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No gaps in Wisconsin health exchange market

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Associated Press
September 19, 2013

MADISON—Everyone in Wisconsin will have multiple choices for purchasing health insurance through new online marketplaces that begin accepting applications in less than two weeks, based on a list of providers' coverage areas released Thursday.

The list released by the state insurance commissioner's office showed that 59 of the state's 72 counties will have at least two providers selling individual plans through the marketplace, or exchange. Each provider is required under federal law to sell at least two levels of plans, so even in the 13 counties with just one company selling there will be multiple options available.

Before the release of that information, it was unknown how expansive coverage would be in Wisconsin.

“It's what we were hoping for,” said Robert Kraig, director of the health care advocacy group Citizen Action Wisconsin. “We were hoping that people would have a lot of options.”

Kraig said based on a quick analysis, nearly 96 percent of the state's population would have two or more providers selling coverage through the exchange.

The enrollment period for plans sold through the exchange begins in less than two weeks, on Oct. 1. Coverage takes effect in January.

The marketplaces are a key aspect of President Barack Obama's health care law, which requires everyone to have insurance by Jan. 1 or to pay a penalty.

About 500,000 people in Wisconsin are expected to be shopping for coverage through the exchange, including about 92,000 who will be losing their Medicaid coverage in January and another 400,000 who have no insurance.

The exchanges are supposed to transform the way individuals and small businesses buy private health insurance by increasing transparency and competition and boosting government oversight of insurers. The federal government will pay hundreds of billions of dollars to subsidize the policies.

A month ago, the Wisconsin Office of the Commissioner of Insurance announced that 13 insurance companies would be offering plans to individuals through the exchange, and nine would be selling plans to small businesses. But it did not provide any details about rates or coverage areas.

Earlier this month, the agency provided some rate information that projected dramatic increases for individuals. But it didn't take into account federal subsidies that will be available or the differences in benefits under plans sold through the exchange.

The breadth of the coverage area dispels dour predictions among critics of the health care overhaul law that there would be little interest among insurers to offer plans, said Bobby Peterson, executive director for ABC for Health, a nonprofit law firm in Madison that helps people get health care.

The official coverage area breakdown shows there will be a high level of competition in most of the state. Seventeen counties will have two providers and another 17 will have three. Ten counties will have four, 11 counties will have five and four will have six.

Those four counties will the greatest competition will be Dodge, Jefferson, Shawano and Walworth.

Milwaukee County, which is the state's most populous, has four providers. Dane County, which is home to the capital city of Madison, also will have four providers.

The marketplace is less competitive for those selling group plans. The list shows that five counties will have no providers. They are Florence, Green Lake, Lafayette, Marquette, and Menominee.



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