaid work reporting requirements.