Private Coverage in Wisconsin Exceeds Federal Target for First Three Months  

New figures released by federal officials today show that nearly 2.2 million people picked a private health insurance plan through the federal Marketplace by December 28, including nearly 41,000 in Wisconsin.  In addition, more than 44,000 Wisconsinites who applied through the Marketplace were found eligible for Medicaid or the Children’s Health Insurance Program (CHIP).

Back in September, the Centers for Medicare and Medicaid Services (CMS) issued a memo laying out national and state targets for private enrollment through the Marketplace in the first three months. The national target is just 65% of the way to that target (of 3.3 million people), but the Wisconsin figure is 10% above the 3-month CMS goal for our state. (See the table in this useful NY Times article.)

Although I think it’s good news that Wisconsin is at 110% of the CMS target, I suspect that the federal targets don’t carefully account for all the state-level variables, such as the fact that Wisconsin has a large pool of adults in BadgerCare who were being urged to switch over to private coverage.

A disappointing figure for Wisconsin is that just 19% of the initial sign-ups are in the age range of 18-34, compared to 24% nationally.  (See the NY Times analysis.)  Again, I think that could be because a substantial segment of the early enrollment in Wisconsin was coming from parents who had been participating in BadgerCare.

Here are some of the other figures from the first three months of Marketplace data for Wisconsin:

• 56% of the people who have selected a private plan are female.
• 4% are children and, as noted above, 19% are age 18-34.
• 32% are age 35-54, and 45% are age 55-64.
• 69% of Wisconsin enrollees chose a silver plan, versus 19% bronze, 11% gold, just 2% platinum, and 1% chose a catastrophic plan.
• 88% of the Wisconsin enrollees are receiving financial assistance for their plan (compared to 79% nationally).

In Wisconsin and nationally, the number of people who have completed applications and been found eligible to enroll in the Marketplace is about two and a half times the number of people who have selected a Marketplace plan.

The numbers for our state are complicated by the fact that legislation signed into law just before Christmas provides a 3-month extension for adults over the poverty level to keep participating in BadgerCare, and a 3-month delay in the expansion of BadgerCare to childless adults below the poverty level.  Thus, the Wisconsin figures, which don’t account for the last minute changes in eligibility, are a useful indicator of upcoming enrollment levels, but not of actual program participation in January.

An Associated Press article points out that Wisconsin and West Virginia have the highest percentage of enrollees in the 55-64 age range.  The 45% figure for those two states compares to a national average of 33%.  If it remains nearly that high, the Wisconsin figure would be worrisome because that mix of enrollees would almost certainly put upward pressure on rates.  However, I think some time is needed for the data to shake out, especially in light of the unique variables affecting early enrollment in our state.

Jon Peacock