Health OVERHAUL

Despite rejection of Medicaid expansion, next steps in Obamacare set to begin in Wisconsin

2013-06-24T09:20:00Z Despite rejection of Medicaid expansion, next steps in Obamacare set to begin in WisconsinDAVID WAHLBERG | Wisconsin State Journal | dwahlberg@madison.com | 608-252-6125 Chippewa Herald

Though the Legislature last week approved Gov. Scott Walker’s rejection of an optional Medicaid expansion under federal health care reform, the next steps in carrying out the rest of the law are expected to unfold this summer.

“Navigators” will be hired to help people enroll in coverage for next year, and details of the private insurance plans to be offered will be released.

Outreach campaigns will pick up, including a “Get Covered America” effort launched last week by former campaign staffers for President Barack Obama and “Time for Affordability,” organized by America’s Health Insurance Plans.

“The idea is to inform as many people as possible and make sure they get to the right avenue” for buying insurance, said Lisa Olson, director of policy and programs for the Wisconsin Primary Health Care Association, the state’s lead organization preparing to hire navigators.

The developments are expected to take place before online marketplaces, known as exchanges, open Oct. 1 and offer coverage beginning Jan. 1. That’s when most Americans will have to be insured or pay a penalty.

Wisconsin’s exchange, along with its partial Medicaid expansion for childless adults, will insure about half of the nearly 500,000 residents who lack coverage today, state officials say.

Critics say some lower-income people won’t be able to afford insurance on the exchange, even though they will qualify for subsidies.

Under Walker’s plan, almost 90,000 parents on Medicaid who make more than the poverty level will be shifted to the exchange.

The state’s exchange, to be run by the federal government, will offer a variety of private insurance plans. It is designed for people who have no access to employer-based coverage.

Some of those people currently buy insurance on the individual market or through a special plan for people with high-risk medical conditions.

The vast majority of people who get insurance through their jobs won’t use the exchange or see major changes to their coverage next year, said Barbara Zabawa, a health care attorney in Madison with Whyte Hirschboeck Dudek.

Some companies might decide to direct workers to the exchange, however, and the cost of employer coverage likely will increase because of new requirements, Zabawa said.

The Wisconsin Primary Health Care Association applied this month for $829,000 the federal government allocated to the state for navigators.

The association is leading a statewide coalition of 72 health care groups — called Enrollment for Health Wisconsin — which will learn by Aug. 15 if it will receive the money, Olson said.

The association represents the state’s 17 community health centers, including Access Community Health Centers in Madison, which mostly serve low-income people. The centers have collectively applied for another $1.7 million to help sign up people for insurance.

The $829,000 would be used to hire six full-time navigators, who would be able to enroll about 6,000 people in coverage, the coalition estimates.

“It’s barely scratching the surface” of the need, Olson said.

But the coalition plans to organize enrollment fairs and find other ways to reach large numbers of people, she said.

The state budget also includes two pots of state and federal money to hire workers to help implement the law: $10.3 million to hire 88 people for Medicaid enrollment, mostly in Milwaukee; and $38.1 million to help counties assist consumers, including $1.4 million in Dane County to hire 34 economic support workers.

Details about the plans to be offered on the exchange — such as premiums, co-payment amounts and levels of coverage — are expected to be released in late July, said J.P. Wieske, spokeswoman for the Wisconsin Office of the Commissioner of Insurance.

The information should be available on the exchange’s website by Sept. 15, according to the federal government.

Most Madison-area health insurance companies applied by early May to participate in Wisconsin’s exchange, though none has released details of what coverage they will offer.

Dean Health Plan, Group Health Cooperative of South Central Wisconsin, Physicians Plus and Unity applied to be on the exchange next year.

WEA Trust doesn’t plan to participate. Neither does WPS Health Insurance, except for its Green Bay-based subsidiary, Arise Health Plan.

Copyright 2015 Chippewa Herald. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

(20) Comments

  1. southernboy
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    southernboy - June 30, 2013 10:23 pm
    SRLaBelle- type your whole reply in a email or text document then check spelling and content. THEN copy & paste the post into the window here and then press submit
    don't make any changes to it once its here or the software automatically limits its size

    entering it and pressing submit-posts it

    enjoy


  2. ectraveler
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    ectraveler - June 25, 2013 9:15 am
    If we have overfunded healthcare who's fault is it? The doctor who's doing his best to help his patients or the politician that allowed that much money to flow in the first place?
    Defense departments used to have the same rampant spending problems in their budgets. That's when you'd hear reports of the government paying $100 for a hammer and $200 for a toilet seat. It wasn't the private business who was selling the hammer or seat that was at fault. It was the government for allowing it to happen in the first place. Same with healthcare. Cost control measures are necessary yet both parties refuse to address it.
    How can it cost a hospital in Eau Claire 25% more than a hospital in Wausau for the exact same proceedure? Or 50% more in Duluth than in Madison? Would you go to any other service organization and willingly pay 50% more? Why is it somehow OK in the healthcare industry to do just that?
  3. tricky d
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    tricky d - June 24, 2013 11:11 pm
    It's easy to see who here was born with the silver spoon and who wasn't.
    It's also easy to see who deflects the comments about Scooter wrecking the state and who doesn't.

    Stay classy GOP..
  4. SRLaBelle
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    SRLaBelle - June 24, 2013 10:27 pm
    EC,
    I wanted one more bite at this apple.
    You say "medical expenses are underfunded".
    We have nearly quadrupled the % of GDP we spend on healthcare over the past 50 years, underfunded?
    I appreciate your passion about equality and people's health but would you entertain a different take for just a moment... Could it be that we have screwed things up by overfunding healthcare?
    I think that we have raised the financial expectation of everyone involved in the healthcare business by flooding the sector with public money. Our initial 1965 intent, to help older folks who can't afford healthcare has morphed into a financial juggernaut which has made healthcare too expensive for the rest of us.
    From what I understand, the initial law allowed Docs to provide seniors with any care, at any cost and simply send Uncle Sam a bill. Gosh, what could have possibly gone wrong with that?
    Healthcare costs seem to have gone out of control about the same moment we started pouring tax dollars in.. Humm?
  5. SRLaBelle
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    SRLaBelle - June 24, 2013 9:45 pm
    Wis,
    Thank you for your response.
    I agree that there are many reasons for high U.S. healthcare costs. We could talk about tort reform, the nation's diet, gunshot wounds, insurance companies, regulatory bureaucracies, and a hundred other things but the amounts we pay our providers, even when adjusted as they are in the New York Times article which I cited in my earlier comment, are so dramatically out of line with with the rest of the developed world that one must take note.
    I don't see how we can move to better healthcare model with out essentially spending our way into crisis first. Public dollars and third party payer dollars have distorted the healthcare marketplace to the point where a normal person paying cash simply cannot participate. By the way these lawsuits are not just private practice attorneys, check out the Cal dept. of insurance's $10 billion dollar 2006 Pacificare lawsuit wandering through the legal system..
    It is nothing more than a concoction of politics and greed.
  6. wisres1
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    wisres1 - June 24, 2013 8:59 pm
    I'm responding to SRLaBelle's comments about the money spent on healthcare. Yes, healthcare is too expensive. But it's not just Drs. becoming rich. Because a good number of our politicians are attorneys, the question of tort reform never comes into the conversation. Health care professionals spend a fortune on malpractice insurance because there are too many ambulance chasing attorneys willing to help you sue the pants off of them. Don't get me wrong, there are legitimate lawsuits against bad Drs. However, there are also too many frivolous lawsuits that are being filed to line the pockets of lawyers. And until we do something to stem that bleeding, malpractice insurance will continue to skyrocket, which results in higher health care costs. And with lawyers running the country, tort reform will never become part of the national conversation to help reduce healthcare costs.
  7. SRLaBelle
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    SRLaBelle - June 24, 2013 4:45 pm
    It is easy to blame some amorphous "dysfunctionality" for a budgeting problem rather than follow the money. Our doctors, nurses and hospital administrators make far more money, by any measure, than folks who do the same work anywhere else.
    http://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-other-countries-make/?_r=0
    Ignoring that simple fact doesn't make it any less true.
    It's not as if our docs are a third better than Canadian docs or twice as good as French docs.
    To top it all off we have given doc and dentist groups the defacto ability to limit medical and dental school enrollment so the teaching hospitals aren't turning out enough MD's to meet demand. Ask yourself why the University of Wisconsin (and Minnesota) hospital and clinics have somehow become doc owned private businesses?
    I hate to seem disrespectful but it's all about the Money.
    When we run out of good faith and credit.
    Then doc salaries might come back down to earth
  8. ectraveler
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    ectraveler - June 24, 2013 2:30 pm
    It's not the doctors fault medical expenses are underfunded just like it wasn't the teachers fault education expenses were underfunded. They don't pass the laws that stipulate where the money comes from nor what it gets spent on. Put the blame where it belongs - on our dysfunctional government. The most important thing in politics today is to make sure the other party fails.
  9. Sand-Blaster
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    Sand-Blaster - June 24, 2013 1:56 pm
    ...The Wisconsin Primary Health Care Association applied this month for $829,000 the federal government allocated to the state for navigators. ... The $829,000 would be used to hire six full-time navigators, who would be able to enroll about 6,000 people in coverage, the coalition estimates. ...
    $829,000 devised by 6 = $138,166.66! Hopefully that $ is not just for salary.
    Assuming 6000 are enrolled that is $138.17 per enrollee.
  10. Tricky
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    Tricky - June 24, 2013 1:09 pm
    Nope, it's about greed, and republican politics.
    I'll start promoting absurd ideals and life choices when you stop paying for tax breaks for the top 1% and corporations on the backs or the sick, elderly, working middle class and the poor. The whole work hard and earn a better lifestyle is a moot point when your governor has done more to destroy good paying jobs than almost any other governor in history We were almost first in economic growth, now after years of Walker we are almost worst, (8th to 49th.)
    Logic, empathy, and common sense would dictate that this is a good time to make sure all our citizens have adequate health coverage, give them one less thing to worry about while they try and make a better life.
    Instead it is now just another way to punish the growing number working poor in Wisconsin.


  11. SRLaBelle
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    SRLaBelle - June 24, 2013 1:05 pm
    Any clear eyed look around the world would show that our healthcare problem is that we spend too much on ineffective, over priced, healthcare services rather than that we don't tax the rich enough.
    Proper tax rates are another discussion entirely.
    The real debate on the cost of healthcare fell by the wayside during the Obamacare debate. We are apparently going to print money and give it to Docs and hospital administrators until we run out of green ink. No politician has the nerve to stand up to the AMA. You can tax every billionaire and every pauper into starvation and it won't matter a whit. The baby boomers are crowding into Medicare, the highest paid docs are crowded right in there to provide amazingly expensive heroic measures designed to keep 80+ year old folks alive for an extra month or two and there is nobody, on either side of the aisle, who is willing or able to do a thing about it.
    In a decade or so our national credit will be maxxed and then the Docs will take a haircut
  12. ectraveler
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    ectraveler - June 24, 2013 12:36 pm
    Not about the rich at all. It's about equality. You just seem to think equality has an income limit while I do not. I don't give a hoot how much money you make. If you are a billionaire thats great. Good for you. However, it's no reason I should have to pay 25% in taxes while you only pay 13%.
  13. youknowme
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    youknowme - June 24, 2013 11:56 am
    Always about the rich is it? How about your side start promoting ideals and life choices that do not lead to poverty rather than blame the rich for the poor's plight. How about instead of the liberal mantra that you can do what you want when you want and someone else will pay for it comes to an end. How about instead of promoting sexual freedom and deviance that ensures a lifetime of poverty we start educating about the costs of raising children from birth to death. Then, maybe we can start talking about the "working poor" who will never get out of poverty...even by voting democrat.
  14. ectraveler
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    ectraveler - June 24, 2013 11:21 am
    It's not keeping it real. It's playing politics. Can you name a Democratic governor that rejected Obamacare? I couldn't think of one. But, I can name a few Republican governors that are implementing it...
  15. Tricky
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    Tricky - June 24, 2013 11:12 am
    So a working couple without kids earning around or just above the poverty level will now be required to pay roughly 8000 per person annually for insurance (and forgo things like rent and food) or pay the 700 per person per year penalty. All while their work hrs were cut so the employers can get out of paying health care.
    They would have been covered under the expanded Medicare subsidy that for some unfathomable reason the state turned down. Remember, Badgercare is a now 3plus year waiting list with priority going to kids and the state is offering what sort of solution? Oh yes, thats right they are now giving subsitities to for profit schools. Once again lining the pockets of the rich while taking a big steamy one on the working poor.

    Thanks Scott Walker!

  16. Real Deal
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    Real Deal - June 24, 2013 10:47 am
    Only Democrats approved a Major Bill... Now some are coming out and saying well I guess we are going to have problems and it's going to cost us more money. The majority of us wanted our Insurance premiums to go down. There will be a couple of items out of this bill for sure our Costs will Go Up and our Care will go Down. Again it's being rejected by Democrats now too but Obama Admin is strong arming others that want to make changes to the already passed bill. That's keeping it real for sure!
  17. ectraveler
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    ectraveler - June 24, 2013 10:03 am
    It is being rejected because it was Obama's initiative. Republicans simply will not be seen as doing anything that could in any way, shape or form be considered helping a Democrat.
    It's also the same road our state democrats took in regards to the state budget. Rejected as a whole, no ammendments, no debate simply because it was Republican led.

    This is what happens when special interests (on both sides) have too much say in what our government does. Disfunctional government on full display for all to see.

  18. youknowme
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    youknowme - June 24, 2013 8:50 am
    "Everyone needs health insurance." Hahahahahah that's funny/ Especially since the CBO said last week that even under Obamacare uninsured numbers will NEVER be below 30 million. Everybody eh?
  19. Real Deal
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    Real Deal - June 24, 2013 8:05 am
    Sure everyone needs health insurance but everyone doesn't want to pay something for it. Lets get Real Now! If someone is trashing their health by too much smoking, drinking or being way over weight do I want to pay for them or should I have to? This whole thing is heading for disaster. Reading the article hiring navigators well that's spending extra money when you have qualified licensed insurance agents already. I find it hard to understand why this other person commenting blames Walker. About 30 States decided not to enact part of Obamacare by telling the Federal Government they can set up the Exchange because they didn't want any part of it. Great move by the majority of the States again Majority. Something in this bill must not be good...
  20. misthaufen
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    misthaufen - June 24, 2013 7:49 am
    The world is moving ahead. Walker is being left behind in the 19th century. Everyone needs health insurance. The irony of Walker's position is that universal healthcare in a single-payor system is moving ahead nicely in Wisconsin because the state's leader is deficient.
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