Extending Health Care Coverage to the Low-Income Population: The Influence of the Wisconsin BadgerCare Program on Insurance Coverage

Wolfe, Barbara, Thomas Kaplan, Robert Haveman, and Yoon Young Cho
Working paper no. 2004-22


The Wisconsin BadgerCare program, which became operational in July 1997, expanded public health insurance eligibility to families with incomes below 185 percent of the U.S poverty line (200 percent for those already enrolled). This eligibility expansion was part of a federal initiative known as the State Children’s Health Initiative Program (SCHIP). In this paper, we attempt to answer the following question: “To what extent does a public program with the characteristics of Wisconsin’s BadgerCare program reduce the proportion of the low-income population without health care coverage?”

Using a coordinated set of administrative databases, we track three cohorts of mother-only families: those who were receiving cash assistance under the Wisconsin AFDC and TANF programs in September 1995, 1997, and 1999, and who subsequently left welfare. We follow these “welfare leaver” families on a quarterly basis from two years before they left welfare through the end of 2001, making it possible to use the labor market information and welfare history of the women in analyzing outcomes. Hence, these 19,201 families, together with their public and private health insurance coverage experience, are tracked for up to 25 quarters after leaving welfare.

We apply multiple methods to address the policy evaluation question, including pooled probit, random effects, and difference-in-difference strategies, and compare the results across methods. All of our estimates indicate that BadgerCare substantially increased public health care coverage for mother-only families leaving welfare. Our best estimate is that BadgerCare increased the public health care coverage of all leavers by about 17 percentage points and that BadgerCare increased the probability of these women having any health insurance coverage, public or private, by about 15 percentage points.