At the end of June, Governor Walker unveiled his plan for a Health Insurance Exchange. As we reviewed and assessed their proposal, a number of concerns arose regarding the accountability structure and benefits (or lack thereof), which the Walker Administration’s plan will provide for Wisconsin’s women.
Walker proposes to create a health advisory board, comprised of 2 insurers, 2 business representatives, 1 consumer advocate, 1 broker/agent representative. This board will also include a number of non-voting yet still influential members including the Secretary of the Department of Health Services; Dennis Smith. Our qualms with this composition are at first glance apparent; of the 6 voting members there is only one consumer advocate and not a single person well versed in public health. If this exchange is meant to hold insurers accountable to those whom they insure, then why are the two largest parties insurers and business representatives? Though we understand and accept the importance of industry representatives being involved in the governance of the Exchange, so clearly protecting the interests of one side is to the detriment of insurance consumers in Wisconsin. Additionally, if industry representatives are on the board, it is especially important that strong conflict of interest provisions are in place for members – unfortunatley this is not evident in the draft proposal. A public health professional on the board will address the Exchange development and governance in a way that is cost efficient, beneficial to all potential consumers, and community driven – understanding that an Exchange cannot merely be one size fits all.
Our second leading concern with Governor Walker’s exchange plan is the effect of allowing all plans to be marketed through the exchange. While at first glance this idea seems wholly acceptable, it in fact is quite concerning . Allowing all plans into the exchange without oversight and standards to minimally regulate the market will prevent the exchange from achieving it’s promise.
The exchange offers an opportunity to set a standard level of care for those who need it the most. By allowing people to purchase care in league with thousands of others, their individual buying power is increased. Combining these two things, high buying power, and setting minimum covered benefits creates the ability to finally realize huge leaps forward in the level and quality of insured care. For women in particular this means having had a cesarean section or breast cancer will not be a preexisting condition preventing them from accessing coverage.
The Health Insurance Exchange has the potential to better the lives and economic security of thousands of Wisconsinites. While Walker’s plan gives us a start, there’s much more to be done. See the WAWH Exchange Principles, discussed in the previous blog post, for more on what an Exchange benefiting women and families in Wisconsin would look like.