Recent action taken by the U.S. Supreme Court may soon cause Wisconsin Medicaid rolls to swell.
The high court last week denied a petition from the state of Wisconsin to review a complex lawsuit filed in 1993 that challenges the state's method for determining Medicaid eligibility.
This could be good news for providers, because some of their uninsured patients may now qualify for Medicaid.
"We're likely to have to spend more money," said Dan Stier, chief counsel for the Wisconsin Department of Health and Family Services, which administers Medicaid.
The state Medicaid program has 397,000 enrollees and an annual budget of $2.5 billion.
Stier said it's too soon to know how many Medicaid recipients may be added or what the impact on the budget will be.
The Supreme Court's refusal to hear the case lets stand a decision last year by the 7th U.S. Circuit Court of Appeals in Chicago. The appellate court partially overturned a lower-court ruling dismissing the lawsuit.
At issue in the lawsuit is Wisconsin's "economies of scale" approach to determine Medicaid eligibility. The state bases eligibility partly on the size of an applicant's family. The method can make it harder for members of larger families to qualify.
"It seems like it's common sense that a family of six lives cheaper than a family of three," said Susan Ullman, a Wisconsin assistant attorney general, who represented the state in this case.
Ullman said other states, although she couldn't specify how many, determine Medicaid eligibility based partly on family economies of scale.
But the Medicaid applicants who filed the lawsuit argued that the approach assumes an individual's need is less just because he or she is a member of a larger family.
Lawyers on both sides will now try to negotiate a resolution to the lawsuit and bring it before the U.S. District Court in Milwaukee. The district court will issue an order in the case.