INSIGHT ON: Health Insurance – Racing to sign up

Posted on Apr 1, 2014 :: Health Insurance , Insight On
Posted by , Insight on Business Staff Writer


Although Wisconsin residents are slow to sign up for health insurance under the Affordable Care Act, there’s been a strong grassroots campaign across the state to help consumers find the plan that’s right for them.

By the end of February, 71,400 state residents signed up for coverage under the ACA, according to federal data. That is far below the 277,000 expected by the government to sign up for health care on the exchange before the March 31 deadline.

Enrollment numbers also point to a higher percentage of older people signing up for insurance, which could lead to increased costs for those on the exchange. The Kaiser Family Foundation estimates that unless 40 percent of total enrollees are between ages 18 and 34, premiums could increase for everyone since program costs will outpace premium revenue. At the end of February, 21 percent of enrollees in Wisconsin were in the 18- to 34-age range, compared with 25 percent nationwide.

Uninsured residents had until March 31 to sign up for a plan. After that, they face a penalty, which will come on their 2014 tax return. The fine will be $95 per adult and $47.50 per child or 1 percent of your household income, whichever is greater. In 2015, that will increase to $325 per adult or 2 percent of income.

Claire Smith, a communications specialist with the Wisconsin Department of Health Services, says that while the ACA is a federal program – Wisconsin opted not to create its own exchange – the state has still been active recruiting people to sign up to get coverage.

“We made it very local and grassroots,” she says. “We figured the people in Florence County know best how to reach people in their community and share information about the different programs and encourage them to get coverage. The key is to connect people with care.”

Across Wisconsin, the state created 13 regional enrollment networks to help people sign up for health insurance.

Many Wisconsin low-income residents were confused about whether they would be eligible for BadgerCare Plus or need to opt for a plan on the exchange. It’s estimated that Gov. Scott Walker’s expansion of BadgerCare Plus to all adults below the poverty line – not just those with children – added 80,000 adults to the program while a similar amount were transitioned to the exchange because they had incomes above the poverty line.

“It can be confusing, but if someone comes in the wrong door – say, for example, they apply for BadgerCare Plus, but really should be on an exchange plan – we help them get to where they need to be,” Smith says.

Patricia Sarvela, development director for the Partnership Community Health Center in Appleton, says some people prefer to pay the penalty rather than purchase a plan. “There is a gap where people don’t have enough to pay the premiums,” she says. “Some people tell me they need to choose between buying food and paying their premium.”

Partnership got behind efforts to encourage people to sign up for the ACA early and helps residents in Calumet, Outagamie and Waupaca counties to find the program that’s right for them. The group set up shop at 500 W. Franklin St. in Appleton where people could come in and work with someone to sign up for coverage. Sarvela says navigators help people pick out plans and determine if they can receive any subsidies.

“We link the coverage to care and tell them how important it is to get regular preventative care since that can help avoid more costly problems later,” she says. “We did a lot of outreach last fall, holding events at libraries or wherever people wanted us to come and talk about the ACA and what it meant.”

Partnership’s outreach hasn’t just been about encouraging people to sign up for insurance coverage, but also educating them about different terms, such as deductibles and premiums.

“For many people, this is the first time they’ve had insurance or dealt with what a deductible or premium is, so there’s a lot of education going on,” Sarvela says.

Smith says it will be at least mid-April until the state has a better idea of who signed up for insurance through the exchange or signed up for BadgerCare Plus.

“It’s a fluid situation right now and there’s a lot of data still coming in,” she says.

Oshkosh survey shows cost concerns

The Oshkosh Chamber of Commerce asked business leaders about the cost of providing health insurance to its employees. Here’s what they thought about costs in 2014:

» 65 percent expect costs to rise

» 8.8 percent expect no change

» 23.8 percent report not offering insurance to employees

To combat rising costs, company executives say they are considering a combination of ways to hold costs down. These include changing the plan design, increasing deductibles, providing Health Savings Accounts, and/or increasing employee contributions. About 12 percent of respondents said they anticipate discontinuing an employee health insurance plan.