FACT SHEET: WI Health Care Stability Plan

Following years of sabotage and hostility directed towards the Affordable Care Act (ACA), Governor Walker and the legislature pivoted to pass a $200 million reinsurance program, which is expected to slightly lower premiums for those relatively few people who earn too much to qualify for premium tax credits that help defray the costs of purchasing a health insurance plan on the federal ACA Marketplace.

Reinsurance is a concept where insurance companies are reimbursed for paying the health care costs of people who require very expensive care. By helping to insulate insurance companies against the financial risk of having to cover very expensive care, they can offer lower rates for everyone. However, the plan does not require savings to be passed on to consumers, does not address soaring costs of deductibles, or address other health care costs borne by patients and their families. This new law is anticipated to provide a little help in the form of small cost reductions to some consumers, but will not undo the damage caused by Republicans’ efforts to sabotage the Affordable Care Act, which has led to increases in premiums and fewer choices for the people insured through the ACA.

What Wisconsinites need to know about Walker’s $200 million Reinsurance Plan:

  • The plan will do little to make up for the repeated acts of sabotage directed towards the ACA at both the state and federal level.
  • The same day that Governor Walker signed a bill to provide reinsurance funding for the ACA, he authorized the Attorney General to join a lawsuit challenging the ACA, once again placing coverage at risk for hundreds of thousands of Wisconsinites.
  • The plan does not require that insurance company savings be passed on to consumers buying plans.
  • The plan does not address costs of deductibles and other health costs.
  • According to the Governor’s own analysis, the plan could decrease premiums for effected enrollees by 10% and increase enrollment by less than 1%.
  • The plan will largely benefit higher-income individuals and families who make too much to qualify for premium tax credits – about $100,000 per year for a family of four.
  • Proponents of this proposal have said they will find ways to reduce state Medicaid spending by at least $30 million per year to finance the plan. State funding for reinsurance should not come at the expense of our Medicaid program.
  • What little savings this will provide would likely be undone by federal and state efforts to expand the use of skimpier health insurance that’s not required to cover essential health benefits. This will siphon healthier people away from the ACA Marketplace resulting in yet more expensive coverage and fewer options.
  • If the Governor really wanted to stabilize health care he could expand BadgerCare, which would cover nearly 80,000 more people and saving the state $190 million per year. He could use those savings to fund his reinsurance plan, increase provider reimbursement rates, or fund more sensible plans to reduce health care costs for Wisconsinites.

Please comment and tell Governor Walker to include consumer protections to his healthcare stability plans by mandating that savings are passed on to consumers and funding for his plan shouldn’t come from our state’s Medicaid budget. Comments are due by April 14, 2018 and can be submitted electronically to OCI1332WaiverComments@wisconsin.gov.