Wisconsin governor proposes $200M reinsurance program: 5 things to know

Wisconsin Republican Gov. Scott Walker unveiled a “Health Care Stability Plan” aimed at bolstering the state’s individual health insurance market, among other projects.

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Here are five things to know about the plan, announced Jan. 21.

1. Gov. Walker plans to apply for a 1332 state innovation waiver. The federal waivers allow states to opt out of specific ACA requirements to implement different health coverage models, as long as the models have similarly comprehensive benefits and are as affordable, cover a comparable number of state residents and do not increase the federal deficit.

2. Under the waiver, Gov. Walker aims to instate a reinsurance program to stabilize the individual market used by approximately 216,000 residents, according to the Wisconsin State Journal. The proposed reinsurance program would pay 80 percent of claims between $50,000 and $250,000. Slated to start in 2019, Gov. Walker estimates the reinsurance program would cost $200 million a year.

3. CMS has granted Alaska, Minnesota and Oregon approval to establish similar reinsurance programs.

4. Gov. Walker also wants state legislators to pass a Democrat-authored bill making access to private insurance for individuals with pre-existing conditions a state law.

5. Under the Health Care Stability Plan, Wisconsin would also make its SeniorCare program permanent, which is a subsidized prescription drug program for seniors age 65 or older.

More articles on payer issues:
Unlike Kentucky, New Mexico won’t seek Medicaid work requirements
11 medical groups to Anthem: Rescind ED, imaging policies and 25% same-day service payment cuts
Hurricane victims get longer federal exchange, Medicare enrollment periods

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