THE ISSUE

Our country’s health care system is driven by profit, prioritizing the interests of the Medical Industrial Complex (insurance conglomerates, Big Pharma, and hospital monopolies) over the health and well being of the American people. For too many Wisconsinites, high quality, affordable health coverage is simply out of reach. A Fall 2022 survey of over 1000 Wisconsin health care consumers by one of Citizen Action’s research partners found that 52% had delayed or skipped medical care due to cost, and most of them were insured.

Too many of us are uninsured because we cannot afford the monthly costs, or do not use our insurance because of a well-founded fear of unaffordable deductibles, co-pays, medications, and surprise medical bills. Moreover, greedy insurance corporations, pharmaceutical companies and hospital monopolies continually inflate prices, squeezing pocketbooks and contributing to skyrocketing medical debt. Every year, premiums and co-pays increase, deductibles, and coverage exclusions grow larger. These unaffordable costs are a hidden, insidious way of denying care. 

Citizen Action believes that health care is a human right and that constantly rising health care costs that prevent people from getting the care they need is a violation of that right.

THE SOLUTION

Citizen Action of Wisconsin is fighting to shift power away from wealthy insurance corporations and into the hands of the people. We believe that health coverage should be:

• In public hands
• Driven by our health, not profits
• Universal, affordable, simple to use, and readily available
• Inclusive and comprehensive (including medicines, medical equipment, vision/dental/hearing care, reproductive care, mental health care, harm reduction and 
• treatment for substance misuse, preventive care, long-term care, and home and community based care
• Equitable across race, gender, ability, and region

This vision cannot be achieved all at once, but only in steps as we build real grassroots power strong enough to break the stranglehold of the Medical Industrial Complex. Read more about Citizen Action’s theory of change here. Although we do not yet have the power to enact Medicare for All, a major step to system transformation can be robust public option bills which reduce the role of the health care industry in setting the price and the terms of health coverage.

Public health coverage plans, like BadgerCare, keep health care costs down because they do not have to pay for windfall insurance industry profits, and costly overhead for claims denial, and most importantly because we the people through our government set a fair price, not insurance companies, hospital conglomerates, and Big Pharma.

Wisconsin can move toward this vision of universal, affordable, equitable, and high quality health coverage through passing the BadgerCare Public Option Bill.  Authored by Citizen Action Member and ally Rep Kristina Shelton (D-Green Bay), the bill was first introduced into the legislature in 2021 and reintroduced October 31, 2023. This is the only bill introduced in many years that comprehensively takes on the issue of rising and unaffordable health care costs.

The BadgerCare Public Option Bill would: 

• Create a less expensive, high quality BadgerCare Public Option health care plan that would be available for purchase on the Affordable Care Act marketplace by all Wisconsinites, regardless of income level, with sliding scale premium subsidies based on income. The plan would be administered through BadgerCare and include very low cost-sharing provisions, including lower premiums than private insurance plans and very small copays. The Public Option plan would also be available on the small group marketplace so that small businesses and nonprofits could for the first time afford to offer high quality employer-sponsored coverage for their employees at an affordable rate.
• Create a Basic Health Plan (as allowed by the Affordable Care Act and established in neighboring Minnesota) that would be available to Wisconsinites earning between 133% and 200% of the Federal Poverty Line and is separate from the Public Option. Health experts believe people at these income levels do not have the economic means to cope with the cost of private insurance. The Basic Health Plan would dramatically increase the number of lower-income people eligible for public health coverage, giving them an opportunity to enroll in public coverage that is even more affordable than the BadgerCare Public Option. The Basic Health Plan would also be available to lawfully-present immigrants with incomes below 133% of the Federal Poverty Line but who are ineligible for Medicaid because of their immigrant status.
• Create a state-based health insurance ACA online marketplace instead of forcing Wisconsinites to enroll in health coverage through the federal ACA marketplace (healthcare.gov). The state-based exchange will allow Wisconsin control over promoting open enrollment periods, to set our own budget and create our own plans for getting as many people to enroll in coverage as possible, and provide more support for people through the enrollment process.

Please support health coverage for all in Wisconsin by asking your representatives to support Representative Kristina Shelton’s BadgerCare Public Option Bill in the 2023-24 Legislative Session.