healthcare - gloves

When Anthem Blue Cross and Blue Shield announced it would cancel about 14,000 of its individual insurance plans in Wisconsin next year, Republicans pinned the blame on the Affordable Care Act.

But the Republicans are the real culprits. Anthem’s decision is the direct result of GOP efforts in Wisconsin and in Congress to sabotage the ACA rather than fix it.

Anthem said it was leaving because the “Wisconsin individual market remains volatile” and future planning was impossible due to “continual changes and uncertainty in federal operations, rules and guidance, including cost-sharing reduction subsidies.”

What it left unsaid was the source of that volatility and continual uncertainty on the federal level: Donald Trump and congressional Republicans.

And Wisconsin’s volatility? Look no farther than Gov. Scott Walker. As the ACA became law, Walker joined with other right-wing GOP governors in turning down federal funds for Medicaid expansion even as he and the state’s GOP legislature used the ACA to expand the state’s Medicaid program.

Expanding Medicaid while turning down federal support for it is such a bad idea that Wisconsin is the only state that did it. The strategy is projected to cost state taxpayers almost $680 million through the end of this fiscal year.

Anthem obviously recognized the unsustainability of that approach.

Walker and his GOP acolytes have cast doubt on Wisconsin’s insurance market in other ways. For instance, Walker proposed moving state employees to a self-insurance model. With such a change, the state would pay premiums directly to 17 HMOs instead of to insurance companies. Even though the Legislature’s Joint Finance Committee nixed the plan, it raised a giant red flag about the state’s future viability for insurance marketers.

Meanwhile, the U.S. House and Senate have written draconian health care plans that insurance companies oppose. Even Donald Trump branded the House plan as “mean.” Under it, wealthy Americans get ginormous tax breaks while middle and lower-class Americans get shafted by the law’s elimination of insurance subsidies for working families. According to an analysis by Citizen Action of Wisconsin, the Senate Republican bill would eliminate tax credits for more than 100,000 Wisconsinites.

Insurance marketers, who oppose both the House and Senate plans, have said the elimination of ACA subsidies is the “single most destabilizing factor in the individual market.”

The House plan also would allow states to opt out of rules requiring coverage for pre-existing conditions, even though most GOP talking heads refuse to acknowledge that fact. Walker, however, brazenly announced May 5 that he’d consider a waiver allowing insurance companies in Wisconsin to hike premiums on people with pre-existing conditions.

The outcry was swift, and he walked back his announcement later that day — too late to cover up what he’s obviously really thinking.

More uncertainty

People with chronic conditions who can’t afford health insurance wind up turning to emergency rooms for care, which raises the cost of health care for everyone. That’s especially unwelcome news for Wisconsin, which already has the second highest health care costs in the nation, behind only Alaska.

U.S. Rep. Mark Pocan, D-Madison, put plainly what Anthem only hinted at: “You can trace Anthem’s decision to the instability President Trump and Republicans in Congress have injected into the health care marketplace.”

Voters will know exactly who’s responsible when they either lose their insurance or find their premiums and out-of-pocket health-care costs skyrocket to prohibitive levels.

Republicans just don’t seem to understand that — or care.


(1) comment


Actually, Walker's self insurance plan would eliminate premiums to the 17 HMOs and pay admin fees to six third-party administrators (TPAs). This would eliminate the competitive marketplace and put the risk on the state for all claims.

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