State medical aid needs big overhaul
5:58 PM 12/19/02

It's not often that we praise lawmakers for doing nothing, but the Joint Finance Committee's failure this week to agree on how to cover skyrocketing costs for the BadgerCare health plan is the best course of inaction for now.

It's clear that something must be done soon to regain control of the spiraling costs of the state's health care program for the working poor. BadgerCare is about $10 million in the hole and on pace to run out of money in April.

But any health-care fix needs to be more sweeping in scope. If the state wants to solve its deficit problem, it needs to address spiraling costs in all three of the state's major health care programs. Medicaid, BadgerCare and SeniorCare will cost taxpayers $1.65 billion a year by mid-2005, 21 percent more than this year. That's about $235 out of the pocket of every Wisconsin resident. Health care programs, lumped together, could outstrip aid to local governments as one of the state's biggest-ticket items.

Credit Rep. John Gard, R-Peshtigo, for putting a spotlight on the issue. But his plan to cut off new enrollment in BadgerCare on April 1, besides hurting poor people who can't afford private insurance, runs afoul of a federal waiver that reduces federal aid for the program if the state caps enrollment. The state would lose $2.5 million this fiscal year, only adding to the shortfall faced in the program and state government as a whole.

The Joint Finance Committee also has wisely resisted pleas to shift other health-care money into the program. That doesn't solve the state's budget problems or curtail program cost increases.

Creative solutions are in short supply. Incoming Gov. Jim Doyle so far has suggested only that the state create more good-paying jobs so fewer workers would have to rely on the state for health care. That's a fine long-term goal, but it won't solve the immediate crisis. And Doyle's campaign pledge - to seek deeper discounts on the $600 million in drugs annually purchased through state programs - attacks only one aspect of the problem.

We're not out to kill these programs hatched during flush budget times of the 1990s. BadgerCare and a companion program to cover drug costs, SeniorCare, ought to survive the ax-swinging budget session that begins next month.

But these programs shouldn't be insulated from general belt-tightening. New Joint Finance Committee co-chairman Dean Kaufert is on the right track in suggesting that the state tighten eligibility for health programs and impose higher co-payments for drugs and other medical services.

Doyle needs to challenge Washington to give his administration the flexibility to stretch Medicaid dollars as well, redefining eligibility criteria so the program once again is a safety net for the truly needy. The state needs authority to impose incentives to cut costs and encourage smarter health choices among those covered by the programs.

Yes, these moves may shift some financial burdens to those who need care. But such steps lead the state toward a better solution than arbitrarily cutting off help when money runs out, or simply shuttering these recently created programs to help close the expected $2.6 billion budget gap for 2003-05.