Will Policymakers Continue the Remarkable Progress or Reverse Course?

The next year will be a pivotal one for health care because state and federal policymakers might build on the remarkable gains in health insurance coverage achieved over the past two years, or they might undo that progress.

Recently released Census Bureau data show that at both the state and national level there have been huge gains over the past two years in the number of people who have health insurance. From 2013 to 2015 the number of uninsured Americans fell by about 15.5 million, including a drop of 195,000 in Wisconsin.

That’s a remarkable achievement, but there’s still plenty of room for improvement. In Wisconsin last year there were an estimated 323,000 people who were uninsured. To put that in perspective, consider that despite the remarkable improvement in our state, the uninsured population in Wisconsin surpassed the total combined population of four Wisconsin cities: Green Bay, Kenosha, Eau Claire and La Crosse.
The graph above is one of five in a one-page fact sheet illustrating the gains achieved under the federal health care law and also showing the work that remains to be done to ensure that almost all Wisconsinites have access to health insurance and preventative health care.

Since there’s still plenty of room for improvement, the direction lawmakers take will be determined by their political priorities, not by any sort of ceiling on the uninsured rate. Our uninsured rate is twice the rate in Massachusetts, which pioneered the policy changes in the federal health care reform law.

The good news is that Wisconsin continues to have one of the lowest uninsured rates in the country; we were tied for the sixth best coverage rate last year.  On the other hand, as the WCCF one-pager illustrates, Wisconsin’s 5.7% uninsured rate trails that of two neighboring states –Minnesota (4.5%) and Iowa (5.0%). If we keep moving forward and reach the Minnesota rate, there would be almost 70,000 fewer uninsured Wisconsinites!

Several years ago Governor Walker set a goal of cutting in half the number of uninsured people in Wisconsin. We’ve made good progress toward that goal, but to get there we need to reach the 4.5% uninsured rate that Minnesota has achieved.

Cutting in half Wisconsin’s uninsured rate and catching up to Minnesota are very attainable goals if our state simply does two things:

• Wisconsin should take advantage of the part of the health care reform law that would pay for the expansion of BadgerCare coverage to low-income working adults who are slightly above the poverty level.
• Our state needs to do a better job of removing administrative barriers in the BadgerCare enrollment and renewal processes, as a number of other states have done.

But the even more important policy choice is whether Congress and the next president retain and improve the Affordable Care Act or repeal major parts of it. Eliminating the premium subsidies for individual plans, as Speaker Ryan has proposed, would reverse a lot of the progress Wisconsin has made. It would be especially damaging here because Wisconsin lawmakers cut in half the BadgerCare income eligibility ceiling for parents – making far more low-income working families dependent on the federal subsidies for private plans purchased through the new federal Marketplace.

We can be proud that the number of uninsured Wisconsinites has dropped sharply over the past two years. But 323,000 uninsured state residents is still far too many, and this definitely is not a time to reverse direction by repealing key portions of the federal health care reform law.

Jon Peacock