Aligning SNAP and Health Care Programs

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Aligning SNAP and Health Care Programs

• Wisconsins Experience

Jim Jones, FoodShare Director Deputy Medicaid
Director Wisconsin Department of Health Services
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Background

• Wisconsin Population - 5.3 million people
• Mixture of urban and rural.
• SNAP Program FoodShare Wisconsin
• 600,000 members of FoodShare (and 1.1 million
  Medicaid/SCHIP members)
• County-administered (72)/State-supervised
• Administered by Department also responsible for
  Medicaid and SCHIP (BadgerCare Plus)
• Integrated Eligibility System MA, SCHIP, FS,
  CC, TANF, etc.

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A Very Short History

• Wisconsin had integrated systems and
  administration of all programs (MA, FS, AFDC)
  until welfare reform
• Split Administration MA Eligibility, FS and
  TANF went to new Work department and MA benefits
  stayed at Health Services department
• In 1997, MA eligibility came back to Health
  Services
• In 2001, FS came back to Health Services

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Why align SNAP and Health Care Programs?

• Philosophy Nutrition Programs are part of an
  overall strategy to improve our citizens health
  program.
• Enrollment fewer distinctions, easier to
  understand, easier to apply for both equals
  higher participation
• Workload If the programs are the similar -
  fewer mistakes, fewer corrections, less
  explanation, less training, etc.

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What did Wisconsin do?

• Name / Attitude

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What did Wisconsin do?

• Policies
• Took advantage of the first Farm bill
  (Simplified Reporting, Transitional FoodShare,
  adopted income methodologies of Medicaid (where
  allowed), etc.)
• Made FSET Voluntary (Medicaid/SCHIP have not
  work program component)
• Eliminated Child Support Non-Cooperation (mostly
  kept the non-custodial parent off of FoodShare
  and which isnt the case for Medicaid/SCHIP).

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and THEN. . .
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• EXPANSION
• All uninsured children, regardless of income
• Pregnant women under 300 FPL
• Parents/Caretaker Relatives and Childless Adults
  up to 200 FPL
• Child Welfare Parents and Children Exiting
  Foster Care
• STREAMLINING
• No distinctions between different Medicaid and
  SCHIP coverage groups
• All deductions/disregards hidden behind income
  limits
• Simplified all nonfinancial and financial rules
  (as much as allowed by
• Centers of Medicare and Medicaid Services)

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Re-alignment with BadgerCare Plus

• Aligned BadgerCare Plus with FoodShare
• Adopted Simplified Reporting (where possible)
• Same unearned income definitions (used MA and
  SCHIP State Plan Amendments to adopt more liberal
  methodologies).
• No face-to-face requirement (ability to use
  ACCESS or telephone)
• Centralized BadgerCare Plus and FoodShare
  enrollment for childless adults (Internet and
  Telephone) with electronic and telephonic
  signature.

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To Do

• Apply for demonstration project described in last
  Farm Bill to reduce obesity (fits with BadgerCare
  Plus Pay for Performance initiative to reduce the
  number of children who are obese).
• Continue to work towards aligning Medicaid,
  FoodShare and the TANF Child Care program.
• Look for opportunities with National Health Care
  Reform legislation to align FoodShare with
  Medicaid expansions and federal subsidy programs.
• Continue to advocate to make the interview
  requirement a state and applicant/member option.

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Contact Information

• Jim Jones
• Division of Health Care Access Accountability
• P.O. Box 309
• Madison, WI 53701-0309
• 608-266-5312 (phone)
• 608-266-6786 (fax)
• James.Jones_at_Wisconsin.Gov