In a July 30 comment letter to the House Committee on Energy and Commerce (E&C) and Senate Health, Education, Labor & Pensions (HELP) Committee, WHA expressed concerns over Congress creating a new public option. The letter was in response to requests from House E&C chair Frank Pallone and Senate HELP chair Patty Murray about what Congress should do in regard to creating a public health insurance option to increase coverage.
WHA President and CEO Eric Borgerding urged Congress to recognize the successful coverage option that already exists for most states while expressing concerns about creating a redundant public option that would not achieve the coverage gains hoped for, while also leading to painful reimbursement cuts for health care providers.
Noting Wisconsin's unique approach to expanding coverage, Borgerding urged Congress to be wary of one-size-fits all policies that would penalize a state like Wisconsin. While Wisconsin has technically not done full Medicaid expansion, it has achieved better health insurance coverage outcomes than 31 states that did, and is the only such state without a coverage gap. In fact, Wisconsin currently enjoys the eighth lowest uninsured rate in the country.
Borgerding recognized the Affordable Care Act's publicly health insurance marketplace for playing a large role in this success, noting it has helped decrease Wisconsin's uninsured rate by roughly 50% since 2013. Thanks to Congress's recent work to enhance the subsidies in the American Rescue Plan Act (ARPA), Wisconsinites with incomes between 100% and 150% of the federal poverty level (FPL) can sign up for coverage with no premium and very low cost sharing, which is leading to further coverage gains.
Given that these policies have so successfully reduced the uninsured rate and improved affordability, Borgerding urged Congress to recognize they already function as a highly effective coverage option. He cautioned lawmakers against creating a redundant public option that would pay health care providers unfair below-market rates. While policy makers and health care providers have recently put a large emphasis on improving health equity, cutting provider rates will make it harder for providers that already see the most Medicaid and Medicare patients to stay in business. This would hit health care providers and the patients they serve in rural communities and inner cities the most.
Lastly, Borgerding cited the U.S. Department of Health and Human Service’s recent uninsured estimates which show there are approximately 80,000 Wisconsinites below 100% FPL eligible for a no-cost Medicaid plan who remain uninsured, as well as 25,000 with incomes between 100% and 138% FPL eligible for a subsidized marketplace plan who remain uninsured. This suggests that costs alone are not the reason people choose to forgo coverage. Given that, Congress must do more work to understand what obstacles remain in all income brackets to determine what can help achieve further coverage gains.