The Origins and Implementation of BadgerCare: Wisconsin’s Experience with the State Children’s Health Insurance Program (SCHIP)


This report describes the history of BadgerCare, a program in Wisconsin that since 1999 has provided health insurance to working parents with low incomes and their children. Parents are covered by Medicaid, children under the State Children’s Health Insurance Program (SCHIP) enacted by the U.S. Congress in 1997.

By November 2000, Wisconsin under the leadership of Governor Tommy G. Thompson had enrolled almost 95 percent of all uninsured children in families with incomes up to 200 percent of the federal poverty level in either BadgerCare or Medicaid. During the same period, many other states experienced difficulty in enrolling children in SCHIP. Some states may lose a portion of the federal funds granted to them for the program. As a result, the premise of BadgerCare is attracting national attention. That premise, simply stated, is that adults with health insurance are more likely to seek coverage for their children.

This report describes how leaders in Wisconsin developed and implemented BadgerCare. Because the program uses both state and federal funds, Wisconsin officials and their counterparts in the federal Health Care Financing Administration had intense discussions about the interpretation of federal law and regulation. To their credit, they reached sufficient consensus to enable the program to go forward.

The Milbank Memorial Fund is an endowed national foundation that engages in nonpartisan analysis, study, research and communication on significant issues in health policy. Staff of the Fund followed the development of BadgerCare in conversations with officials in the legislative and executive branches of government in Wisconsin. After the program was implemented, the Fund asked these officials if they would give a journalist access to information necessary to write this report with the understanding that, although they would review the report in draft, the author and the Fund would make the final decision about its accuracy and fairness.

We thank the leaders in Wisconsin who granted interviews and provided documents to Coimbra Sirica and then reviewed a draft of the report. Their names are listed in the Acknowledgments.

Daniel M. Fox

Samuel L. Milbank