Many ObamaCare plan choices, affordable options, available in Wisconsin

Open enrollment and re-enrollment period starts November 1

Contact: Donna Friedsam, 608.263.4881, dafriedsam@wisc.edu

Wisconsin’s Insurance Commissioner this week is holding town hall meetings throughout the state to inform residents about the departure or change of service area by some health insurers in the Affordable Care Act (“ObamaCare”) Marketplace. Such changes require an estimated 37,160 residents to shop for a new health plan. They are part of the 224,208 Wisconsin residents who bought Marketplace health insurance last year who will begin a regular process of re-enrollment on November 1. Many health plan choices are available through the Marketplace when open enrollment begins on November 1. Consumers should select a plan by December 15 for coverage to begin January 1, 2017.

Shopping for health plans during open enrollment is common for consumers, who use the opportunity to find better prices, different sets of benefit, or different provider groups. Of 183,000 Wisconsin residents who had enrolled in Marketplace plans in 2015, 82% (about 150,000) re-enrolled in 2016, demonstrating the ongoing demand by these consumers for Marketplace coverage. Of those who re-enrolled from 2015-16, 39% switched to a different Marketplace health insurance plan.

Most counties in Wisconsin will have at least three insurance carriers offering multiple plans through the Marketplace. While some insurers have left, three new carriers – Children’s Community Health Plan, Aspirus Arise, and Health Partners – have entered the Marketplace and offerings are strong. This map shows information on the insurance carriers offering plans in each county.

The need for Marketplace plans remains substantial. In addition to those who will be re-enrolling in coverage, about a quarter (84,000) of the estimated 353,000 remaining uninsured Wisconsin residents are currently eligible for federal subsidies to purchase health insurance through the Marketplace.

While many may worry about the increase in premium prices, federal premium subsidies through the Marketplace will continue to keep premiums affordable for most consumers. About 85% of those purchasing Marketplace insurance coverage last year qualified for federal subsidies, known as premium tax credits, reducing premiums by an average of 73%. Last year, the 224,208 Wisconsin residents who purchased Marketplace policies paid an average monthly premium of $125, and most had an option to buy a policy for less than $100.

Many consumers in Wisconsin have been purchasing policies “off-exchange” and not through the Marketplace, paying much higher prices than they need to: an estimated 53,000 Wisconsin residents who purchase “off-exchange” coverage would be eligible for federal premium subsidies if they purchase their coverage through the ACA Marketplace instead. It is also important to also note that an estimated 124,000 currently uninsured residents are eligible for Medicaid or BadgerCare and can apply today for such coverage. This coverage has no premium and very little cost-sharing.

Consumers are encouraged to seek help to enroll or re-enroll in health insurance coverage. They can call 2-1-1 to find local help, or contact Covering Wisconsin, the state’s largest federally-certified and state-licensed Navigator entity.