Summary of Gov. Scott Walker's proposals to limit Medicaid released

MADISON — Gov. Scott Walker is forging ahead with plans to move more people off state BadgerCare Medicaid that include capping benefits for childless adults who aren't working, charging premiums and subjecting some to drug tests.

A summary of his proposals — which require sign-off from the federal government — was posted online Monday. If approved by President Donald Trump's administration, Walker is all but guaranteed to market the changes as a national blueprint for Medicaid reforms in the same way he's touted his signature 2011 legislation that limited collective bargaining power of public employees.

The most talked about proposal would require applicants to complete a screening assessment for illegal drug use and test likely users. People who refuse a drug test would be ineligible for coverage until the test is completed, while people who test positive would get treatment. Those who refuse treatment would lose benefits for six months.

"The governor hears from employers all the time who tell him they are looking for people who are ready to work and able to pass a drug test," said Walker's spokesman, Tom Evenson. "If someone fails the test, we help them with rehabilitation, so they can get healthy and ready to enter the workforce."

But critics argue the plan could have the reverse effect, leaving Wisconsin with more drug-addicted people in need of medical care who are no longer covered under BadgerCare.

"There's an old saying that applies here: You can catch more flies with honey than vinegar," said Dr. Rich Brown, a drug treatment expert and founder of the University of Wisconsin School of Medicine's Wisconsin Initiative to Promote Healthy Lifestyles. Brown said the millions of dollars to fund the drug tests would be better spent expanding treatment options and addressing the state's long waiting lists for substance abuse programs.

Critics also took aim at one of Walker's proposals that would charge childless adults on BadgerCare with a certain level of income monthly premiums of $1 to $10.

Jon Peacock, research director of the Wisconsin Council on Children and Families, said for single adults, the premiums would apply to someone making roughly $200 to $1,000 a month. He argues paying the premiums would be logistically challenging to the individuals, many of whom don't have checking accounts or credit cards, and a burden to counties in charge of collecting them.

Democrats, for years, have argued that Walker should've accepted hundreds of millions of dollars in federal money to expand Medicaid, as some Republican-controlled states did.

"Instead of expanding access to BadgerCare, Walker is again trying to restrict access to health care for individuals who need it most," said Rep. Lisa Subeck of Madison. "This is just another Republican attempt to limit access to care."

But Walker continues to defend his decision and push his homegrown reforms instead.

"Nobody ever grew up dreaming of becoming dependent on the government," his spokesman, Evenson, said. "Governor Walker's goal is to have less people on government assistance, not because we kicked them off, but because they are healthy and working and don't need it any longer."

Other requested changes include:

- Requiring childless adults to contribute $8 toward their first emergency room visit each year and $25 for subsequent visits.

- Limiting the cumulative amount of time childless adults can be covered by Medicaid to four years. Recipients who have reached the maximum will lose benefits for six months. This only applies to adults ages 19-49 and does not apply to people who work or participate in employment training programs for at least 80 hours a month. It also excludes full-time students and individuals with disabilities.

Full details of Walker's proposals will be available for public comment beginning Wednesday. The Wisconsin Department of Health Services plans to submit an application to the U.S. Centers for Medicare and Medicaid Services at the end of May.