Big Decline in State’s ACA Recipients

One in four Milwaukee County residents who got health care through the Affordable Care Act (ACA) in 2017 did not get ACA coverage this year, according to the UW-Madison Institute for Research on Poverty.

In 2017, 242,863 Wisconsin residents statewide  – including 38,843 in Milwaukee County – enrolled in marketplace exchanges for ACA health care. This year, the statewide number fell to 205,118 – a drop of 15.5 percent. That was more than twice the 6.5 percent drop in ACA enrollees nationally, according to the Kaiser Foundation.

The drop was even greater in Milwaukee County, where the number of ACA enrollees dropped to 28,320 – a 26 percent decrease – this year.

Although those numbers may suggest the ACA in Wisconsin is in trouble, state Health Services Department Secretary Andrea Palm and UW researcher Donna Friedsam insist that Obamacare has improved health care in Wisconsin overall and remains critically important.

It’s also a timely issue. Sunday is the deadline to sign up for ACA coverage in 2020.

The ACA meant that many in Wisconsin “could have access, for the first time, to affordable health care,” Palm said in a WisconsinEye interview last week. Also consider ways the ACA reformed the national rules over health care coverage. It said providers could not base coverage on pre-existing conditions. It outlawed dollar limits on coverage. It allowed young adults up to age 26 to be covered by their parents’ policies.

Before the ACA, about 550,000 Wisconsin residents didn’t have health insurance – a number that has dropped to 300,000, said Friedsam, health policy programs director for the Institute for Research on Poverty. “Clearly, we’ve picked up people – a large number of people – in our insurance coverage because of the ACA and other factors,” including an improved economy that allowed some people to move into jobs with employer-provided health care, Friedsam said.

Friedsam also said research has shown that Wisconsin residents between ages 55 and 64 are most likely to rely on the ACA for health care. Between 35 percent and 38 percent of the 205,118 ACA enrollees in Wisconsin this year may be in that age 55-to-64 age bracket, she estimated.

ACA participation “definitely skews toward that older group of people who are nearing retirement but not eligible for Medicare,” Friedsam said.

Low-income residents are now the ones struggling to be able to afford the ACA, Friedsam said. “They are the ones making $7 or $8 per hour,” and would likely have been covered by Gov. Tony Evers plan to expand Medicaid, Palm added. Republican legislators, however, killed that plan.

That’s one reason for the 26 percent drop in Obamcacare enrollees in Milwaukee County over the last two years.

Other large two-year drops in the number of ACA enrollees were in Brown County, down 21 percent; Manitowoc County,  down 20 percent, and Waukesha County, down 16 percent.

Statewide, one-third of all ACA enrollees this year lived in just four counties: Milwaukee, Dane, Waukesha and Brown.

Friedsam said there were several reasons for the 15.5 percent drop in ACA enrollees statewide. Wisconsin state government did not actively promote the ACA, for example, and  “volatile” prices discouraged enrollment.

This year, about 5 percent of Wisconsin adults got health care through the ACA, or Obamacare.

As Sunday’s deadline approaches, ACA health-care plan prices “have really stabilized” and residents in all 72 Wisconsin counties now have more than one health care provider to choose from, Friedsam said.

Palm said it’s easy to get information on how to enroll in the ACA: Go to the healthcare.gov Website or dial the 211 helpline to be connected to a “navigator” who can guide someone through the process.

No one should avoid ACA enrollment because of fears it is going away, Palm said. “Plans are set for 2020. People should get enrolled.”

Wisconsin’s senior U.S. senator, Republican Ron Johnson, made repealing ACA his top campaign issue in 2010, when he won a first term.

Asked about his current position, a Johnson aide last week cited the senator’s recent comments. In a telephone town-hall meeting, Johnson noted that his daughter has a congenital heart defect and that he doesn’t see the protection for pre-existing conditions as “up for debate.”

“The good news is that there are ways of covering people with pre-existing conditions without causing premiums to double, triple and quadruple,” Johnson said. “The faulty architecture of Obamacare caused that.”

Steven Walters is a senior political reporter with the nonprofit public affairs channel WisconsinEye. Contact him at stevenscotwalters@gmail.com