10th Annual Health Cost Report


Citizen Action of Wisconsin
is releasing the 10th annual Wisconsin Health Insurance Cost Ranking report Monday morning on a statewide media call.

In addition to providing new numbers and cost rankings for 2016, this year’s report includes data on the historic rates of health insurance inflation for each city. This year’s report also provides data on the quality of health insurance plans offered in each city and region.

For the first time, this year’s report will provide composite health insurance cost rankings that include premiums and deductibles for all major types of insurance by Wisconsin metro area.

The report finds a large disparity in health insurance costs and inflation between cities and regions of Wisconsin.

Download the full report

Key Findings in 2016 Report

  • Wisconsin Health Care Hyperinflation is a Long Term Trend. Wisconsin large group health insurance costs (premiums and deductibles) have more than tripled since the year 2000, increasing 216% statewide, with regional rates of inflation varying between a low of 170% in Madison to highs of 365% in Green Bay, 254% in Oshkosh, 247% in Appleton, and 226% in Milwaukee, for benefits packages that is less generous (See Chart 5, p. 7).

  • Southeastern and Central Wisconsin are Highest Cost Areas, Madison is Lower Cost. According to a new composite measure which combines all types of health insurance, Milwaukee, Racine, Wausau, have the highest costs in Wisconsin while Madison has the lowest (See Chart 1, p. 5).

  • Regional Cost Disparities Persist. There continue to be wide cost variations between higher and lower cost areas of the state. The cost variation is even higher in our composite index for all types of health insurance than they are in the large group market. There is a 30% cost variation between the highest cost metro area (Milwaukee) and the lowest cost metro area (Madison), which amounts to a $2,221.48 difference for a single policy each year (see Chart 8, p. 8; Chart 1, p. 5; and Chart 9, p. 9).

  • Regional Cost Disparities Are Greatest on the Individual Market. Although there are large regional cost variations for all types of insurance, the biggest disparities are in the individual market. The highest cost areas (Wausau, Stevens Point, Wisconsin Rapids, and Marshfield) are an astounding 69% higher than the lowest cost areas (Madison, Appleton, and Janesville/Beloit). This amounts to a gap of $4,470 per year for individual coverage (Chart 4, p. 6).

  • Disparities within Regions Suggest Underlying Medical Costs are Not the Only Driver of Insurance Costs. Insurers often claim that their prices merely reflect medical costs. However, there are major variations in relative cost within regions for different types of insurance. This suggest that the numbers measure not only underling medical costs but also distortions in the insurance market. For example, the FoxValley has above average insurance rates in large group insurance and well below average rates in the individual and small group markets. Wausau has very high costs for large group and individual market insurance, but relatively low costs in small group. Madison is not nearly as low in the small group market as it is for the other types of insurance. Eau Claire is high in all employer-based insurance, but below average on the individual market (Charts 2, 3, & 4, pp.5-6).

  • Individual Market Costs Increased Substantially Statewide. There was a 28% increase statewide in premiums and deductibles combined from 2015-2016 (Chart 7, p. 8).

  • Striking Price Volatility on the Individual Market in a Major Policy Concern. Some metro areas had very large increases in cost from 2015 to 2016 while others actually saw reductions. Individual market prices increased by over 69% in Racine, and 60% in Milwaukee, while declining by over 8% in Madison and Janesville/Beloit (Chart 7, p. 8). This 79% percent spread in inflation rates between Wisconsin cities is a warning sign that insurance rate setting practices may require greater scrutiny.

  • Price Volatility is also a Concern on the Small Group Market. Although not as severe as the individual market, there were significant disparities in the rate of inflation between Wisconsin metro areas for small employers. While Green Bay and the FoxValley saw greater than 10% increases, Stevens Point, Wisconsin Rapids, and Marshfield saw cost reductions of over 12% (Chart 6, p. 7).

  • Cost and Quality are not Correlated. As in past reports, the 2016 report finds that there is no clear correlation between quality and health insurance costs, with some of the low cost areas of the state having higher quality insurance plans and some higher costs areas having lower quality plans.

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