Wisconsin's BadgerCare Plus reform: impact on low-income families' enrollment and retention in public coverage

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.