HOW HEALTH INSURANCE REFORM WILL BENEFIT WISCONSIN
Topics on this page:
The New Numbers:
Health Insurance Reform Cannot Wait in Wisconsin
Last week, the U.S. Census released its new numbers for
the uninsured. The results are sobering and confirm that
health insurance reform cannot wait another year.
Nationwide, the number of uninsured increased from 39.8
million in 2001 to 46.3 million in 2008. The facts below
underscore the urgency of health insurance reform for
residents of Wisconsin.
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The status quo is not an option. The number of
uninsured in Wisconsin has increased from 390,000 in
2001 to 535,000 in 2008. The percent of non-elderly
adults without insurance increased from 9.9% to 13%. And
this number only considers people who are uninsured for
an entire year – it does not include people in
Wisconsin who have more recently lost coverage through
the recession, or who had shorter gaps in their
coverage.
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Private coverage is eroding under the status quo.
The percentage of people with employer-based coverage
decreased from 81.7% of the population in 2001 to 74.3%
in 2008.
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More workers are being left without protection from
health care costs. Too many workers in Wisconsin
do not have health coverage, at 361,000 in 2008. And the
proportion of workers from Wisconsin without insurance
has increased, from 9.1% in 2001 to 12.3% in 2008.
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The problem of the uninsured is a problem that
crosses income brackets. The new Census numbers
also drive home the fact that everyone in Wisconsin is
vulnerable to losing health insurance. An additional
30,000 people from high-income households are now uninsured.
LOWER COSTS FOR RESIDENTS OF WISCONSIN
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Ending the Hidden Tax – Saving You
Money: Right now, providers in Wisconsin lose
over $876 million in bad debt which often gets passed
along to families in the form of a hidden premium
“tax”.1 Health insurance reform
will tackle this financial burden by improving our
health care system and covering the uninsured, allowing
the 124 hospitals2 and the 17,311
physicians3 in Wisconsin to better care for
their patients.
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Health Insurance Premium Relief:
Premiums for residents of Wisconsin have risen 90% since
2000.4 Through health insurance reform,
459,400 to 522,000 middle class Wisconsin residents will
be eligible for premium credits to ease the burden of
these high costs.5
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Strengthening Small Businesses: 94,633
employers in Wisconsin are small businesses.6
With tax credits and a health insurance exchange where
they can shop for health plans, insurance coverage will
become more affordable for them.
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Reforms that Reduce Your Costs: Under
health insurance reform, insurance companies will be
prevented from placing annual or lifetime caps on the
coverage you receive. Insurance companies will
also have to abide by yearly limits on how much they can
charge for out-of-pocket expenses, helping 29,100
households in Wisconsin struggling under the burden of
high health care expenses.7
INCREASE YOUR CHOICES: PROTECTING WHAT WORKS AND FIXING
WHAT'S BROKEN
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Insurance Stability and Security:
Health insurance reform will strengthen our system of
employer-based health insurance, with an additional
62,300 people in Wisconsin potentially getting insurance
through their work.8 Health insurance reform
will also ensure that you will always have guaranteed
choices of quality, affordable health insurance if you
lose your job, switch jobs, move or get sick.
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Eliminating Discrimination for Pre-Existing
Conditions, Health Status or Gender: 7% of
people in Wisconsin have diabetes9, and 26%
have high blood pressure10 – two
conditions that insurance companies could use as a
reason to deny you health insurance. Health insurance
reform will prevent insurance companies from denying
coverage based on your health, and it will end
discrimination that charges you more if you’re
sick or a woman.
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One-Stop Shopping – Putting Families in
Charge: With the new health insurance exchange,
you can easily and simply compare insurance prices and
health plans and decide which quality affordable option
is right for you and your family. These proposals
will help the 465,800 residents of Wisconsin who
currently do not have health insurance to obtain needed
coverage, and it will also help the 292,600 Wisconsin
residents who currently purchase insurance in the
individual insurance market.11
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Guaranteeing Choices: The largest
health insurer in Wisconsin holds 32% of the market,
which limits the choices that you have for finding
coverage.12 With a competitive public
insurance option, you will have more choices and
increased competition that holds insurance companies accountable.
ASSURE QUALITY, AFFORDABLE HEALTH CARE FOR AMERICANS
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Preventive Care for Better Health: 33%
of Wisconsin residents have not had a colorectal cancer
screening, and 21% of women have not had a mammogram in
the past 2 years.13 By requiring health plans
to cover preventive services for everyone, investing in
prevention and wellness, and promoting primary care,
health insurance reform will work to create a system
that prevents illness and disease instead of just
treating it when it’s too late and costs more.
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Improving Care for Children and
Seniors: 20% of children in Wisconsin have not
visited a dentist in the past year14, and 26%
of seniors did not receive a flu vaccine15.
Health reform will ensure coverage for kids’
dental, vision, and hearing needs, and will promote
quality coverage for America’s seniors, including
recommended immunizations.
1 Hospital uncompensated care cost is estimated
using a GAO model and the Hospital Cost Reports. Total
uncompensated care is computed as hospital uncompensated
care divided by 63% (Hadley and Holahan’s study on
“The Cost of Care for the Uninsured” for
Kaiser in 2004 found that hospitals account for 63% of
total uncompensated care). Data expressed in 2009 dollars
using Centers for Medicare and Medicaid Services,
“National Health Expenditure Data.”
2 2007 AHA Annual Survey Copyright 2009 by
Health Forum LLC, an affiliate of the American Hospital
Association, special data request, March 2009. Available
at http://www.ahaonlinestore.com.
3 American Medical Association, Physicians
Professional Data, year of data 2008, copyright 2008:
Special Data Request.
4 Center for Financing, Access and Cost Trends,
AHRQ, Medical Expenditure Panel Survey - Insurance
Component, 2000, Table II.D.1.
Center for
Financing, Access and Cost Trends, AHRQ, Medical
Expenditure Panel Survey - Insurance Component, 2006,
Table X.D. Projected 2009 premiums based on Centers for
Medicare and Medicaid Services, “National Health
Expenditure Data.”
5 U.S. Census Bureau, Current Population
Survey. Annual Social and Economic Supplements, March 2007
and 2008.
6 Center for Financing, Access and Cost Trends,
AHRQ, Medical Expenditure Panel Survey - Insurance
Component, 2006, Table II.A.1a.
7 Center for Financing, Access and Cost Trends,
Agency for Healthcare Research and Quality, Medical
Expenditure Panel Survey, 2006.
8 U.S. Census Bureau, Current Population
Survey. HIA-4 Health Insurance Coverage Status and Type of
Coverage by State--All Persons: 1999 to 2007, 2007.
Calculations based on Congressional Budget Office. Letter
to the Hon Charles Rangel on America’s Affordable
Health Choices Act, July 14, 2009.
9 Behavioral Risk Factor Surveillance System
Survey Data. Atlanta, Georgia: U.S. Department of Health
and Human Services, Centers for Disease Control and
Prevention, 2008.
10 Behavioral Risk Factor Surveillance System
Survey Data. Atlanta, Georgia: U.S. Department of Health
and Human Services, Centers for Disease Control and
Prevention, 2007.
11 U.S. Census Bureau, Current Population
Survey. Annual Social and Economic Supplements, March 2007
and 2008.
12 American Medical Association. (2008,2009).
"Competition in health insurance: A comprehensive
study of U.S. Markets: 2008 Update," American Medical Association.
13 Behavioral Risk Factor Surveillance System
Survey Data. Atlanta, Georgia: U.S. Department of Health
and Human Services, Centers for Disease Control and
Prevention, 2007.
14 Child and Adolescent Health Measurement
Initiative. 2007 National Survey of Children's Health,
Data Resource Center for Child and Adolescent Health.
15 Behavioral Risk Factor Surveillance System
Survey Data. Atlanta, Georgia: U.S. Department of Health
and Human Services, Centers for Disease Control and
Prevention, 2007.
Congress and the President are working to enact health
care reform legislation that protects what works about
health care and fixes what is broken. Wisconsinites know
that inaction is not an option. Sky-rocketing health
care costs are hurting families, forcing businesses to
cut or drop health benefits, and straining state
budgets. Millions are paying more for less. Families and
businesses in Wisconsin deserve better.
WISCONSINITES CAN’T AFFORD THE STATUS QUO
- Roughly 3.7 million people in Wisconsin get health
insurance on the job1, where family
premiums average $13,488, about the annual earning of
a full-time minimum wage job.2
- Since 2000 alone, average family premiums have
increased by 90 percent in Wisconsin.3
- Household budgets are strained by high costs: 17
percent of middle-income Wisconsin families spend more
than 10 percent of their income on health care.4
- High costs block access to care: 8 percent of people
in Wisconsin report not visiting a doctor due to high costs.5
- Wisconsin businesses and families shoulder a hidden
health tax of roughly $900 per year on premiums as a
direct result of subsidizing the costs of the uninsured.6
AFFORDABLE HEALTH COVERAGE IS INCREASINGLY OUT OF REACH
IN WISCONSIN
- 9 percent of people in Wisconsin are uninsured, and
67 percent of them are in families with at least one
full-time worker.7
- The percent of Wisconsinites with employer coverage
is declining: from 74 to 67 percent between 2000 and 2007.8
- Much of the decline is among workers in small
businesses. While small businesses make up 77 percent
of Wisconsin businesses,9 only 41 percent
of them offered health coverage benefits in 2006 --
down 7 percent since 2000.10
- Choice of health insurance is limited in Wisconsin.
Blue Cross Blue Shield WI alone constitutes a dominant
percent of the health insurance market share in Wisconsin.
- Choice is even more limited for people with
pre-existing conditions. In Wisconsin, premiums can
vary based on demographic factors and health status,
and coverage can exclude pre-existing conditions or
even be denied completely.
WISCONSINITES NEED HIGHER QUALITY, GREATER VALUE, AND
MORE PREVENTATIVE CARE
- The overall quality of care in Wisconsin is rated as “Strong.”11
- Preventative measures that could keep Wisconsinites
healthier and out of the hospital are deficient,
leading to problems across the age spectrum:
- 13 percent of children in Wisconsin are obese.12
- 21 percent of women over the age of 50 in
Wisconsin have not received a mammogram in the
past two years.
- 33 percent of men over the age of 50 in
Wisconsin have never had a colorectal cancer screening.
- 74 percent of adults over the age of 65 in
Wisconsin have received a flu vaccine in the past year.13
The need for reform in Wisconsin and across the
country is clear. Wisconsin families simply
can’t afford the status quo and deserve better.
President Obama is committed to working with Congress to
pass health reform this year that reduces costs for
families, businesses and government; protects
people’s choice of doctors, hospitals and health
plans; and assures affordable, quality health care for
all Americans.
1 U.S. Census Bureau, Current Population
Survey. HIA-4 Health Insurance Coverage Status and Type of
Coverage by State--All Persons: 1999 to 2007, 2007.
2 Center for Financing, Access and Cost Trends,
AHRQ, Medical Expenditure Panel Survey - Insurance
Component, 2006, Table X.D.
Projected 2009
premiums based on Centers for Medicare and Medicaid
Services, "National Health Expenditure Data,"
available at http://www.cms.hhs.gov/nationalhealthexpenddata/.
3 Center for Financing, Access and Cost Trends,
AHRQ, Medical Expenditure Panel Survey - Insurance
Component, 2000, Table II.D.1.
Center for
Financing, Access and Cost Trends, AHRQ, Medical
Expenditure Panel Survey - Insurance Component, 2006,
Table X.D.
Projected 2009 premiums based
on Centers for Medicare and Medicaid Services,
"National Health Expenditure Data," available at http://www.cms.hhs.gov/nationalhealthexpenddata/.
4 Center for Financing, Access and Cost Trends,
Agency for Healthcare Research and Quality, Medical
Expenditure Panel Survey, 2006.
5 Behavioral Risk Factor Surveillance System
Survey Data. Atlanta, Georgia: U.S. Department of Health
and Human Services, Centers for Disease Control and
Prevention, 2007.
6 Furnas, B., Harbage, P. (2009). "The
Cost Shift from the Uninsured." Center for American Progress.
7 U.S. Census Bureau, Current Population
Survey. Annual Social and Economic Supplements, March 2007
and 2008.
8 U.S. Census Bureau, Current Population
Survey. HIA-4 Health Insurance Coverage Status and Type of
Coverage by State--All Persons: 1999 to 2007, 2007.
9 Center for Financing, Access and Cost Trends,
AHRQ, Medical Expenditure Panel Survey - Insurance
Component, 2006, Table II.A.1a.
10 Center for Financing, Access and Cost
Trends, AHRQ, Medical Expenditure Panel Survey - Insurance
Component, 2001, 2006, Table II.A.2.
11Agency for Health Care Research and Quality.
2008 State Snapshots. Available http://statesnapshots.ahrq.gov/.
12 Child and Adolescent Health Measurement
Initiative. 2007 National Survey of Children's Health,
Data Resource Center for Child and Adolescent Health.
13 Behavioral Risk Factor Surveillance System
Survey Data. Atlanta, Georgia: U.S. Department of Health
and Human Services, Centers for Disease Control and
Prevention, 2007.
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