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State officials say they're ready for ACA launch

Sep. 27, 2013
 

Special report

As key parts of the Affordable Care Act begin to take effect, Gannett Wisconsin Media has launched a special series of stories, “Health Care Reform & You,” examining the most important issues for consumers. Coming Sunday: How the law will affect people from various walks of life. Follow the series online at postcrescent.com/healthcarereform.

What’s a health insurance exchange?

Wisconsin’s health insurance exchange, or marketplace, will be a website where you can go to shop for health insurance. You will fill out an application and then be able to compare plans based on price, benefits, quality and other features. You also will find out if you qualify for lower costs. Enrollment starts Tuesday, the deadline is Dec. 15 and coverage begins as early as Jan. 1. For more details, visit www.healthcare.gov.

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MADISON — Wisconsin health and insurance officials said Friday that the state is as prepared as can be for next week’s launch of open enrollment under the new federal health law.

But no one is quite sure what to expect.

“I’ll tell you Wednesday,” joked Kevin Moore, Wisconsin’s deputy secretary of health services when asked Friday whether there will be a stampede or trickle of people attempting to sign up for insurance Tuesday when the enrollment period begins.

The online exchange, or marketplace, is supposed to offer a consumer-friendly way to buy health insurance while forcing insurers to compete for business. Consumers can apply online at healthcare.gov, through a call center, in person or through the mail.

Gov. Scott Walker opposes the Affordable Care Act, or “Obamacare,” as it’s often called, and he declined to have the state set up the exchange, deferring instead to the federal government.

Walker also turned down federal money to pay for keeping people on Medicaid who earn up to 138 percent of the poverty line. Instead, Walker lowered Medicaid eligibility from those who earn 200 percent of the poverty line to those who earn 100 percent of it or less. That will force about 92,000 adults off of the BadgerCare program and into the exchange.

The new income eligibility limit for Medicaid starting in January will be $11,500 for an individual or $23,550 for a family of four.

They are among about 690,000 people who are expected to be eligible to buy insurance through the exchange. Another roughly 470,000 people currently have no insurance and some portion of the roughly 200,000 people who already privately purchase insurance will also be able to shop on the exchange.

There could be people who lose employer coverage and will be added to those shopping under the exchange, but it’s impossible to predict how many that may be, said deputy insurance commissioner Dan Schwartzer.

Thirteen of the 25 private insurance companies that offer policies to individuals will be selling plans on the exchange, with the entire state having at least two providers competing.

The federal health care law requires individuals to have health insurance starting in January or face a penalty. The enrollment period that begins Tuesday runs through March 31, although Dec. 15 is the cut-off date to sign up for policies that begin in January.

Despite Walker’s opposition to the law, his administration has been working closely with health insurance providers, insurance agencies, advocacy groups, community organizations and others to establish ways to help those who will be using the exchange, Schwartzer and Moore said.

“This has been a long road,” Schwartzer said at a news conference called to discuss the status of the exchange. “We have done everything to be ready to regulate our market.”

Both Schwartzer and Moore said they encouraged everyone using the exchange to shop around, both for plans sold there that are eligible for federal subsidies and those outside the exchange in the private market.

Low-income people, including those being kicked off Medicaid, will be eligible for federal subsidies. But those earning more may not be, so they may find better deals outside the exchange.

“If you’re a good shopper, you’re shopping all markets available,” Schwartzer said.

Still, given the complexity of eligibility criteria, the plans available and subsidies, Schwartzer recommended that shoppers seek out those who have been trained to help navigate the system.

“This is confusing,” he said.

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Football fans

If you've ever answered "Who has the ball?" with "It's halftime," you might recognize The Airhead. Check out the characters in our cartoon gallery of oddball fans.

Special Reports