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Wisconsin health insurance exchange

wisconsin guide to health insurance

Wisconsin enrollment increasing by more then 15,000 people per month

By
March 31, 2014

Open enrollment in Wisconsin ends on March 31.  But HHS is allowing an extension for applicants who begin the process by that date, but are unable to complete their enrollment by the end of the day on March 31.  The extension is expected to be valid until mid-April, and applicants will have to attest to the fact that they tried to enroll by March 31 but were unable to finish because of technical problems or other extenuating circumstances.

By the first of March, 71,443 people had selected private QHPs in the Wisconsin exchange – a 27% increase since the beginning of February, and the second month in a row with more than 15,000 new private plan enrollees.  In addition to the QHP enrollees, Wisconsin’s exchange also enrolled 68,655 applicants in the state’s BadgerCare Medicaid program.

Wisconsin lawmakers voted on December 19 to allow 72,000 people covered by BadgerCare Medicaid to remain on that program through March 31 (instead of the end of December), giving them more time to enroll in the exchange.  Wisconsin dropped Medicaid eligibility to 100% of poverty level, which resulted in those 72,000 people losing BadgerCare eligibility.  In order to have seamless coverage, with a new exchange plan starting on April 1 following the loss of BadgerCare on March 31, enrollees would have needed to complete their exchange enrollment by March 15.  They can still enroll until March 31 (or later, if they experience glitches that prevent them from completing their enrollment by that date and qualify for the extension), but they will have a one-month gap in coverage, as their new plan will not begin until May 1 if their application was finalized between March 16 and April 15.

An additional 83,000 childless adults with incomes below 100% of poverty level are expected to be newly eligible for BadgerCare, but their enrollment will now be delayed until April 1.

Governor Scott Walker and Insurance Commissioner Ted Nickel asked HHS in early December to include Wisconsin in a pilot program that would allow people to purchase subsidized insurance directly through carriers, sidestepping the exchange.  The push to be let people receive subsidies without using the exchange was originally proposed when Healthcare.gov was working poorly, but the site is generally very functional now and it’s unclear how willing HHS will be to allow widespread purchase of subsidized plans outside of the exchanges.

Thirteen health insurance carriers are offering policies in the Wisconsin exchange.  But despite the robust competition, rates are relatively high.  The average premium for the lowest-cost bronze plan in Wisconsin is $287, compared with $249 nationally.  In late October, Citizen Action of Wisconsin created a report highlighting the very different ACA paths taken by Minnesota and Wisconsin, and placed some of the blame for Wisconsin’s high rates on the fact that the state ultimately took a hands-off approach to the exchange and also refused to expand Medicaid.  Rates in Wisconsin are double the rates of neighboring Minnesota.

Gov. Walker had previously expressed a preference for a state-run exchange rather than a “one size fits all” federally operated exchange. In 2011, Walker used an executive order to create the Office of Free Market Health Care to plan for a Wisconsin exchange.  Walker’s plan for a “free-market, consumer driven approach” leaned heavily on an insurance marketplace implemented by former Gov. Jim Doyle. According to one state insurance expert, the only notable change proposed by Walker was to put the exchange online.

However, Walker showed a changed mindset in 2012, returning a $38 million federal grant and closing the Office of Free Market Health Care. In announcing his November 2012 decision to accept a federally operated exchange, Walker said the state would have no real control and much higher financial risk with a state-run exchange.

According to Kaiser’s statehealthfacts.org, about 10 percent of Wisconsin’s population lacks health insurance — about 560,000 people. An Associated Press story included estimates that about 60 percent of them will gain coverage through the exchange and that 63,000 small employers in the state will use the exchange.

Wisconsin health insurance exchange links

HealthCare.gov
800-318-2596

Wisconsin Office of the Commissioner of Insurance
Assists consumers who have purchased insurance on the individual market or who have insurance through an employer who only does business in Wisconsin.
(800) 236-8517 / ocicomplaints@wisconsin.gov

State Exchange Profile: Wisconsin
The Henry J. Kaiser Family Foundation overview of Wisconsin’s progress toward creating a state health insurance exchange.

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Wisconsin Governor Scott Walker
115 East Capitol
Madison, WI 53702
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