Bill Kaplan: Affordable Care Act premiums down

Bill Kaplan: Affordable Care Act premiums down

Photo by: Douglas Fron

As the 2020 enrollment period nears, Affordable Care Act (ACA) private health insurance premiums are down for the second year in a row. The average price for the second lowest cost silver plan (most commonly used) will drop 4 percent for 2020. Moreover, 20 more health insurers will sell ACA insurance on the federal exchange. Most Americans will have at least 3 insurers to choose. The news is also good in Wisconsin.

The 2020 rate for ACA private health insurance will be 3.2 percent lower in Wisconsin. And, the number of Wisconsin ACA insurers will increase from 12 to 13. “Sixty-one of Wisconsin’s 72 counties will have 3 or more insurance carriers” (Wisconsin Public Radio). Donna Friedsam, UW-Madison Institute for Research on Poverty, said: “The marketplace has stabilized quite substantially in the last couple of years.” 193,303 Wisconsinites are enrolled in an ACA health insurance plan (89 percent receive federal tax credits to lower premiums).

That’s down from 2018. Why? The Trump administration has done everything it can to sabotage the ACA: cutting the open enrollment period by half; slashing advertising and enrollment assistance; ending federal cost-sharing payments (now paid by insurers); and allowing the sale of worthless “junk insurance”. Trump is also trying to have the ACA declared unconstitutional through a federal lawsuit orchestrated by former GOP Governor Scott Walker. A decision is imminent.

However, Democratic Governor Tony Evers is fighting back. He withdrew Wisconsin from Walker’s lawsuit. And, Evers has awarded $500,000 to Covering Wisconsin to help eligible Wisconsinites sign up for ACA private insurance and the state Medicaid program (BadgerCare). He also supports the Medicaid expansion bill introduced by state Senator Jon Erpenbach (D) and state Representative Daniel Riemer (D). “(E)xpanding Medicaid in Wisconsin would substantially lower private health insurance premiums for insurance coverage offered through the (ACA) exchange …” (Health Affairs). Low-income individuals with acute costly health conditions and enrolled in ACA private insurance could move to BadgerCare, thereby improving the risk pool for ACA private insurance, further decreasing premiums.

53 percent of Americans “now view the ACA favorably”, and many want to “build” on the ACA (Kaiser Family Foundation). The American Medical Association (AMA) said: “The ACA is not broken, but it is imperfect. Improving the ACA appropriately targets providing coverage to the uninsured population, rather than upending the (private) health insurance coverage of most Americans.” The AMA supports: covering more Americans by “expanding eligibility for (ACA) premium tax credits beyond 400 percent of the federal poverty level”; making those tax credits more generous; and covering more with help for out-of-pocket costs.

The AMA is willing to help expand Medicaid by working “with state and specialty medical societies in advocating at the state level to expand Medicaid eligibility to … 138 percent of the federal poverty level … .” In addition, the AMA supports extending 100 percent federal funding (3 years) to states like Wisconsin that finally expand Medicaid. Doctors are leading.

The ACA works well; millions are covered. Premiums are down nationally and in Wisconsin.

–Kaplan wrote a guest column from Washington, D.C. for the Wisconsin State Journal from 1995 – 2009.

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