jsonline- Guy Boulton: The system of managed care for the almost 300,000 children and adults covered by BadgerCare Plus in southeastern Wisconsin may be crumbling. The state cut payment rates to the managed care organizations by 11% in 2011 and then again this year as it struggled to balance its budget.
At issue: At least three of the four organizations managing the BadgerCare Plus program in the region say they are losing money on it. One of the organizations, United HealthCare, is dropping its contract with the state at the end of this month. Now a second, Molina Healthcare Inc., is warning it may soon have to do the same, for the same reason.
I’m on Badgercare, so I’m familiar with the new rate structure, one that already charges larger co-pays. If they get any larger, there will be only a slight difference between private rates and Medicaid’s. And rate increases are already on their way. This is what will happen to block granted Medicare plans pushed by Republicans too.
The Wisconsin Department of Health Services said it is working to develop rates for next year to ensure that adequate networks are in place. BadgerCare Plus, a Medicaid program, covers families with children under 19 that have incomes of less than 200% of the federal poverty threshold - or about $46,100 for a family of four. By federal law, the state must pay the health insurers rates that are based on their expected costs.
And that apparently isn't happening so, I guess you could correctly say, the Walker Authority is breaking the law, again.