Wisconsin Could Create a Totally New Health Care Model

(This article first appeared in the Shepherd Express on Oct 27th, 2015)

Beyond Obamacare

Problem: Obamacare didn’t go far enough.

Solution: Wisconsin should propose a visionary health care 2.0 plan of its own next year.

Many people accept the Affordable Care Act (ACA)—or Obamacare—as the best deal that could have been struck in Congress even though it didn’t create a totally new model for delivering cost-efficient health care to more Americans. Some had hoped that national health care reform could have gone even farther, perhaps with a single-payer, Medicare-for-all model. Others argue that health care reform should foster more competition among private insurance companies. Both of these camps seem to be arguing that we need a totally new health care model instead of grafting new options onto the old, expensive system that the Affordable Care Act seems to preserve but reform so that it serves us better.

The good news is that we don’t have to wait for Congress to reform the ACA. Wisconsin could reform the state’s health care system by itself.

Tucked away in the Affordable Care Act is a hidden gem known as the “innovation waiver,” and it’s a big deal. The innovation waiver says that by 2017 a state can make any change to any health care program it wants—that includes not only the ACA, but also Medicare, COBRA insurance and other programs—as long as it covers more people and costs less.

That means that Wisconsin could propose and implement a single-payer system or a more competitive private insurance model that shrinks costs or perhaps allow BadgerCare to become a public option that anyone could buy into as long as the new model is less expensive and covers more people than the ACA. We absolutely can ensure that we have a health care system where you can qualify for affordable quality insurance that is there whenever you need it. Without excessive out-of-pocket cost surprises. Without drug companies bleeding us dry.

That said, the proposal will need to be crafted by 2017. Unfortunately, Gov. Scott Walker and current legislative and administrative leaders don’t seem to be interested in fixing the ACA so that it truly serves more people the most efficiently. But other states might try to do so, which would leave Wisconsin’s health care system even further behind. Examples include California, which is considering allowing undocumented immigrants to purchase coverage; Minnesota, which is looking into better insurance coverage without individual or employer responsibility mandates; and Rhode Island, which is looking into partnering with other states to negotiate with big insurance companies for even better deals.

The innovation waiver is good news for health care advocates who sincerely want to improve our health care system. Now that the Affordable Care Act is clearly here to stay we can propose visionary solutions to fix this health care system. If you think we need to go further, the opportunity is in front of us.

Kevin Kane is the lead organizer at Citizen Action of Wisconsin and is one of the state’s noted experts on health care reform. The Shepherd ran his series Understanding Obamacare when the ACA was being implemented. The Shepherd and Citizen Action of Wisconsin will answer your questions about Obamacare during the next few weeks. Email your questions to editor@shepex.com.

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