An expansion of health care for children and families that Gov. Jim Doyle's administration said would not cost taxpayers more money is projected to cost another $25 million this year.

Advocates for low-income families say the BadgerCare Plus program is still a bargain that gives tens of thousands of children and parents access to good health care. But Republican lawmakers, who have been skeptical of the cost claims all along, said they weren't happy with the new expected price tag.

News of the added cost comes as the state faces a tight budget and the Democratic governor's administration seeks to move forward with an expansion of the state's Medicaid health program for poor families to cover childless adults.

"It's troubling because this was supposed to cost nothing," said Rep. Leah Vukmir, R-Wauwatosa, chairwoman of the Assembly Health Committee. "The program has opened up to far more people than was anticipated."

The state has added 85,400 children and parents to its Medicaid rolls — more than three times the number originally projected by state officials — since BadgerCare Plus was rolled out in mid-January. The program essentially makes Medicaid coverage available to more parents and all uninsured children in Wisconsin, except those whose parents already have access to adequate coverage through an employer.

The expansion is aimed at reaching more uninsured families partly by raising income limits. But Stephanie Smiley, a spokeswoman for the state Department of Health Services, said 85 percent of the children and parents enrolled through BadgerCare Plus were people who qualified for state coverage all along, but who are now receiving it because of efforts to simplify Medicaid programs.

"Thanks to these efforts, far more poor children and their parents now have health-care coverage," Smiley said. "Preventive care helps reduce health-care costs in the long run."

Exceeded budget

In addition to the $25 million in projected cost overruns for the year ending in June 2009, BadgerCare Plus also exceeded its budget for the previous year, Smiley said, though she could not say by how much.

Medicaid director Jason Helgerson said the health department did its best beforehand to do the complicated projection of how many people would sign up for BadgerCare Plus, estimating that 26,000 would do so by June 2009.

The Doyle administration said the state's share of the cost to cover those enrollees could be more than paid through increased use of HMO-style managed care organizations, other administrative savings and monthly premiums or other charges to enrollees.

$88 million deficit

Smiley said state officials were working to correct a projected deficit of $88 million as of June 30 in taxpayer dollars in the state's overall Medicaid fund — an expected shortfall of about 4 percent. The state could save an estimated $8 million by taking steps to reduce prescription drug bills, use more managed care and delay Medicaid payments by the state until after the federal government puts in place a higher reimbursement rate for the state's costs, Smiley said.

"We are doing a whole bunch of things to try to control costs," Helgerson said.

Rep. Kitty Rhoades, R-Hudson, co-chairwoman of the Legislature's budget committee, said in a time of economic troubles the state needs to be careful about "expanding programs we can barely afford now."

Still a bargain

Jon Peacock, research director for the Wisconsin Council on Children and Families, said the BadgerCare Plus program was still a good deal, given that it insured 85,000 more people.

"It's actually remarkable that the net cost is only $25 million given how many more people we're serving," Peacock said. "This program's still a bargain."

Peacock said the health department's early cost estimates appeared optimistic to him.

"I thought there was a pretty fair chance that it would have a net cost," Peacock said of BadgerCare Plus. "I was surprised that the (agency's cost) numbers weren't higher initially."

BADGERCARE PLUS COSTS

The news: A state health program for families will cost a projected $25 million more than originally expected this year.

The response: Critics point out that Gov. Jim Doyle said the program wouldn't cost taxpayers. But supporters pointed out the program is costing more because it's serving three times more people than expected.