December 23, 2013

Wisconsin family braces for a transition

Brian Sorensen (left), his wife, Lisa Nerenhausen, and son, Parker Sorensen, at their home in Appleton, Wis., on December 20, 2013. Lisa and her husband are losing coverage under BadgerCare, as part of the approximately 70,000 people that will be forced to move on to the private health care exchange. But their son, Parker, stands to gain coverage from the change, as he is among the 80,000 or so poor childless adults who may qualify for coverage under the new system.

Lukas Keapproth/Press Gazette Media

Brian Sorensen (left), his wife, Lisa Nerenhausen, and son, Parker Sorensen, at their home in Appleton, Wis., on December 20, 2013. Lisa and her husband are losing coverage under BadgerCare, as part of the approximately 70,000 people that will be forced to move on to the private health care exchange. But their son, Parker, stands to gain coverage from the change, as he is among the 80,000 or so poor childless adults who may qualify for coverage under the new system.

Main story

Neighbors diverge on health care

Under the Affordable Care Act, Minnesota will soon expand Medicaid coverage, while Wisconsin is narrowing its requirements for enrollment

In Lisa Nerenhausen’s house, the consequences of the state of Wisconsin’s approach to the Affordable Care Act are mixed.

For Nerenhausen and her husband, it will likely mean being kicked off of Medicaid and sent to the new federal exchanges where they will face higher medical costs.

Parker Sorensen at his home in Appleton, Wis., on December 20, 2013. Parker is a student at UW-Fox Valley majoring in Psychology. While his parents are losing their coverage under changes to BadgerCare, Parker hopes to be one of the 80,000 childless young adults to receive BadgerCare coverage. Diagnosed with Attention Deficit Disorder, Parker must pay $160 a month for his medication. His inability to afford his medication has affected his schoolwork, he says.

Lukas Keapproth / Press Gazette Media

Parker Sorensen at his home in Appleton, Wis., on December 20, 2013. Parker is a student at UW-Fox Valley majoring in Psychology. While his parents are losing their coverage under changes to BadgerCare, Parker hopes to be one of the 80,000 childless young adults to receive BadgerCare coverage. Diagnosed with Attention Deficit Disorder, Parker must pay $160 a month for his medication. His inability to afford his medication has affected his schoolwork, he says.

But her 21-year-old son, Parker Sorensen, could become newly eligible for Medicaid coverage. For now, though, he remains without: His ability to enroll has been pushed back, to April 1.

“It’s stressful for people like us, who are just above the poverty level, to try to figure this out,” said Nerenhausen, 53, of Appleton.

Nerenhausen’s family of five first enrolled in BadgerCare in 2003 when her husband, Brian Sorensen, was laid off from his job as custodial and maintenance supervisor with the city of Appleton. When he started working again, part time, his income remained low enough to maintain their eligibility.

The couple has occasionally paid premiums for BadgerCare coverage, depending on income, and are sorry to see it go. “It’s a good insurance plan,” Nerenhausen said. “It’s been there for us.”

Sorensen, 56, suffers painful neuropathy — a consequence of successful treatments for neck cancer a few years ago. Even with BadgerCare and Social Security, the couple still has a hard time covering his medications and occasional hospital visits.

After April 1, that may prove even harder, as the couple may have to rely on what coverage they can get through the exchanges. (The couple’s daughter, age 15, has a suspected mitochondrial disease, Nerenhausen said, and will continue to be covered under a special state program for children with complex medical needs. Her 18-year-old son may remain eligible for BadgerCare until he turns 19.)

Lisa Nerenhausen holds a letter she received notifying her of changes to her family's BadgerCare Plus enrollment status at their home in Appleton, Wis., on Dec. 20, 2013. Lukas Keapproth/Green Bay Press-Gazette

The family’s income lies between 101 and 133 percent of the federal poverty level. Residents within this bracket will lose eligibility in Wisconsin and gain it in Minnesota and some other states that accepted the federal expansion dollars.

Nerenhausen is most concerned about the impact of the anticipated premium and deductible on the household budget — which could range up to $15,000 for the deductible. Under Nerenhausen’s Medicaid, there was no deductible. She and her husband will likely qualify for subsidies to minimize the burden of monthly premiums, though she admits she is still confused about what her options may cost.

She has called hotlines and talked to a state health official and a health care advocate, but Nerenhausen still has questions.

“I don’t know where to go,” she said. “The information isn’t out there.”

Brian Sorensen and his wife, Lisa Nerenhausen, talk about changes to their health insurance at their home in Appleton, Wis., on Dec. 20, 2013. Lukas Keapproth/Green Bay Press-Gazette

Shelby Jensen, economic support manager for the Department of Human Services in Green Lake County, said this is a common concern.

“One of the biggest obstacles we’ve had to face here is the communication of the marketplace,” she said. “Getting the word out has been an issue, especially in the smaller counties.”

Nerenhausen is frustrated with the politics behind Wisconsin’s health care decisions. “We’re not just crying wolf, trying to get some sort of entitlements,” she said.