Walker administration hiding benefits to health care reform

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Robert Kraig
Thursday, September 8, 2011

The Walker administration recently released a report at a closed “by-invitation only” media briefing purporting to show that the new national health care reform law would negatively affect Wisconsin’s health insurance market. I attempted to attend the briefing but was forced to leave. Reporters were told the briefing was “off the record” and couldn’t use recording devices or quote the speakers. The study author, health care economist Dr. Jonathan Gruber of MIT, wasn’t invited.

In addition to the oddly secretive release, Walker’s administration attempted to bury many of the most important report findings to create a negative impression of the Affordable Care Act. The most significant finding in Gruber’s report is that the new law will result in 340,000 uninsured Wisconsinites gaining coverage. However, this information isn’t even mentioned in the Walker administration’s press release about the report.

The administration also gave a slanted account of the impact of reform on Wisconsin individual and small group health insurance markets, focusing entirely on premium increases that will impact some participants. They didn’t highlight report findings that showed substantial premium reductions for Wisconsinites who pay the highest rates currently. Instead, they focused attention on those who would pay more in the short term because health reform forces the insurance industry to end discrimination based on pre-existing conditions, age and gender, and requires higher quality coverage.

Currently, individuals and small groups that are younger and healthier get lower rates because insurers discriminate against others and often sell substandard policies. Insurers can deny coverage, charge discriminatory rates or impose exclusionary riders for policyholders with pre-existing conditions. Over 1 million Wisconsinites younger than 65 have pre-existing conditions serious enough to trigger such discrimination. Ending this discrimination will cause some individuals who are fortunate enough to get low premiums in the current system to pay higher premiums in the short term, but in return they’ll be guaranteed higher quality coverage, which the insurance industry can never take away as they age and face medical conditions.

The only permanent “losers” in ending health insurance discrimination are the insurers who profit by offering affordable coverage only to people whom they deem less likely to file medical claims. Those fortunate enough to be young and healthy might get good deals from the health insurance industry, but they can lose coverage or be priced out as they age or if they face medical conditions. If a small employer has affordable coverage today, one employee suffering a serious medical condition can price the whole group out of the market.

Once the Affordable Care Act is fully implemented, consumers will have a right to buy affordable coverage in a new marketplace where insurers cannot take it away or charge discriminatory rates as someone ages or the person’s health status changes.

The way the Walker administration handled the release of this important report raises questions about how Wisconsin will implement national health care reform. Wisconsin residents must watch closely this fall when the Legislature is expected to take up this crucial issue.

Robert Kraig is executive director of Citizen Action of Wisconsin, 221 S. 2nd St., Suite 300S, Milwaukee, WI 53204; phone (414) 671-9760; email robert.kraig@citizenactionwi.org; website www.citizenactionwi.org.

Last updated: 6:24 pm Thursday, December 13, 2012

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