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Healthcare in Wisconsin

Wisconsin: A Consumer State, No More?

We might be living in the past, but we can’t help to mourn the loss of the days of consumer protection in Wisconsin. As a leader in health care access, other safety-net programs, and public policy that protects citizens in need and strengthens the community in which we live, we wonder – are those days over?

You might remember our shocking blog post, in November, when we revealed the Walker Administration’s decision to request that Wisconsin be exempt from one important insurance reform – “medical loss ratio.” In summary, this provision of the Affordable Care Act (ACA) mandates that insurance companies spend at least 80-85% of their premium revenue on health care, rather than administrative costs or profits. What is the penalty for not complying? The insurance company must send rebates to members, which sounds like a good consumer protection to us. If you would like to read more about this, link here to view our blog post. Thankfully, the federal government denied this request.

So what has the Walker Administration done, now, to further reduce transparency? Well if it were up to Wisconsin Office of the Commissioner of Insurance (OCI), the majority of money from premiums wouldn’t have to be spent on health care, and premium increases in the double digits wouldn’t have to be justified or reviewed. In fact, the OCI Commissioner, Ted Nickel, has officially asked to reduce accountability measures set in place by the ACA. Specifically, the state has requested that Wisconsin be allowed an exemption from the 10% mark that is currently set in place – and to conduct their own research to determine what review rate marker would be appropriate.

Thus far, there have been 20 insurance rate hike reviews that have been made public. Of these, 3 were reviewed by the federal government – where 2 of them were found to be unreasonable rate increases. Seventeen were reviewed by Wisconsin – none were found to be unreasonable. Fourteen remaining rate increases are pending review, and would affect over 30,000 of our neighbors. The total tab those individuals would pick up? Almost $20 million in rate increases.

Nationally, nine states – including Wisconsin – have proposed rate increases that are 10% or higher. Women are more likely to make the coverage decisions for their families; Wisconsin women need leadership that supports accountability, transparency and public opinion regarding their premium rates.  The Wisconsin Alliance for Women’s Health will continue to support consumer protections – including those implemented by the ACA – that make access to affordable coverage a reality for all Wisconsin women and families.

Are the consumer protection days over for Wisconsin? No! But we need all Wisconsin women, and those who love them, to raise their Wisconsin voice to reflect and speak up about the direction they want Wisconsin to go. That’s why starting June 1st; we will be kicking off our “5 Questions to Ask Yourself Before June 5th” blog series to reflect on where the state is headed – and where it could go – depending on the state’s recall election next week. 

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