By Louise Norris
February 20, 2014
By the first of February, 56,436 people had selected private QHPs in the Wisconsin exchange – an increase of more than 15,000 people since the end of December. Wisconsin has been trailing the national average for the percentage of enrollees between the ages of 18 and 34, but the state’s percentage of young adult enrollees grew slightly – from 19% to 20% of total enrollment – during January. Nationwide, 25% of QHP enrollees are between 18 and 34, but Wisconsin is one of nine states where young adults account for no more than 20% of total enrollment. Experts caution that it’s too early to draw any real conclusions about sustainability at this point though, because they expect a wave of younger, healthier people to enroll leading up to the March 31 end of open enrollment.
In addition to the QHP enrollees, Wisconsin’s exchange also had more than 60,000 applicants who were eligible for Medicaid/CHIP during the first four months of open enrollment, bringing total enrollment to 116,521.
Wisconsin lawmakers voted on December 19 to allow 72,000 people currently covered by BadgerCare Medicaid to remain on that program through March (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 at the end of the year. They now have until March 15 to enroll in their new subsidized plan through the exchange and have an effective date of April 1. 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. By December 31, the exchange had already identified 32,000 applicants who qualify for the BadgerCare program – nearly doubling the number from a month earlier.
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
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 / firstname.lastname@example.org
State Exchange Profile: Wisconsin
The Henry J. Kaiser Family Foundation overview of Wisconsin’s progress toward creating a state health insurance exchange.