Commissioner Nickel Op-ed: When Washington Fails, Wisconsin Leads
When it became clear Washington was not going to repeal or fix the Affordable Care Act (ACA), also known as Obamacare, Wisconsin stepped in to lead.
In Governor Walker's 2018 State of the State Address, he proposed the Health Care Stability Plan, a program intended to reverse the double-digit increases in Wisconsin's individual insurance market under the ACA. This includes
last year's 44% average increase for Wisconsinites buying coverage on the individual market.
The Health Care Stability Plan garnered bipartisan support by the Wisconsin Legislature, and on July 29, 2018, the U.S. Department of Health and Human Services and the U.S. Department of the Treasury approved Wisconsin's Health Care Stability Plan. Based on initial rate filings received by my office, the Wisconsin Office of the Commissioner of Insurance,
the program is expected to lower 2019 premium rates in Wisconsin's individual health insurance market on a weighted average by 3.5% from 2018 rates, and by an estimated 11% as compared to without the waiver.
While not every consumer will see their rates decrease, this is a significant change from last year and from the double-digit increases in previous years.
Wisconsin's individual health insurance market has experienced over $480 million in losses since the ACA's inception. Worse, for 2018, over 75,000 of our friends and neighbors lost their coverage. When they had to choose a new plan─ they had far fewer options. In fact, in large parts of Wisconsin there was only one plan available. Wisconsin is far from alone. An estimated one-third of U.S. counties only had one insurer in 2017. In 2018, that number jumped to over half of U.S. counties.
As the President of the National Association of Insurance Commissioners in 2017, I was in a unique position to hear about issues facing states across the country. Minnesota instituted a subsidy program and a reinsurance program after their market nearly collapsed. Iowa had only one insurer. A headline in
Iowa's Des Moines Register stated, "Consumers bemoan largest health insurance price hike in Iowa history, at 57% or more."
Under the Health Care Stability Plan, the State of Wisconsin agreed to run a $200 million reinsurance program to lower premiums for Wisconsin consumers.
Reinsurance is insurance for insurance companies. It provides coverage for events just like your insurance coverage. In this case, the state has agreed to pay 50% of any claims between $50,000 and $250,000. Insurers pay the other half of those costs, and 100% of claims below $50,000 and above $250,000. The program is funded by both state and federal dollars with the federal government picking up an estimated 83% of the cost (approximately $166 million) and the state paying 17% of the cost (approximately $34 million) through general purpose revenue.
Under Governor Walker's leadership and with federal approval, Wisconsin will now begin implementing the Health Care Stability Plan.
If Congress continues to avoid action, states will need to continue stepping in to protect citizens from the negative consequences of the law. In Wisconsin, we will seek additional approaches that lower costs and bring more competition to the Wisconsin health insurance market.