Health & Science
1:48 pm
Thu August 22, 2013

Group Tracks Reach of Health Care Exchange in Wisconsin

Everyone in Wisconsin will have at least two choices of health insurance providers in the new federal marketplace, according to Citizen Action of Wisconsin.

People can begin enrolling in the marketplace or exchange in October. Premiums will be due in mid-December for coverage that starts January 1.

Fourteen providers will begin competing for Wisconsin subscribers, in October

Fourteen insurance companies notified the state that they intend to sell plans on the exchange - it's where people will be able to shop for health care coverage under the Affordable Care Act.

The group Citizen Action surveyed the coverage areas of the 14 providers. It reports that at least two cover all of Wisconsin, at least three cover 99% of the state and four cover at least 68% of Wisconsin.

The survey indicates that if Humana and United Healthcare join the exchange in 2015 as they have said, 94% of state residents will have four or more insurers competing for subscribers.

This week, state leaders kicked-off  public meetings across Wisconsin, to inform people of the big health care changes approaching. On January first, the state will enact new eligibility rules for Medicaid and the federal marketplace will begin operating.

The state intends to mail a letter in September to adults Wisconsin will welcome to Medicaid and those it will drop. The cut-off will be the federal poverty line - an income of about $11,000 peer adult. The state will direct those it drops, to the new federal marketplace.

Joy Tapper, head of the Milwaukee Health Care Partnership says the experience of enrolling in private insurance will be new for some people, including those with disabilities. In addition, some have not had to pay premiums in the past or co-pays, or choose among levels of coverage. The providers in the exchange will offer four 'medal' levels: bronze, silver, gold and platinum - each offering different levels of coverage and cost.

Tapper estimates it taking an hour to enroll each person in the exchange. She says her agency is working to assemble a huge network of people to assist. Enrollees will also need to bring their latest tax return, in order to determine what federal aid they qualify for, to help pay the plan's cost.

In the Greater Milwaukee area, she says 84,000 people will become eligible for Medicaid, 92,000 will be cut, and up to 125,000 residents without insurance will gain access through the exchange.