Despite limited resources and continuing serious problems with delivery of social service program benefits, the state is surging forward with plans to expand existing programs like BadgerCare. Before the state goes any further, I am formally asking the co-chairpersons of the Joint Committee on Audit that I serve on to request that the Legislative Audit Bureau conduct a full review of the BadgerCare program.
Where there's smoke, there's fire. We are still trying to figure out all the things that went wrong with Wisconsin Shares, and we still haven't learned our lessons from the food stamp debacle a few years ago. Writer George Santayana is most famous for his quote, "Those who cannot remember the past are condemned to repeat it." Santayana's historic words are especially true applied to recent controversies in Wisconsin health programs.
Warning signals that could and should have prevented scandals of today were apparent years ago. During 2003, the Audit Bureau reported that "Wisconsin's food stamp benefit payment error rate...has been at an historical high of 4.4 percentage points above the national average. Since FFY 1993-94, the federal government has imposed a total of $10.6 million in sanctions as a result of Wisconsin's high error rates. Wisconsin had the third-worst error rate in the nation during these two years (FFY 2000-01 and 2001-02). Only California and Michigan had higher error rates than Wisconsin."
Serious errors occurred in the food stamp program, followed by fraud in Wisconsin Shares. A Milwaukee Journal Sentinel investigation turned up astounding levels of fraud in Wisconsin Shares, identifying nearly $750,000 in suspicious child care disbursements. Since then, the Audit Bureau has estimated that fraud and errors cost Wisconsin taxpayers $16.7 million to $18.5 million last year alone.
Problems continue. Earlier this year, the state created BadgerCare Plus Core, an extension of the BadgerCare Plus program to include adults that don't have children. The state Senate Health Committee that I serve on was informed the waiting list for BadgerCare Plus Core has ballooned to about 7,000 people. The earliest the waiting list applicants would be eligible for insurance would be March 2010 and by then the waiting list could grow to over 20,000.
The Milwaukee Journal Sentinel reports a flood of applicants to BadgerCare Plus Core, about 600-700 has caused backlogs for the new food stamp program, FoodShare resulting in thousands of people waiting months for benefits. The newspaper reports the US Department of Agriculture views Wisconsin's backlog of cases among the worst in the country. Failure to process applications and distribute or deny benefits in a timely manner could mean federal sanctions issued against the state.
Wisconsin Department of Health Services (DHS) Secretary Karen Timberlake has supplied data reported by the Journal Sentinel that the state received more than 46,000 applications for FoodShare from June 15 to October 19, 2009. Over 29,000 applicants waited more than 30 days to either obtain a debit card to purchase food or have their enrollment rejected. Wait times over the telephone to receive information about FoodShare applications are lasting over an hour.
There's more. At a meeting last month of the state Senate Health Committee that I serve on, DHS announced three options being explored to expand BadgerCare Basic.
Option 1 covers emergency room (ER) visits and applies a Medicaid standard plan cost sharing. Generic drugs have a $3 copayment per script. Total cost: $100.05.
Option 2 limits inpatient hospital to two visits. ER visits are unlimited. There is a $15 copayment for outpatient non-ER services and professional services and $60 for ER visits. Inpatient hospital has a $100 co-payment per visit and generic drugs have a $5 copayment per script. Total cost: $131.66
Option 3 has a $7,500 deductible on all hospital services including ER visits. Once the deductible is reached, all hospital services are covered generic drugs carry a $5 copayment per script, and modest Medicaid standard plan cost sharing applies. Total cost: $106.89
No matter the option (s) chosen by DHS, problems are sure to follow. Each option would result in another expansion of membership, pressuring an already strained system. Option 2 with its unlimited ER visits would attract applicants in droves. The high deductible provision arguably makes Option 3 the most cost-effective; however an unaffordable increase in members is likely.
The fiscally irresponsible pattern starts with the mantra that people need coverage followed by the argument that people are under-covered. Programs keep getting bloated, never getting smaller. Government falls further and further behind in its attempts to keep promises and then makes the injudicious decision to make more promises, create more programs, and spend more money it does not have.
We owe it to the taxpayers to ensure their money is being spent as wisely and efficiently as possible.
- Sen. Mary Lazich, R-New Berlin, can be reached at Sen.Lazich@legis.wisconsin.gov or 1-800-334-1442.
Where there's smoke, there's fire. We are still trying to figure out all the things that went wrong with Wisconsin Shares, and we still haven't learned our lessons from the food stamp debacle a few years ago. Writer George Santayana is most famous for his quote, "Those who cannot remember the past are condemned to repeat it." Santayana's historic words are especially true applied to recent controversies in Wisconsin health programs.
Warning signals that could and should have prevented scandals of today were apparent years ago. During 2003, the Audit Bureau reported that "Wisconsin's food stamp benefit payment error rate...has been at an historical high of 4.4 percentage points above the national average. Since FFY 1993-94, the federal government has imposed a total of $10.6 million in sanctions as a result of Wisconsin's high error rates. Wisconsin had the third-worst error rate in the nation during these two years (FFY 2000-01 and 2001-02). Only California and Michigan had higher error rates than Wisconsin."
Serious errors occurred in the food stamp program, followed by fraud in Wisconsin Shares. A Milwaukee Journal Sentinel investigation turned up astounding levels of fraud in Wisconsin Shares, identifying nearly $750,000 in suspicious child care disbursements. Since then, the Audit Bureau has estimated that fraud and errors cost Wisconsin taxpayers $16.7 million to $18.5 million last year alone.
Problems continue. Earlier this year, the state created BadgerCare Plus Core, an extension of the BadgerCare Plus program to include adults that don't have children. The state Senate Health Committee that I serve on was informed the waiting list for BadgerCare Plus Core has ballooned to about 7,000 people. The earliest the waiting list applicants would be eligible for insurance would be March 2010 and by then the waiting list could grow to over 20,000.
The Milwaukee Journal Sentinel reports a flood of applicants to BadgerCare Plus Core, about 600-700 has caused backlogs for the new food stamp program, FoodShare resulting in thousands of people waiting months for benefits. The newspaper reports the US Department of Agriculture views Wisconsin's backlog of cases among the worst in the country. Failure to process applications and distribute or deny benefits in a timely manner could mean federal sanctions issued against the state.
Wisconsin Department of Health Services (DHS) Secretary Karen Timberlake has supplied data reported by the Journal Sentinel that the state received more than 46,000 applications for FoodShare from June 15 to October 19, 2009. Over 29,000 applicants waited more than 30 days to either obtain a debit card to purchase food or have their enrollment rejected. Wait times over the telephone to receive information about FoodShare applications are lasting over an hour.
There's more. At a meeting last month of the state Senate Health Committee that I serve on, DHS announced three options being explored to expand BadgerCare Basic.
Option 1 covers emergency room (ER) visits and applies a Medicaid standard plan cost sharing. Generic drugs have a $3 copayment per script. Total cost: $100.05.
Option 2 limits inpatient hospital to two visits. ER visits are unlimited. There is a $15 copayment for outpatient non-ER services and professional services and $60 for ER visits. Inpatient hospital has a $100 co-payment per visit and generic drugs have a $5 copayment per script. Total cost: $131.66
Option 3 has a $7,500 deductible on all hospital services including ER visits. Once the deductible is reached, all hospital services are covered generic drugs carry a $5 copayment per script, and modest Medicaid standard plan cost sharing applies. Total cost: $106.89
No matter the option (s) chosen by DHS, problems are sure to follow. Each option would result in another expansion of membership, pressuring an already strained system. Option 2 with its unlimited ER visits would attract applicants in droves. The high deductible provision arguably makes Option 3 the most cost-effective; however an unaffordable increase in members is likely.
The fiscally irresponsible pattern starts with the mantra that people need coverage followed by the argument that people are under-covered. Programs keep getting bloated, never getting smaller. Government falls further and further behind in its attempts to keep promises and then makes the injudicious decision to make more promises, create more programs, and spend more money it does not have.
We owe it to the taxpayers to ensure their money is being spent as wisely and efficiently as possible.
- Sen. Mary Lazich, R-New Berlin, can be reached at Sen.Lazich@legis.wisconsin.gov or 1-800-334-1442.
