Health Care Law Implementation Moving Ahead in Wisconsin
Walker and Van Hollen vow to sue, but insurance exchanges are being studied and debated
As he promised during his campaign, Walker will allow Attorney General J.B. Van Hollen to sue to prevent portions of the federal health care bill from being implemented in the state. Walker and Van Hollen both oppose the requirement that individuals purchase “minimum essential coverage” for themselves and their dependents.
But that isn't stopping the federal and state governments from moving ahead with reform.
Some portions of the federal bill have already gone into effect. Small businesses that provide insurance for their employees are eligible for a tax credit this year; seniors are eligible for $250 to help fill the Medicare Part D donut hole; young adults can be covered by a parent's policy; insurers cannot refuse to cover children with pre-existing conditions; insurers are barred from rescinding coverage from someone who becomes sick; and lifetime and annual limits are eliminated.
And despite Walker’s very public opposition to the “minimum essential coverage” requirement, it doesn’t mean that he wants to completely block the bill’s implementation in the state.
In fact, Walker seems to support the requirement that states must set up health insurance exchanges in which individuals and small businesses may purchase coverage. In these exchanges, consumers could use federal subsidies to purchase private insurance policies that are approved and regulated by the state or another entity. If a state doesn’t implement an exchange, the federal government will do so and the state could lose hundreds of millions of federal dollars.
Just last week Walker wrote to President Barack Obama saying he’s already got ideas about how Wisconsin’s exchange should operate.
“It is my hope that your administration will allow Wisconsin to take a free-market, consumer-driven system approach under the health care exchange provisions of the federal act,” Walker wrote to the president.
Walker’s transition office didn’t respond to the Shepherd’srequest to clarify the governor-elect’s position on health care reform.
Neither has his transition team given direction to a special committee set up by the state’s Legislative Council to study how to implement health care reform in the state and then forward its recommendations to the state Legislature.
Committee members include Democratic and Republican lawmakers plus a broad spectrum of experts on health care, representing the interests of consumers, health care providers, insurers and workers. Members include Robert Phillips, medical director, government relations at the Marshfield Clinic; William Petasnick, president and CEO of Froedtert Memorial Lutheran Hospital; Wendy Arnone of UnitedHealthcare of Wisconsin; Tim Bartholow, senior vice president at the Wisconsin Medical Society; Robert Kraig, executive director of Citizen Action of Wisconsin; Candice Owley, head of the Wisconsin Federation of Nurses and Health Professionals; David Newby of the state AFL-CIO; David Riemer, director of Community Advocates Public Policy Institute; Robert Palmer, CEO of Dean Health Plan; and Joe Leean, a former Republican lawmaker who implemented BadgerCare when he served as secretary of Health and Family Services under Gov. Tommy Thompson.
Sen.
Darling Repeats Health Care Myth
The committee,
chaired by state Sen. Jon Erpenbach (D-Middleton) and state Rep. Jon Richards
(D-Milwaukee), met twice before the Nov. 2 gubernatorial election. The
committee even brought in experts from Utah, which has its own version of a
health insurance exchange.
But the
committee’s work almost ground to a halt during its Nov. 9 meeting, when two
Republican members—state Sen. Alberta Darling of River Hills and state Rep. Pat
Strachota of West Bend—wondered why they were even convening at all.
Strachota
said that since the committee had been set up while Democrats controlled both
houses of the state Legislature, it would not be effective now that Republicans
were in charge.
“Would we be
the group that the new Legislature would choose?” Strachota asked the top-flight
experts and her fellow lawmakers.
Darling said
that the country had spoken on Nov. 2 and that she didn’t think the committee
should proceed until after the new governor and Republican-led Legislature took
over in January.
“We do not
want to launch a government-run system,” Darling said.
Darling
seemed to come around after Froedtert’s Petasnick suggested that the exchange
should be built around plural markets, meaning that multiple private insurers
could participate in it. He also suggested that the exchange should be governed
by a third-party entity that’s isolated from politics.
“At least
we’re not talking about government-run health care,” Darling said.
(Darling did
not respond to the Shepherd’s request
to comment for this article.)
Proceeding
With Reform
Committee
co-chair Richards told the Shepherd
that it’s “nonsense” to believe that Walker’s election meant the end of the
committee. He said Van Hollen’s potential lawsuit—which he called “frivolous”
and “politically driven”—had no impact on the committee’s study of how the
federal law could be implemented in Wisconsin. He also said that he hoped that
Walker’s health care team would discuss their views with the committee.
“To address
the crisis that we have with the cost of health care, it’s going to require
everybody at the table,” Richards said. “That’s what we have with this
committee. The questions should be answered publicly and accountably and it
needs to be done now. I will fight any attempt to move this discussion to a
backroom or to put it off for another year or another decade.”
He said that
while Walker’s team hadn’t contacted him yet, he felt that the committee could
come up with recommendations that would meet Republicans’ approval.
“I think
there’s broad consensus within this committee that we want to have a
pluralistic health care system,” Richards said. “We want to give people
choices. That means that we have a strong private sector insurance market still
in the mix providing health insurance for Wisconsinites.”
Kraig, of
Citizen Action, said that Walker’s openness to a free-market-friendly health
insurance exchange is in line with other Republican plans, including the
exchange in U.S. Rep. Paul Ryan’s very conservative “Roadmap for America’s
Future.”
Kraig said
about 80% of Ryan’s proposed exchange is in sync with the committee’s
discussions thus far.
“The
question is whether you can negotiate on the other 20%,” Kraig said.
He said
Wisconsin would miss a huge opportunity—and up to $900 million in federal
subsidies to reduce health care costs—if it fails to implement an exchange.
“If we don’t
do it, we would have double-digit rate increases and health care would be
unaffordable in this state,” Kraig said. “So we have a huge incentive to do
this. We need the provider community and advocates and other leaders to come
together in a public and transparent process.”
The
committee’s next meeting will be held on Monday, Dec. 13, in Madison.
Rep. Richards is right about this exchange business. The idea of Van Hollen suing to block parts of the federal health care reform is wasteful-waste of time and money.
I've heard people complain that Wisconsin is a "money-making state". Meaning it's about those in government and business making money off it's own people. Fees, taxes, prices, you name it! Profit reigns supreme, especially in the SE region, aka Milwaukee metro. (Landlord-Tenant commissioners are all landlords themselves, so the tenants before them lose, etc.)
My employer acknowledged that healthcare costs for greater Milwaukee happen to be double the national average. What we need is to DROP PRICES, not mandate that a 20% markup insurance company be involved in the cash flow to these healthcare providers. Better yet, encourage more preventive info and care so people will not need to see the doctror! So people can take care of a problem while they are lower cost, not wait until they are expensive (or a trip to Emergency). ER should be for accident victims, not for uninsured sick people!
Difference between Liberal and Progressive -- 1) Liberals use taxes to redistribute wealth and pay FULL PRICE for services to the poor. 2) Progressives combine this same redistributed wealth for these same services, but with a mandated drop in prices... like Medicare had tried to do. (why not fix that?)
But healthcare providers don't like those Medicare terms, they would much rather serve only those who can pay full price (and will not sue). Of course, back when my union made my emplower pay 100% of those premiums, I DID NOT CARE ABOUT HIGH PRICES!
Bottom line, employer paid health insurance is what made healthcare prices go high. Suggestion, instead of allowing the insurer to collect a fee off the dollars handled, why not limit them to a fee for services hadled! What's the difference? If an insurer wants to make double the money, the first way means just double the price, the other way means double the amount of care.
But, did the free market, private industries deliver the goods? HMOs aka "Managed Healthcare" tried to lower costs since employers paid the lions share relative to workers. Did we like how the prices were "managed" by financially making doctors perform a financial triage and withhold care?
Then came the PPO networks, requiring doctors to offer a discount and cap for in-network patients, but a really good doctor could get away with charging the higher out-of-network prices. Meant the in-network providers were the doctors that had lousy, ineffective care in order to make a profit on those discounted and capped terms.
It's all about level playing field! Free market will ONLY serve the ones they can make profit off of, and the ones they lose money on will ALWAYS fall through the cracks.
Only a Strong and Enforced government mandate can ever succeed in leveling the playing field. You don't need Government owned and operated healthcare. By making all "private, free market" policies and practices play by the same rules, you level the playing field. Allowing each state to set their own rules, and then lobbying to let the corrupt states sell across state lines to the people of the states that play by higher standards is not going to work!
It's like CitiBank saying "the US Supreme Court has now ruled that in an interstate dispute, the provider's state rules applies (where it used to be the customer's state)." South Dakota, if you agree to lowering your state's standards on credit cards, then we will move all our headquarters (and those jobs) to your state. THAT's the corruption I am talking about in selling insurance across state lines!
To stop these practices, only a FEDERAL rule that forces all states (and insurers) to follow the same rules will succeed. If you really do want each state to do their own thing, then you also need to follow with dropping the Federal tax rate to a flat 7%, cut off ALL federal subsidies to states, and force each state to pay their own way, meaning the states will need to raise their taxes to IRS 1040 levels. And let each of those states provide their own military, and each state apply customs rules and immigration rules to their own borders against interstate commerce and people trying to change states!
Call it the "Divided States of America!" Sounds to me like that's what we really want!
Waukesha guy, when I read diatribes from you and other lazy, ineffectual liberals I often ask myself how can you acually live in this country without just being miserable? You absolutely loathe everything that made this country the greatest society in the history of mankind. You hate capitalism, free markets, private property, profits, corporations, the individual pursuit of excellence, self-reliance, personal responsibility, and on and on. I know you are bitter failure that wants to project his deficiencies on everybody else but you need to come to the realization that your belief system is intellectually inferior and flawed just like you.