Wisconsin's BadgerCare Plus Reform: Impact on Low-Income Families' Enrollment and Retention in Public Coverage

Authors

  • Lindsey Jeanne Leininger,

    1. University of Chicago, 1313 East 60th Street, Chicago, IL 60637
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    • Address correspondence to Lindsey Jeanne Leininger, Ph.D., Researcher, Chapin Hall at the University of Chicago, 1313 East 60th Street, Chicago, IL 60637; e-mail: lleininger@chapinhall.or. Donna A. Friedsam, M.P.H., Emma Hynes, M.P.A., M.P.H., and Alison Bergum, M.P.A., are with the Population Health Institute, University of Wisconsin–Madison, Madison, WI. Laura Dague, Ph.D. candidate, and Shannon Mok, M.S., are with the Department of Economics, University of Wisconsin–Madison, Madison, WI. Milda Aksamitauskas, M.P.P., is with the Wisconsin Department of Health Services, Madison, WI. Thomas R. Oliver, Ph.D., M.H.A, is with the Department of Population Health Sciences, University of Wisconsin–Madison, Madison, WI. Thomas DeLeire, Ph.D., is with the Department of Population Health Sciences and the La Follette School of Public Affairs, University of Wisconsin–Madison, Madison, WI.

  • Donna Friedsam,

    1. Population Health Institute, University of Wisconsin–Madison, Madison, WI
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  • Laura Dague,

    1. Department of Economics, University of Wisconsin–Madison, Madison, WI
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  • Shannon Mok,

    1. Department of Economics, University of Wisconsin–Madison, Madison, WI
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  • Emma Hynes,

    1. Population Health Institute, University of Wisconsin–Madison, Madison, WI
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  • Alison Bergum,

    1. Population Health Institute, University of Wisconsin–Madison, Madison, WI
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  • Milda Aksamitauskas,

    1. Wisconsin Department of Health Services, Madison, WI
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  • Thomas Oliver,

    1. Department of Population Health Sciences, University of Wisconsin–Madison, Madison, WI
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  • Thomas DeLeire

    1. Department of Population Health Sciences and the La Follette School of Public Affairs, University of Wisconsin–Madison, Madison, WI.
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Abstract

Objectives. To examine the impact of a Wisconsin health care reform enacted in early 2008 on public insurance enrollment and retention.

Data Sources. Administrative data covering the period January 2007 to November 2009.

Study Design. We calculate unadjusted enrollment trends and exit rates stratified by age, income group, and enrollment mode. Kaplan–Meier curves and Cox proportional hazards models are estimated to assess the impact of the reform on program exits.

Principal Findings. Overall enrollment increased by approximately one-third and exit rates decreased by approximately one-fifth. The majority of new enrollment came from the previously income eligible.

Conclusions. Wisconsin's enactment of eligibility expansions coupled with administrative simplification and targeted marketing and outreach efforts were successful in enrolling and retaining low-income children and families in public coverage.

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