DIAGNOSIS REGARDING UNPAID
MEDICAL BILLS.
THE WISCONSIN HOSPITAL
ASSOCIATION REPORTS A 7.6%
INCREASE IN 2018 IN UNPAID
PATIENT BILLS.
ALSO KNOWN AS UNCOMPENSATED
CARE.
THE TAB TOTALS A DEBT OF 1.2
BILLION DOLLARS OWED TO OVER
150 WISCONSIN HOSPITALS.
THESE ARE EXPENSES EITHER
PATIENTS REFUSE TO PAY OR
SIMPLY CANNOT AFFORD.
THE TOTAL ALSO INCLUDES CHARITY
CARE PROVIDED BY HOSPITALS AT
NO CHARGE TO CERTAIN QUALIFYING
PATIENTS.
WE WORK THROUGH THIS
DEVELOPMENT WITH BOBBY PETERSON
THE DIRECTOR OF ABC FOR HELP
THAT HELPS PEOPLE FIND
AFFORDABLE HEALTHCARE COVERAGE.
THANK YOU FOR BEING HERE.
IN YOUR MIND THE OVERRIDING
COST OF THIS ARE EFFORTS TO
UNDO THE AFFORDABLE CARE ACT AT
BOTH THE NATIONAL AND STATE
LEVEL.
>> WHEN YOU SOW CONFUSION YOU
GET PEOPLE MORE TENTATIVE
APPLYING FOR PROGRAMS.
THEY THINK THEY DON'T EXIST.
A LOT OF MARKETPLACE CONFUSION
OUT THERE.
SO IT LEADS TO PEOPLE NOT
GETTING THE COVERAGE THAT THEY
NEED WHEN THEY GET CARE
OFTENTIMES THEY'RE UNABLE TO
PAY FOR IT.
>> SO INCLUDED IN THIS IDEA YOU
SAY IS THAT IN WISCONSIN THE
MEDICAID OF BADGERCARE PROGRAM
YOU DESCRIBE THE ELIGIBILITY
PROCESS AS A CORN MAZE.
JUST THE DIFFICULTY IN
NAVIGATING THE SYSTEM, THE CORN
MAZE LEAVES PEOPLE GOING
UNCOVERED?
OR WHAT ARE THE IMPLICATIONS?
>> SOMETIMES.
YOU THINK ABOUT IT THERE ARE 16
DIFFERENT ELIGIBILITY FEATURES
BETWEEN MEDICAID AND BADGERCARE
IN THE MARKETPLACE AND WHICH
WAY DO YOU GO?
PARENTS ARE DIRECTED TOWARD THE
MARKETPLACE.
CHILDREN ARE DREKTD TOWARDS
BADGERCARE PLUS.
FAMILIES MIGHT HAVE SPLIT
COVERAGE, DEPENDS ON THEIR
INCOME, HOW IS IT ATTRIBUTED TO
THEIR CHILDREN?
IT CREATES A CORN MAZE
ELIGIBILITY.
FEELING YOUR WAY THROUGH THE
PROCESS TRYING TO GAIN
ELIGIBILITY.
SOMETIMES YOU MISS OUT.
SOMETIMES YOU GIVE UP.
AND WHEN YOU DO, AND YOU HAVE
MEDICAL CONCERNS AND MEDICAL
ISSUES, IT CAN OFTEN GO UNPAID.
>> YOU ALSO CITE JUNK INSURANCE.
HOW DOES THAT CONTRIBUTE TO
PEOPLE NOT PAYING FOR MEDICAL
CARE?
>> BECAUSE THE INSURANCE ISN'T
PAYING WHAT IT SHOULD BE.
IF YOU THINK ABOUT
COMPREHENSIVE HEALTH INSURANCE
THAT COVERS MOST OF THE CARE
NEEDS.
INSURANCE IS CHANGING SO THERE
IS MORE CO-PAYMENTS AND
DEDUCTIBLES.
WE TALK ABOUT SPECIFIC
SOLUTIONS AND POLICIES THAT ARE
TEMPORARY POLICIES, ASSOCIATION
HEALTH PLANS, THAT REALLY NOT
AS ROBUST AS WHAT WE SEE IN THE
AFFORDABLE CARE ACT OR TYPICAL
PRIVATE HEALTH INSURANCE.
>> WERE THESE JUNK PLANS LIKE
DURING WHEN ACA WAS IN FULL
FORCE THEY DIDN'T EXIST?
>> THEY CAME -- THE TRUMP
ADMINISTRATION HAS PUT FORWARD
RULES THAT HAVE MADE IT EASIER
FOR THOSE PLANS TO GROW.
PRIOR TO THE TRUMP
ADMINISTRATION THEY WERE MORE
SPECIFICALLY EXCLUDED.
>> WOULD THAT BE THE CASE, TOO,
WITH THE KIND OF CORN MAZE OF
THE MEDICAID PROGRAM IN
WISCONSIN?
DID IT HAVE TO DO WITH
TINKERING AROUND THE EDGES?
>> I THINK WISCONSIN DIDN'T
EXPAND MEDICAID SO WHEN WE
TINKERED AROUND THE EDGES AND
SAID WE COULD EXPAND UP TO 100%
FOR ADULTS AND UP TO 306% FOR
SOME CHILDREN IT CREATES
DIFFERENT ELIGIBILITY PATHWAYS.
WHICH WAY DO I GO FOR MY KIDS,
MYSELF, MY INCOME IS
FLUCTUATING.
I MIGHT BE ON OR I MIGHT BE OFF.
>> REALLY COMPLICATED.
>> SEASONAL EMPLOYMENT OR
SALES, FARMING INCOME THAT
COULD DROP SUDDENLY BECAUSE OF
FUEL COSTS OR OTHER THINGS.
A LOT OF VARIABLES.
IT IS HARD FOR PEOPLE TO STAY
ON TOP OF.
>> YOU TALK ABOUT SURPRISE
MEDICAL BILLS.
WHAT ARE THOSE?
>> THEY'RE NOT NEW TO ME
BECAUSE I HAVE BEEN PRACTICING
IN THIS AREA FOR 30 YEARS.
BASICALLY SOMETIMES WHEN YOU
HAVE A BILL THAT WAS UNEXPECTED
AND TYPICALLY IT'S BECAUSE YOU
ARE PAYING BEYOND THE USUAL AND
CUSTOMARY EXPENSES.
THE HOSPITAL SAYS WE'LL CHARGE
YOU $15,000 FOR THIS TREATMENT,
THE INSURANCE COMPANY SAYS WE
ONLY PAY UP TO $10,000.
SO YOU TYPICALLY SIGN A WAIVER
AND AGREE TO PAY WHAT THE
INSURANCE COMPANY WOULD PAY.
YOU THINK YOU HAVE COVERAGE BUT
THEN YOU HAVE A $5,000 BILL
BECAUSE YOU HAVE AGREED TO
ACCEPT LIABILITY.
YOU SIGN A LOT OF PAPERS WHEN
YOU GO INTO THE HOSPITAL OR DO
THE TOUCH SCREEN.
SOMETIMES IT LEAVES YOU EXPOSED
TO MEDICAL BILLS AND LIABILITY.
>> YOU SAY WHAT HAPPENS IN THE
UNCOMPENSATED AND CHARITY CARE
SCENARIO IS THAT IT GETS SPREAD
AROUND TO OTHER HOSPITAL BILLS.
SO WE'RE BASICALLY ALL PAYING.
>> RIGHT, AT THE END OF THE DAY
UNCOMPENSATED CARE DOESN'T JUST
VANISH AND DISAPPEAR.
WE TALK ABOUT THE SOCIALIZATION
AND REDISTRIBUTION OF THE DEBT
TO EVERYBODY ELSE'S BILL.
IT BRINGS UP THE COST OF
HEALTHCARE IN TERMS OF HIGHER
COSTS, MORE EXPENSIVE SERVICES
BECAUSE THOSE DEBTS DON'T JUST
DISAPPEAR.
THEY ACTUALLY HAVE TO BE
ABSORBED.
>> ISN'T THAT WHAT THE
AFFORDABLE CARE ACT WAS LOOKING
TO GET AT EXACTLY?
>> RIGHT.
YOU THINK ABOUT IT, PAY ME NOW
OR LATER.
IF WE WILL BE PRO-ACTIVE AND
FRONT END LET'S TRY TO MAKE IT
SEAMLESS FOR FAMILIES AND KIDS
TOGETHER AS MUCH AS POSSIBLE.
LET'S PROVIDE A COMPREHENSIVE
LEVEL OF SERVICE AND COVERAGE.
BECAUSE AT THE END OF THE DAY
IF THEY INCUR MEDICAL DEBT THEY
CAN'T PAY IT ENDS UP WE ALL END
UP PAYING FOR IT IN THE