- BadgerCare increased the rate of public coverage
among single mother welfare leavers by an estimated 17 percentage points,
based on difference-in-difference estimation which compared the 1995
and 1997 cohorts before and after BadgerCare.
estimation also shows that BadgerCare increased the rate of any coverage
(public or private) among single mother welfare
leavers by roughly 15 percentage points. This reflects a decline
in private coverage offset by a relatively larger increase in public
- The effects of BadgerCare were greater for
the 1995 cohort, the more “job
ready” group relative to the 1997 cohort. Public coverage
was estimated to increase by between 24 and 29 percentage points
the 1995 cohort and by between 2 and 4 percentage points for the
These estimates are based on pooled probit and random effects estimation
models that control for factors other than BadgerCare that could
In many states, welfare reform led to a decline in public health insurance
coverage. The experience with BadgerCare in Wisconsin indicates that expanding
SCHIP eligibility to parents as well as children can increase public coverage
with only modest offsets from declines in private coverage. Such programs
provide important opportunities to promote coverage for populations most
at risk of losing coverage due to welfare reforms.
The analysis is specific to the experiences in one state, Wisconsin, and to
the details of the BadgerCare program. Although we would expect expansions
in public coverage to parents and higher income groups leaving welfare
to increase overall coverage, the magnitude of the effects may differ across
states or programs.
The focus was on single mother families, the
dominant type of family receiving cash assistance. The findings may
to other types of families.
Private coverage is imputed using data from
state unemployment records. Specifically, the authors assume that
workers have private insurance
if they are not enrolled
in Medicaid or BadgerCare and they have worked full time for 2 quarters
or more for a firm that has reported to the Unemployment Insurance
it offers health insurance to its employees. Results were robust to two
alternative ways of imputing private coverage.
Administrative data from the state of Wisconsin: the Client Assistance for
Reemployment and Economic Support (CARES) system and the Computer Reporting
Network (CRN) for information on AFDC and W-2, and Wisconsin’s Unemployment
Insurance system for information on earnings and employers. The time period
for the analysis is 1995-2001. The sample is comprised of women listed
as the “case head” – meaning no father listed—who
have at least one minor child, who received assistance under the AFDC or
W-2 programs in September of 1995, 1997, or 1999, and who exited within
the next 3 months and remained off welfare for at least 2 consecutive months.
Several methods are employed to estimate the effects of BadgerCare on the probability
of public coverage: pooled probit estimation, logistic regression with
random effects, and difference-in-difference estimation. Three cohorts
of single mother welfare leavers are tracked on a quarterly basis from
two years prior to leaving welfare through the end of 2001(25 quarters
for the 1995 cohort, 17 quarters for the 1997 cohort, and 9 quarters for
the 1999 cohort). An income-based algorithm is used to estimate eligibility
for Medicaid and BadgerCare.
Extending Health Care Coverage to the Low-Income Population: The Influence
of the Wisconsin BadgerCare Program on Insurance Coverage
Barbara Wolfe, Thomas Kaplan, Robert Haveman, and Yoon Young Cho
University of Wisconsin-Madison
Conference paper presented at ERIU Research Conference,
ERIU Working Paper #18 (Adobe PDF)
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Funded by The Robert Wood Johnson Foundation, ERIU is a five-year program shedding new light on the causes and consequences of lack of coverage, and the crucial role that health insurance plays in shaping the U.S. labor market. The Foundation does not endorse the findings of this or other independent research projects.