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Piggy bank with stethoscope

A comparison of health insurance regulation in Wisconsin & Minnesota.

On Friday, September 6, Minnesota officials released information regarding the premiums that will be charged for insurance policies offered on that state’s new insurance Marketplace (“MNsure”), which begins offering coverage in January 2014. In comparison to the Wisconsin press release issued a few days earlier by the Office of the Commissioner of Insurance (OCI), the Minnesota material contains far more information. (See the range of MN documents here.)

The release from the MN Dept. of Commerce lays out the lowest premium levels (without federal subsidies) for people of three different ages in the St. Paul/Minneapolis area, for each of the four different tiers of coverage (bronze, silver, gold and platinum plans). It also compares the MNsure rates in the Twin Cities with the premiums in other major metropolitan areas and contends that the average (across all four metal tiers) appears to be lower in Minneapolis/St. Paul than the average in any of the other metro areas where rates have been announced.  (See this graphic with that comparison.)

Milwaukee is not part of that comparison because our state hasn’t released any premium levels.  Instead, the OCI press release contains percentage increases – comparing the average, unsubsidized cost of the new plans in Wisconsin next year with the 2013 cost of inferior individual plans. OCI has said that it will not release specific premium amounts.

According to Channel 27 News in Madison: ”OCI Deputy Secretary Dan Schwartzer told WKOW 27 News on Tuesday that the data used is proprietary and would not be readily understood by the general public.” That story reports that Citizen Action of Wisconsin has filed an open records request to try to obtain the actual rates.

If the MN Commerce Dept. had used the sort of approach employed by OCI, it might have said that the lowest cost plan was increasing by 59%.   Described that way, it sounds alarming. However, the picture is considerably different when you look at the dollar amounts and compare a 2014 premium of $90.59 per month (for a bronze MNsure plan for a 25 year-old in the Twin Cities) to a plan that now costs $57, but doesn’t provide the same access to preventive care and doesn’t cover preexisting conditions.

In light of the very substantial changes in insurance next year because of the Affordable Care Act, it’s nearly impossible to make apples-to-apples comparisons of the cost for the new plans and existing coverage available in the individual market.  But at least for me, comparisons that use actual dollar amounts are more meaningful because we can put those figures into the context of rates we are familiar with in the group market.

Once people can start applying for coverage through the federally facilitated Marketplace in Wisconsin, the premium information will come out.  As those numbers emerge, it will be very interesting to see how premiums compare in Wisconsin (and other states that have been resisting the federal law) with those in Minnesota and the states that have developed their own Marketplaces or that are playing a more active role in reviewing the premiums.

It will also be interesting to see if Wisconsin officials frame the information in negative ways or embrace the notion that robust participation in the new Marketplace would be good for Wisconsinites. It isn’t hard to imagine that some governors and insurance commissioners who have been opposing the law for the last couple of years might continue to be less than enthusiastic about helping it to succeed. However, active or passive resistance to the Marketplace would be very problematic in a state that is relying on that part of the ACA as the way to provide insurance for almost 100,000 adults who are being removed from BadgerCare.