Effective ACA Implementation

Community Advocates Milwaukee Wisconsin

The Effective ACA Implementation Project seeks to harness the full potential of the Affordable Care Act (ACA).

A major goal of this project is to help policymakers understand how the ACA can improve addiction and mental health treatment. These strategies include exploring and adopting smart enrollment procedures at county jails and treatment centers, and at state prisons and other institutions; creating a sound relationship between Medicaid and the Marketplace; and rethinking the interaction between insurance and stand-alone treatment programs.

A key aim is to enroll soon-to-be released prisoners or jailed individuals--many of whom are newly eligible adults without dependent children--in Medicaid or Marketplace insurance plans. This will not only enable them to obtain needed treatment for addiction and mental illness, and improve their overall health, it will also reduce crime, lower rates of recidivism, and help many low-income adults to avoid the criminal justice system and lead safe and productive lives.

This project also builds on the successes of our previous project, the Project for Health Insurance Exchange Education (PHIXE), which focused on using properly structured competition to maximize coverage, reduce costs, and improve quality. As part of this effort, we educated policymakers about how an exchange with a pool of buyers that is (1) average in risk, (2) very large in size, and (3) incentivized to choose low-cost health plans could lower costs and enhance quality. We are currently partnered with researchers at the University of Wisconsin to understand how these and other factors have helped lower premiums in Dane County for the State Employee Health Plan.

During the project, Community Advocates Public Policy Institute staff will:

  • Hold educational meetings and in-depth seminars with advocates and policymakers about the ACA and how it can lower costs and improve addiction and mental health treatment; and
  • Assist state policymakers who are seeking to harness the tools given to states by the ACA.

The Effective ACA Implementation Project is generously funded by the Open Society Foundations.


Supreme Court Decision on the Affordable Care Act

On June 28, 2012, the Supreme Court of the United States upheld most of the Affordable Care Act, though its decision allows states to choose whether to expand Medicaid. Community Advocates Public Policy Institute's Senior Fellow, David Riemer, stated: "This decision is a big victory for the millions of uninsured Americans who will gain affordable health coverage with expanded benefits..." and "We should specifically focus on expanding Medicaid to the population that remains uninsured below 133% of poverty, which the Affordable Care Act allows Wisconsin to do in a way that actually lowers overall state Medicaid spending."

Community Advocates previously submitted three amicus briefs (friends of the court filings) to the Supreme Court, and was the only Wisconsin-based advocacy organization to participate in the case. The briefs contended that (1) the individual mandate does not violate the Commerce Clause; and (2) the ACA’s expansion of Medicaid does not create “onerous conditions” on states (and in fact imposes no burden at all); and (3) if the individual mandate is struck down, the balance of the ACA should stand.

PPI Advocates for Improving the Governor's Partial Expansion of BadgerCare

The Public Policy Institute was on the forefront of advocating for Wisconsin to implement a full expansion of BadgerCare. PPI's Riemer and Bare met with every member of the Legislature's Joint Finance Committee, other members of the Legislature, the Governor's office, and several members of the Administration, to advocate for improving the Governor's partial expansion plan. See more about PPI's efforts here and here.

PPI's Bare Testifies at State Senate Hearing on ACA

On Friday, September 21, 2012, Mike Bare, PPI's Research and Program Coordinator, testified before the State Senate Health Commitee on why Wisconsin should establish and operate state-based health insurance exchanges and why it should expand Medicaid. Read or listen to a story about the hearing from Wisconsin Public Radio here, or watch the hearing in its entirety here.

PPI Advocates for an Expansion of Medicaid that Will Fill Eligibility Gaps, Save State Taxpayers Millions of Dollars, and Help Employers Avoid a Federal Tax Increase

According to a Public Policy Institute analysis, Wisconsin employers will pay a a big new tax if the Governor and Legislature fail to expand BadgerCare by filling its gaps in eligibility. Doing so will also cover significantly more Wisconsinites and save state taxpayers millions of dollars. View the press release and letter to the governor and legislature here.

PPI Offers Solutions to Help Low-Income Individuals Pay Health Costs

The Public Policy Institute published a report on options for policymakers, qualified health plans, and advocates to help low-income individuals continue to make payments to health insurance plans. PPI has since had productive conversations with Wisconsin QHPs about these solutions. See the full report here, and a brief version here.

PPI Leads Group of Health Advocates to Question Governor Walker's BadgerCare Decision

The Public Policy Institute led a group of advocates in asking the Governor to reconsider his changes to BadgerCare and the timeline of those changes, after technical glitches caused many individuals to miss the window to transition from BadgerCare to coverage offered via the health insurance Marketplace. View the press release and letter to the Governor and Legislature here.

PPI Leads Group of Health Advocates to Call on Governor Walker to Keep His BadgerCare Promise to Non-Custodial Adults

The Public Policy Institute led a group of advocates in pressuring the Governor to keep his promise of affordable BadgerCare coverage for non-custodial adults. View the press release and letter to the Governor and Legislature here.


ACA 101 Presentation

Introductory Presentation on ACA Exchanges

Exchange Options for States

Diagram of Exchange Design Options

Low Income Health Coverage Options Beginning in 2014

PPI's Recommendations for a Wisconsin Health Exchange

Diagram of Wisconsin's Health Coverage System Beginning April 1, 2014

Diagram of ACA Changes to the Health System

Essential Health Benefits Fact Sheet

Expanding Medicaid Can Help Employers Avoid Federal Tax

Creating a SHOP Exchange that Holds Down Premiums

ACA Pressure Points for Substance Use Disorder and Mental Health Treatment

Ensuring Exchanges Improve Addiction Treatment

PPI's Comments on Proposed Exchange Regulations

PPI's Comments on Guidelines for Federally-Facilitated Exchanges

PPI's Comments on Proposed BadgerCare Waiver