As I stated yesterday, in the face of the failure of the GOP bid to repeal and replace the Affordable Care Act, instead of considering accepting the Medicaid expansion like a number of other Republican states, Wisconsin’s Governor Scott Walker wants to move more people off of BadgerCare (the Wisconsin Medicaid implementation).

the governor again rejected the idea of expanding BadgerCare to people with somewhat higher incomes, saying it could make people more dependent on the government.

“My goal is not to put more people on Medicaid. My goal is to get people off,” Walker said.

Instead, Walker is sending a proposal to the Centers for Medicare and Medicaid Services that could affect tens of thousands of childless adults in Wisconsin with incomes below the federal poverty level — $12,060 a year for single adult and $16,240 a year for a couple.

And toward that end he has a number of arcane policy changes to accomplish his goal!

Here’s what Walker wants to do starting in April 2019:

Charge sliding scale premiums of $1 to $10 a month for single adults making $2,533 to $12,060 a year. BadgerCare recipients would have a 12-month grace period to pay past due premiums but if they don’t eventually catch up, they’ll lose their coverage for six months or until they start paying. Emergency visits would also start having copays of $8 for the first visit and $25 for those afterward in a year to nudge people toward cheaper forms of care.

Give premium breaks to recipients who complete a health risk assessment and who don’t engage in risky behaviors such as smoking, obesity, illegal drug use, not using seat belts and alcohol abuse. Recipients can also get the premium breaks if they are working to manage their risk in those areas.

Limit the amount of time on Medicaid for able-bodied workers between 19 and 49 years old to 48 months. After that they would lose coverage for six months. But if recipients are working or getting job training at least 80 hours a month, they could stay on the program for as long as they meet the other requirements.

And then for those of you who were wondering where I got the title for this blog post:

Screen these Medicaid applicants with questions about illegal drug use and actually test some of them for it. Refusing the test will mean the applicants go at least six months without state coverage. If they test positive, the individuals could receive treatment. Toward that goal Walker is asking federal officials to allow for residential substance abuse treatment for childless adults within Medicaid.

I don’t even know where to start…but this may be against the 5th Amendment…it is probably in violation of the Health Insurance Portability and Accountability Act (HIPAA)…may be an invasion of privacy…and may actually deny health insurance to the group of residents most in need of it. And isn’t this one of those things that the GOP always wants to promote in their health insurance schemes…patients working with their own doctors? But Governor Walker hasn’t found a safety net program that he didn’t think he couldn’t improve via drug testing its applicants (i.e. food stamp and unemployment benefits).

Oddly enough, these changes won’t save the state any money even if they are implemented:

These Medicaid changes won’t be cheap — when fully phased in they would cost an estimated $48 million a year in state and federal money and affect about 49,000 childless adults a year, according to the Legislative Fiscal Bureau.

Huh?

And how much do you think it will cost to collect those $1 to $10 monthly premiums?

There are some serious issues in Wisconsin that need some direct and immediate attention. And our governor is dinking around fine tuning something that ain’t broke…and could be improved by accepting the ACA Medicaid expansion? Does this sound like something that will garner votes in 2018? Apparently it does to one person. My goodness!

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