- Marguerite Burns, Laura Dague, Brendan Saloner, Kevin Look, et al
- August 2019
- Link to BC-2014-Waiver-Provisions-Final-Report-08302019 (PDF)
The University of Wisconsin conducted an evaluation of the Wisconsin BadgerCare Reform Demonstration Project implemented under Wisconsin’s CMS-approved 2014 Medicaid § 1115 Demonstration waiver. The evaluation assesses how the changes affect two Medicaid populations: (1) parents and caretaker adults who are eligible for Medicaid through Transitional Medical Assistance (TMA Adults) and (2) childless adults (CLAs) with an effective income level at or below 100% of the federal poverty level (FPL). The waiver tested three policy demonstrations: 1) premiums for the TMA population, 2) Restrictive Reenrollment Periods (RRPs) for non-payment of premiums, and 3) provision of standard Medicaid benefit plan for CLAs with incomes below 100% FPL. The Wisconsin Department of Health Services (DHS) DHS had defined 17 evaluation questions focusing on these policies and populations, and the evaluation applied rigorous methods to address the DHS-defined hypotheses.
The evaluation required administrative data from the Wisconsin DHS on (a) claims and encounters, (b) diagnostic codes, (c) enrollment, and disenrollment reason codes, and (d) premium payment information. The evaluation team also conducted surveys, in 2016 and in 2018, of currently enrolled and disenrolled BadgerCare members. The surveys assessed insurance coverage, measures of health service utilization, health status, knowledge of program requirements, perceptions of Medicaid policies, and response to premiums.