Health & Science
1:00 am
Thu July 11, 2013

Daunting Task: Helping Low-Income Milwaukee Adults Switch Health Coverage

With big health care changes looming on the state and federal levels, Milwaukee's free clinics are bracing for confusion and to be needed, like never before, even though supporters of each change say it's designed to serve the most vulnerable.

Deadlines are flying toward the safety net health clinics – and the people they serve. As of now, both the federal and state changes will take effect on January 1st.

In November, Wisconsin will notify adults it plans to welcome into Badgercare that they must enroll in December, and the state will inform those it will kick off, that they need to head to the federal marketplace. They can begin enrolling in October and must pay a premium by mid-December.

“It is going to be a wild ride, this fall,” says Joy Tapper, executive director of the Milwaukee Health Care Partnership. It helps coordinate community-based care.

Tapper says tens of thousands of people here will need to make changes. Tapper calls the biggest - enrolling in the marketplace. Wisconsin will point adults toward private coverage, as soon as they earn more than 100 percent of the poverty level – about $11,000 a year.

“This will be a very new experience for many individuals, many of whom have not had to pay premiums before, let alone make choices about various insurance plans. We anticipate this will be very challenging for, particularly individuals who are marginalized with disabilities, behavioral health needs, learning disabilities,” Tapper says.

Milwaukee free health clinics keep medical records on patients. Soon, more time may be spent enrolling them in BadgerCare or the federal exchange

Tapper says most clinics know how to enroll people in BadgerCare. However, entering folks into the federal marketplace will be new. For instance, they will likely need to produce a tax return.

She says there’s not much prepping clinics can do right now because the federal government has not yet finalized the application or posted which providers here will take part. Wisconsin declined to create its pool. So, what the partnership is doing in the meantime, is building an enrollment network.

“It’s anticipated, the best case scenario, will take at least one hour to assist a person enrolling in the exchange,” Tapper says.

As for the free clinics, Tapper says they will each determine the role they play. She expects the more comprehensive programs to help people enroll, while the smaller ones may advise people to call 2-1-1.

Georgia Seis runs the church-supported clinic at Unity Church in Bay View. Every Wednesday evening, people stand in line outside. They pick a number, put it in a bag, and if Seis selects theirs, they get to see the doctors or nurses who’ve volunteered their time or get a prescription refilled.

“$15-$30 – it’s a lot of money to pay for pills, if you don’t have it,” says Douglas Bartz.

Bartz is one of the lottery winners this evening. He and about 20 others are sitting on chairs in the hallway – the waiting room.

“I’ve been out of work for three years, so the clinic helps. It’s a very humbling experience, to see all the people who really need help. Sometimes I feel like giving my number to someone else - they look in worse shape than me,” Bartz says.

Bartz says he has high blood pressure, pins in his legs and a crushed disc. The clinic gives him medication and exercises. He says he’s been trying to determine whether he qualifies for Social Security disability, but can’t figure out how it works. So navigating a new marketplace is probably out of the question.

Besides, there will be a cost, according to clinic director Georgia Seis. She says she knows people will continue needing free medical care – even if they qualify for BadgerCare or federal subsidies for the new marketplace.

”There’s no doubt in my mind, they will not be able to afford the monthly premiums. If they can afford the premiums, they might not be able to pay the co-pays or deductibles,” Seis says.

Some Milwaukee clinics estimate that 50 percent of their clients will have to switch coverage, before the end of the year. Discussions are already underway as to what those patients may need next, after they’re settled into a program.