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Healthy Wisconsin Council

Healthy Wisconsin Council. Reinsurance Institute Presentation July 19, 2007 Jim Johnston, DOA Milda Aksamitauskas, DHFS. The Changing Wisconsin Health Care Market. As of 2004, the publicly insured now exceed the commercially insured. 2000 - 2004.  32%.  21%.  37%.  32%.

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Healthy Wisconsin Council

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  1. Healthy Wisconsin Council Reinsurance Institute Presentation July 19, 2007 Jim Johnston, DOA Milda Aksamitauskas, DHFS

  2. The Changing Wisconsin Health Care Market As of 2004, the publicly insured now exceed the commercially insured. 2000 - 2004  32%  21%  37%  32% Office of Commissioner of Insurance; Department of Health and Family Services * Estimated figure for Self-Funded Population.

  3. Wisconsin’s Medicaid Program

  4. Wisconsin’s Uninsured • Wisconsin has 5.3 million residents • 276,000 were uninsured for the whole year (5%) • 38,000 children were uninsured for the whole year (3%) and 110,000 children were uninsured for at least a portion of the year (9%) • Source: • Wisconsin Health Insurance Coverage, 2005 (annual report) • http://dhfs.wisconsin.gov/stats/familyhealthsurvey.htm

  5. Wisconsin’s Uninsured All uninsured children Uninsured adults up to 200% of FPL

  6. January 2006 Governor Calls for ReformJuly 2006 Governor Issues Executive Order • Create Healthy Wisconsin Council • Reduce the number of uninsured • Reduce health care premiums • Improve the individual and small group market • Increase the number of businesses that offer comprehensive, affordable insurance

  7. Anthem Blue Cross/Blue Shield United HealthCare of Wisconsin WPS Insurance WEA Trust Wis. Federation of Coops Humana 2 State Senators 1 State Representative Wis. Independent Businesses Wis. AFL-CIO 2 Doctors 1 Hospital Administrator 5 Business Representatives Council Membership

  8. Healthy Wisconsin Council Agenda • Define target population • Mapping the structure of reinsurance • Funding options • Participation in the program

  9. Options Considered • Primary insurance product for small group market with Reinsurance • Reinsurance product for small group market • Statewide catastrophic Reinsurance pool • Medicaid expansion for low-income, uninsured adults

  10. Council’s Recommendations • Medicaid expansion to childless adults • Reinsurance Authority • Reinsurance Product • Subsidy (cigarette tax)

  11. Council’s Recommendations – cont.

  12. Lessons Learned Large subsidies needed to make a substantial impact on health insurance premiums

  13. Lessons Learned cont. • Challenge between helping uninsured and businesses that already provide insurance • Actuarial analysis vital to finalizing recommendations • The Council failed to reach a unanimous consensus on all recommendations

  14. Governor's Seven Point Strategy to Achieve Health Care Goals • Universal Access – BadgerCare Plus Expansion • Lower Premiums Tax Deduction • Decrease Smoking Increase Tobacco Tax • MA Provider Rate Increase • Reduce Health Care Costs –Establish Healthy Wisconsin Authority • Strengthen Co-op Care • Improve Quality and Reduce Medical Errors by promoting e-Health Initiatives

  15. 98% Access to Health Care

  16. Future Directions • Governor’s 2007-2009 budget request includes Healthy Wisconsin Authority • Senate budget plan retains Authority concept, but broadens mission to implementing a universal insurance plan • Assembly budget plan deletes Healthy Wisconsin and instead emphasizes personal responsibility and HSAs

  17. Additional Information Healthy Wisconsin Council website: http://dhfs.wisconsin.gov/healthywisconsin

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