Loss of subsidies fuels Wisconsin health insurance hike

MADISON, Wis. (AP) - Wisconsin health insurance companies assumed there would be no more subsidies for plans sold through the federal exchange, which led to a projected 36 percent increase for the average premiums.

State insurance officials announced the premium increase Thursday, just hours before President Donald Trump said he was immediately ending the federal subsidies.

The subsidies, or CSR (cost-sharing reduction) payments, are paid directly from the federal government to insurance companies who offer plans on the marketplace. Those insurers pass the savings along to lower-income enrollees, who then pay less for their insurance. Without CSRs, experts say premiums could rise by double-digit percentages in upcoming years.

Deputy Insurance Commissioner J.P. Wieske said Friday that Trump's announcement does not change the 36 percent increase projection the state made. However, he says if the subsidies remain, it could mean that policy holders would see a refund or lower costs in 2019.

Data obtained by the Associated Press shows 242,863 people in Wisconsin get insurance through the federal exchange, and 51.3% of them qualified for a subsidy. In 2017, CSR payments are estimated to total $152,474.532.

Click here to see data for all 72 counties (see information about the data below).

County by county, Marinette has the third-largest percentage of ACA enrollees helped by payments to reduce their costs -- 58.2% of the 2,2299 enrolled.

In Oconto County, 56.1% of 2,157 customers insured through Obamacare qualified for CSR.

In Outagamie County, CSR benefited 52.1% of the 7,428 enrolled.

In Winnebago County, 55.1% of the 6, 337 enrolled get cost-sharing reductions.

Brown County has the fourth-largest number of people insured through the marketplace: 11,121 people, 51.8% of them qualifying for a CSR.

Gov. Scott Walker has been an outspoken opponent of the federal health care law and refused to set up a state-run exchange. He says Wisconsin will look for flexibility under the law to cut costs.

(Copyright 2017 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)

About the data

To arrive at the annual CSR payments by county figure, The Associated Press multiplied the number of CSR recipients for each tier of the program by the average monthly CSR subsidy at that tier, added those figures and then multiplied that total by 12.

The 2017 CSR recipient county data is pulled from 2017 ACA public user files: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Marketplace-Products/Plan_Selection_ZIP.html

The 2016 CSR payment by county data is pulled from the Office of the Assistant Secretary for Planning and Evaluation: https://aspe.hhs.gov/health-insurance-marketplace-cost-sharing-reduction-subsidies-zip-code-and-county-2016

In counties with low marketplace enrollment counts, numbers have been suppressed, and enrollment and payment information may be missing.



 
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