Health Care Reform

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Report 2016: Wisconsinites Still Paying More for Healthcare than Minnesotans

Report 2016: Wisconsinites Still Paying Far More Than Minnesotans for Healthcare

For the 3rd year in a row, Citizen Action's Minnesota Vs Wisconsin Healthcare Report shows that Wisconsinites are continuing to pay far more for healthcare than their Midwestern neighbor. Click here to read the whole report.

The findings in this report should be a wakeup call that state policy has a significant impact on health insurance costs, and that solutions should be near the top of the agenda in Madison.

As in all the previous studies, this report suggests that the two states differing approaches to implementing the Affordable Care Act partially explain the gap in health insurance rates between the two states. The obsession of Wisconsin elected leaders on obstructing the Affordable Care Act has distracted them from taking common sense steps that could improve  the Wisconsin health care system and make it more affordable.

Public discussion of Minnesota’s health insurance inflation has up to this point failed to include the impact of deductibles. This exclusive focus on premiums has distorted understanding of overall costs to consumers. For example, in Minnesota metro areas such as Rochester and Duluth, the overall cost to consumers of both premiums and deductibles together has actually gone down for 2016.

Deductibles represent a major cost for consumers. Deductibles must be met before the insurer payments kick in for most medical services.

Comparing full consumer cost, both premiums annually and deductibles, within major metro areas reveals dramatic and shocking regional differences in what consumers pay.

Policy Proposals in this report

  • Wisconsin should increase its rate review authority, as has been proposed in a bill by Senator Chris Larson and Rep. Debra Kolste. In addition, Wisconsin could explore an “active purchasing” model to directly challenge high premiums and out-of-pocket costs
  • Wisconsin should immediately accept enhanced Medicaid funds to strengthen BadgerCare and begin to plan to accept “Basic Health Plan” dollars which can be used to return BadgerCare eligibility to 200% of poverty line for adults. Wisconsin should also explore federal waivers that can be used to ease health insurance costs for low income consumers.
  • Wisconsin should follow Minnesota, and end the sale of substandard non-Affordable Care Act-compliant health plans.

Questions? Email Kevin Kane at Kevin.kane@citizenactionwi.org

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Republicans & Democratic Party Members in Ohio Cooperating Around Human Rights

In our democratic republic when should Democratic and Republican Party members cooperate around compassion and human rights?  

Caring Citizens’ Congress delegates say, “Always.” 

Read more.

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Understanding Obamacare: You Still Have Time to Enroll

Article first appeared in the January 8th edition of the Shepherd Express

Question: Do I still have time to sign up for Obamacare?

Answer: Yes, the Affordable Care Act gives people ample opportunity to sign up for quality and affordable health care. The open enrollment session is only half over.

Starting on Jan. 1, more than a million Wisconsinites gained the right to access coverage that could no longer discriminate because of pre-existing conditions or gender. Thousands have already enrolled. Consumers have until March 31 to sign up for coverage. These enrollment sessions and deadlines are important because they encourage personal responsibility.

But the law recognizes that when big life events happen, coverage needs to change. The Affordable Care Act gives people the opportunity to enroll into marketplace coverage through special enrollment periods for major life changes, such as getting married, having or adopting a child, moving to a new area, losing health coverage from a job, expiring COBRA coverage, a divorce and more.

That’s not all. If you’re already enrolled in a marketplace plan, a change in income or household makeup will give you the opportunity to enroll in a new policy. You can enroll in BadgerCare any time during the year if you become financially eligible. And lastly, small businesses can offer health coverage to their employees at any time.

Flexibility is important, but so is responsibility. The law encourages people to get coverage early before they need it. After all, you don’t wait until your house is on fire before calling around for quotes for home insurance. Likewise, you shouldn’t wait for a health crisis before signing up for health insurance. But no matter what, you will have guaranteed access to quality, affordable health coverage, thanks to Obamacare.

—Kevin Kane, lead organizer, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act during its implementation. Got a question? Email editor@shepex.com.

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Understanding Obamacare: Young Adults Win Big

This article was originally featured in the Sept 11, 2013 edition of the Shepherd Express in Milwaukee

Question: I’ve heard that Obamacare has some benefits for young people like me. What are they?

Answer: The Affordable Care Act has good news for young adults: You can stay on your parent’s insurance coverage. Young adults often go without coverage. In fact, 35% of adults between the ages of 19 and 25 had no health care coverage before the law passed. Some of it is a general mindset of invincibility, the belief that “It can’t happen to me.” But there is another hard reality at work. Entry-level jobs frequently do not offer the level of benefits they did 10, 20 or 30 years ago.

To fix this problem, the Affordable Care Act has required that insurance companies allow young adults to stay on their parent’s policy until the age of 26. Now an estimated 6.6 million young adults can confidently enjoy the assurance of being able to stay on their parent’s coverage even if they are out of school, even if they are employed and even if they live in a different state than their mom or dad.

This protection is in place now, but starting on Oct. 1 young adults can purchase new coverage options that will protect them from being discriminated against because of age, gender or preexisting conditions. Young and healthy adults won’t stay young and healthy forever, but they too deserve the protection of an insurance marketplace that treats them fairly. The Affordable Care Act guarantees that. It’s good to finally have someone on our side.

—Kevin Kane, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act in the weeks leading up to its implementation. Got a question? Email editor@shepex.com.

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Vote for Kevin for Most Valuable Organizer

For Citizen Action's work in promoting the Affordable Care Act and fighting for BadgerCare with new partners, CAW's lead organizer Kevin Kane has been nominated to be the New Organizing Institute's (NOI) "Most Valuable Organizer"!

We believe that this is an important way to promote the work that Citizen Action has been doing, and bring national attention to the fight to make Wisconsin stronger and healthier; and we're hoping you agree with us! Because for Kevin to win, and for Wisconsin's campaigns to get this national attention, we need you to vote for us. The candidates with the most votes will be chosen from. So please help us by doing the following:

  • Once you've done that, click this link or use the app below to support our Thunderclap - Thunderclap allows us to post the same message to all of our Facebook/Twitter pages at the same time and get a lot of attention!
  • Lastly, help share this page with others - you can forward the link, use the sharing buttons at the bottom or go to our recruitment page to see all the other tools for sharing that will give you credit for doing so!
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Understanding Obamacare: Insurance Companies Can’t Discriminate Against Women

This article was originally featured in the Oct 8, 2013 edition of the Shepherd Express in Milwaukee

Question: How does Obamacare help women’s health?

Answer: Obamacare has important benefits for women and finally addresses persistent inequities in our health system. Before the Affordable Care Act it was perfectly legal for insurance companies to charge women more than their male counterparts, everything else being equal. Quite a bit more. For example, a 22-year-old woman could be charged 150% higher premiums than a 22-year-old male.

Why? Because, in insurance terms, women are more of an “actuarial risk” than men. Meaning they use the benefits they’re given: they go to the doctor more, they get more checkups and—obviously—they tend to get pregnant more. The consequence of being more responsible and getting care early is that women also live longer. For these reasons, insurance companies charge women more for care simply because of their gender.

This discrimination ends Jan. 1, 2014.

Furthermore, the Affordable Care Act requires insurance companies to provide a series of benefits with no out-of-pocket costs, period. Preventive care such as mammograms, colonoscopies, well-women exams and depression screenings must be covered, no co-pays or deductibles allowed. Contraceptives must also be covered without out-of-pocket costs, and that includes all methods, not just the pill.

Insurance companies can no longer treat pregnancy as a “pre-existing condition,” nor can insurance companies exclude maternity care. All plans must offer this coverage as an “essential health benefit.”

This freedom from discrimination is very important. Before the Affordable Care Act, small businesses and nonprofits could be charged more based on the health and gender of their employees. How many employers, because of the bottom line, were tempted to choose the male candidate over the female one for just that reason?

—Kevin Kane, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act during its implementation. Got a question? Email editor@shepex.com.

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Understanding Obamacare: The Freedom to Start Your Own Business

This article was originally featured in the Oct 16, 2013 edition of the Shepherd Express in Milwaukee

Question: How does Obamacare give me more freedom to control my life?

Answer: The new options provided by the Affordable Care Act will help Americans find reasonably priced insurance on their own, without having to rely on their employer’s plan. This will help many would-be entrepreneurs, freelancers and potential small business owners take the leap into self-employment.

For many Americans, the majority of their weekday is spent at work. And we all know people—perhaps even yourself—who stay at jobs they don’t like because they need the health care. Unfortunately, the American health care system links coverage to employment, and leaving a safe job with good benefits and looking for individual coverage can be downright scary—and expensive. On average, employers contribute close to 80% of the cost of a single health insurance premium; without that contribution many would-be entrepreneurs are priced out. And when we remember that pre-existing conditions and other insurance discrimination existed up until Obamacare, it is no surprise that people feel “stuck.”

But many Americans do take that leap and leave their jobs and employer-sponsored coverage for new opportunities—taking time off, or writing a book or starting their own company. And now, thanks to Obamacare, many more can have the freedom to do so. Individuals can now access affordable coverage, with tax credits reducing the cost. The Robert Wood Johnson Foundation estimates that 34,000 Wisconsinites will be able to be self-employed because of Obamacare.

You can now take that time off or start a new business without fear of losing your health insurance coverage. Allowing people stuck in bad jobs the freedom to become their own boss—thanks, Obamacare.

—Kevin Kane, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act during its implementation. Got a question? Email editor@shepex.com.

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Understanding Obamacare: How To Sign Up

This article was originally featured in the Oct 1, 2013 edition of the Shepherd Express in Milwaukee

Question: When can I access Obamacare and where do I go?

Answer: Open enrollment is here! Oct. 1 marked the start of open enrollment for health coverage to start Jan. 1, 2014. You can now go to the new health marketplace to see the new options for purchasing health coverage.

If you have access to a computer, the easiest place to go is the website for the health marketplace in Wisconsin, healthcare.gov. The healthcare.gov marketplace will show you all the plans in your area with a clear apples-to-apples comparison between plans, and will inform you if you qualify for a tax subsidy to reduce the cost or if you’re eligible for BadgerCare.

There are many other options for comparing plans and enrolling in coverage for those who prefer methods other than the website. A 24/7 number is available to hear your options and enroll over the phone, 1-800-318-2596. Across Wisconsin, a number of organizations will have navigators and certified application counselors available to show you your options and help you enroll. Many of these organizations are in your community, but regardless of location, these organizations will serve any Wisconsin resident who calls. Public libraries and many community institutions like hospitals, community health centers and some free clinics will be a resource for you on the ground, directing you on how to get coverage or helping you access the website. And lastly, agents/brokers are still a great resource, and many are trained to enroll in this marketplace.

When you want to sign up, it is worth having these documents close by: Social Security numbers (or document numbers for legal immigrants); birth dates; pay stubs, W-2 forms, or “Wage and Tax Statements”; policy numbers for any current health insurance; and information about any health insurance you or your family could get from your employer.

In no time at all, you can be enrolled in a new health plan that will be there when you need it. Soon, we will live in an America where everyone has the freedom to control their own health decisions, including the kind of coverage they can access.

—Kevin Kane, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act during its implementation. Got a question? Email editor@shepex.com.

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Understanding Obamacare: Insurance Companies Must Cut Overhead Costs and Profits

This article was originally featured in the Sept 23, 2013 edition of the Shepherd Express in Milwaukee

Question: How does Obamacare require more accountability from insurance companies?

Answer: One of the major ways that Obamacare (the Affordable Care Act) requires more accountability from insurance companies is a provision known as the 80/20 rule, which went into effect right after the Affordable Care Act became law. So right now all insurance companies must spend 80-85% of premium dollars on actual health care costs. Not administrative costs or paperwork, not fancy offices, not profits, not CEO compensation, not insurer agent commissions—actual health care. And if an insurance company fails to do so, it must send a rebate back to the consumers it overcharged, either in the form of a check or lower premiums.

In Wisconsin, these rebates have been substantial. In the first year that the 80/20 rule was in effect, insurance companies sent more than $10.4 million in rebates back to Wisconsin consumers they overcharged. The most recent year saw insurers returning more than $3.5 million to consumers. Why the difference? Because we are seeing insurance companies changing their business practices and using our premium dollars more effectively.

The insurance system desperately needed this jolt. As more and more of our premium dollars were swallowed into administrative costs of companies and not into our treatments, costs were skyrocketing with little benefit to the consumer. Before the Affordable Care Act, the combination of overhead, greed and waste meant that 20 to 30 cents of every premium dollar went just to administrative costs.

But no longer, thanks to Obamacare. Insurance companies can’t suddenly raise your rates to excess without looking at the actual cost of health care, unless they come back to you with rebate check in hand.

This is just one of the benefits that you have now thanks to Obamacare, and even more security and control in the new health marketplace, healthcare.gov, after Oct. 1.

—Kevin Kane, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act in weeks leading up to its implementation. Got a question? Email editor@shepex.com.

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Understanding Obamacare The End of Discrimination

This article was originally featured in the Sept 3, 2013 edition of the Shepherd Express in Milwaukee
Question: What will Obamacare do for someone who hasn’t had health insurance because of a pre-existing condition?

Answer: The Affordable Care Act, commonly referred to as Obamacare, brings a number of major protections to consumers and corrections to an imbalanced insurance market. But one of the most important protections is the end of pre-existing-condition discrimination for individuals. Commonly, before reform, insurance companies could charge you more, deny you, drop you or exclude whole body parts based on whether or not any conditions you had were “pre-existing.” "Pre-existing condition" is the term insurance companies use to describe people with, or a history of, cancer, diabetes, arthritis, high blood pressure, high cholesterol and many other health conditions. Nor is this a rare occurrence: more than 1.3 million Wisconsinites under the age of 65 (about one out of four of us) have already been diagnosed with pre-existing conditions that, without health reform, could lead to denials of coverage or discriminatory rates. And as we age it only gets worse. Just over half of the population between the ages of 55 and 64 have a diagnosed “pre-existing condition.” Being sick or injured should never be a permanent barrier to getting health care, yet the markets allowed this inequity.

Starting Jan. 1, 2014, insurance companies cannot discriminate against adults with pre-existing conditions, and right now they are forbidden to do so by law for children under 18. All thanks to the Affordable Care Act.

And if you don’t think this pertains to you, consider this: many insurance companies consider pregnancy a pre-existing condition—a pre-existing condition that, safe to say, runs in most families.

—Kevin Kane, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act in weeks leading up to its implementation. Got a question? Email editor@shepex.com.

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