Last week Wisconsin Health Services Secretary Dennis Smith and Insurance Commissioner Ted Nickel released a report at a closed "by-invitation only" media briefing purporting to show that the new national health care reform law would have a negative impact on Wisconsin's health insurance market. I attempted to attend the briefing but was forced to leave by Walker Administration officials.



The report release also did not involve the primary author of the report, nationally renowned health care economist Dr. Jonathan Gruber of MIT, whose firm received a $400,000 federally funded contract from the Doyle Administration to do the research.

 

In addition to the secretive way in which the publicly funded research was released, Secretary Smith and Commissioner Nickel attempted to bury many of the most important findings in the report in order to create a negative impression of the new health care reform law, the Affordable Care Act (ACA). Arguably the most important finding in Dr. Gruber's report is that the ACA will result in 340,000 uninsured Wisconsinites gaining coverage.



However, this information is not even mentioned in the Walker Administration's press release about the report, and is only discussed in the last slide (page 16) of the PowerPoint presentation given at the closed media briefing.

 

Secretary Smith and Commissioner Nickel also gave a slanted account of the impact of health care reform on Wisconsin individual and small group health insurance markets, focusing entirely on premium increases that will impact some participants. They did not highlight report findings that showed Wisconsinites who buy insurance on their own will receive $729 million in federal subsidies to make health insurance more affordable and that 41 percent will receive significant premium reductions averaging 56 percent. They also did not highlight the finding that 47 percent of Wisconsin small employers will see premium reductions averaging 16 percent, or that most small employers who provide health coverage to their employees will continue to do so after reform is implemented.

 

Instead, Secretary Smith and Commissioner Nickel focused attention on those who would pay more because health care reform forces the insurance industry to end discrimination based on preexisting conditions, age, and gender, and requires higher quality coverage. In the current health insurance market, individuals and small groups which are younger and healthier get a lower rate because the insurance industry can discriminate against others and sometimes because it provides substandard coverage with exclusionary riders. Ending this discrimination will cause some individuals to pay higher premiums in the short term, but in return they will get a guarantee of higher quality coverage which the insurance industry can never take away from them as they age and acquire medical conditions.

 

Perhaps the most significant point covered over by the Walker's Administration's spin on the report is that comparing the insurance people or small employers can buy on their own today to what will be available under the Affordable Care Act is not an apples to apples comparison. If someone is fortunate enough to be young and healthy today, they might get a good deal from the health insurance industry, but they can lose coverage or be priced out as they age or if they acquire medical conditions. If a small employer has affordable coverage today, one employee acquiring a serious medical condition can price the whole group out of the market. That is why only 37 percent of small employers in Wisconsin provide health insurance coverage today, down from nearly 60 percent a decade ago.

 

Once national health care reform is fully implemented, consumers will have access to coverage in a new marketplace where the insurance industry cannot take it away or charge discriminatory rates as a person ages or their health status changes. Even if a consumer who buys insurance on their own or a small employer has to pay more for this coverage in the short term, they are getting in return a real guarantee of quality affordable coverage in return. The only real "losers" in ending health insurance discrimination are the health insurance companies who profit by offering affordable coverage only healthier and younger people (and younger and healthier small groups) who are less likely to file medical claims.

 

The way the Walker Administration handled the release of this crucial report raises questions about how they will seek to implement the Affordable Care Act in Wisconsin. Under the new law, the states play a crucial role in implementation. Health care advocates will be watching closely this fall when the Walker Administration reveals its implementation plans. The Legislature is expected to take action on Wisconsin national health care reform implementation plans this fall.

 

Robert Kraig is executive director of Citizen Action of Wisconsin.