Wisconsin vs. Minnesota
In Wisconsin, as of April 1, approximately 77,500 people are expected to lose Medicaid and will have to obtain coverage through the private exchanges. These include 38,067 people between 100 percent and 133 percent of the federal poverty level, and 35,781 between 133 percent and 200 percent.
Also losing coverage are about 5,000 childless adults who have managed to get on the program before enrollment was capped, and 3,600 children in households making over 300 percent of the poverty threshold.
But an additional 82,000 Wisconsin residents who now do not receive Medicaid are expected to become eligible. They will have to apply for coverage through county human service agencies.
The Minnesota Department of Human Services anticipates about 35,000 childless adults will be added to Medical Assistance because of the Medicaid expansion, in addition to the 113,000 that joined the program because of the expansion to 75 percent of the dederal poverty level. That number doesn’t include children and parents that are moving from MinnesotaCare to MA because of the expansion.
About 85,000 parents and children will move from MinnesotaCare to Medical Assistance by 2015.
—Nora G. Hertel
Minnesota, Wisconsin differ widely on costs
It’s called the Affordable Care Act, but it looks as though obtaining health care coverage on the new private exchanges will generally be much more affordable in Minnesota than Wisconsin.
The lowest-cost “silver tier” plan in Minnesota will cost an estimated $192 per month, according to averages calculated by the U.S. Department of Health and Human Services in September. The same level of coverage in Wisconsin is expected to cost an average of $344.
Progressive advocacy group Citizen Action of Wisconsin released a report comparing Badger and Gopher premiums in more detail. The report argues that policy decisions affected the difference in premium rates.
“Wisconsin’s decision to turn down enhanced federal Medicaid dollars, and its decision not to implement more robust rate review, can explain a substantial portion of the premium gap with Minnesota,” states the report, authored by Kevin Kane and Robert Kraig of Citizen Action.
The St. Paul Pioneer Press also analyzed premiums in each state along the St. Croix River. Its analysis found Minnesota rates lower than its eastern neighbor. The article chalked this up to different management of the states’ pools of people requiring high-risk insurance.
Minnesota’s high-risk pool is closing at the end of 2014 and won’t accept new enrollees after Dec. 31. Minnesota will continue to offer state insurance for its high-risk pool, while Wisconsin officials are closing that category of coverage under the state’s Medicaid program, BadgerCare. Wisconsin’s Health Insurance Risk-Sharing Plan members are being directed to the private health-care exchanges. This could drive up the cost of premiums for Wisconsin residents shopping in the private market.
Other factors are also at play. Merton Finkler, an economics professor at Lawrence University in Appleton, Wis., said the two states have managed their health care systems differently for the last few decades.
Minnesota is better than Wisconsin at focusing on primary care and the Twin Cities have lower health care costs than other regions because of business alliances active for two or three decades, Finkler said.
At a November conference by the Wisconsin Institute for Public Policy and Service, J.P. Wieske, public information officer for the Wisconsin Office of the Commissioner of Insurance, cautioned against Minnesota and Wisconsin comparisons.
“It’s almost not an apples-to-apples comparison,” said Wieske. “Minnesota started with a market that was different from a rate perspective than we have here… So our changes were much bigger than Minnesota’s were. There are a lot of factors.”
— Nora G. Hertel