BadgerCare Public Option

THE PROBLEM: Health Care is Unaffordable

For too many Wisconsinites, high quality, affordable health coverage is simply out of reach. Even having health insurance does not make health care affordable. 52% of Wisconsinites have delayed or skipped medical care due to cost over the past year, and most of them were insured.

Too many of us do not use our insurance because of a well-founded fear of unaffordable deductibles, co-pays, medications, and surprise medical bills. Many of us are uninsured because we do not get insurance from work, cannot afford the monthly insurance premiums, and don’t qualify for BadgerCare.

THE CAUSE: The Health Care Industry Has Rigged the System Against Us

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.

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. 

According to a recent Rand Report, Wisconsin has the highest hospital prices in the Midwest and the 5th highest in the nation. The report found hospital consolidation/mergers and lack of price transparency are the primary causes.

THE SOLUTION: Shifting Control of Health Care to the People Step by Step

Our Long Term Vision: 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.  Citizen Action of Wisconsin is fighting to shift power away from wealthy insurance corporations and into the hands of the people. We need to build the power to enact Medicare for All to replace corporate health insurance, and break up the big hospital and drug corporations monopolies.

We do not yet have the power to achieve this vision all at once, but only in steps as we build real grassroots power strong enough to begin to break the stranglehold of the Medical Industrial Complex over our elected officials. 

The Immediate First Step: The first major step to system transformation that can be achieved in the next couple of years is a robust public option bill which reduces the role of the health care industry in setting the price and the terms of health coverage and massively expands access to Wisconsin’s BadgerCare program.

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, which has been introduced every Legislative session since 2018 and achieved a record 43 co-sponsors in 2024. 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. 
• Be available on the small group marketplace so that small businesses and nonprofits (with 50 employees or less) could for the first time afford to offer high quality employer-sponsored coverage for their employees at an affordable rate. Only one-third of small businesses can currently afford health coverage, leaving their employees on their own.
• 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. 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.
• 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.

 

See here for guidance on Good Messaging and Storytelling in Health Care. For Citizen Action’s Strategy and Theory of Change see Explainers on Radical Pragmatism and Agenda Setting.

To join our healthcare organizing, contact: Kristie.Tweed@citizenactionwi.org