Progressive Thinking

Report finds continuing regional disparities on cost, inflation, and quality. Wisconsin health insurance costs have more than tripled since 2000.

STATEWIDE - Citizen Action of Wisconsin released its 10th Annual Wisconsin Health Insurance Cost Ranking report Monday morning on a statewide media call. A full audio recording of the media call can be downloaded here.

The full report includes 11 charts ranking the cities and regions of Wisconsin on health insurance costs, rate of inflation, and quality, and can be downloaded here.

This year’s report finds wide disparities between higher and lower cost regions of Wisconsin, as well as large differences in the rate of health insurance inflation. There is a 30% variation in the for all types of health insurance for premiums and deductibles between the lowest cost metro area (Madison) and the highest cost area (Milwaukee), which amounts to a difference of $2,221.48 per year for single health coverage.

The magnitude of this gap could have significant economic consequences. The report finds that Wisconsin health insurance premiums for large and medium sized employers have more than tripled since 2000, increasing 216% since the year 2000 statewide, and as much 365% in some areas.

This year’s report also finds significant volatility on in the price for health insurance people buy on their own. There is also a $4,470 gap in annual premiums and deductibles between the highest cost area (Wausau) and the lowest cost (Madison) on the individual market.

The report recommends that policymakers in Madison make controlling health care costs a more central focus. The report notes that making better use of all the tools available under the Affordable Care Act, such as taking enhanced dollars for BadgerCare and implementing more robust health insurance rate review could begin the process of moderating health insurance premiums in Wisconsin. Other reforms which go beyond the Affordable Care Act such as more strictly regulating excessive prescription drug prices and surprise medical bills would also lower consumer costs.

“The striking numbers in this report make it clear that state policymakers need to move beyond the divisive debate over the Affordable Care Act and put a sharp focus on health care costs,” said Robert Kraig, the report lead author and the Executive Director of Citizen Action of Wisconsin. “Wisconsin workers and families will not have full control of their own health care decisions until we get health care costs under control.”

Key Findings: Wisconsin Health Insurance Cost Ranking 2016

• Wisconsin Health Care Hyperinflation is a Long Term Trend. Wisconsin large group health insurance costs (premiums and deductibles) have more than tripled since the year 2000, increasing 216% statewide, with regional rates of inflation varying between a low of 170% in Madison to highs of 365% in Green Bay, 254% in Oshkosh, 247% in Appleton, and 226% in Milwaukee, for benefits packages that is less generous.

• Southeastern and Central Wisconsin are Highest Cost Areas, Madison is Lower Cost. According to a new composite measure which combines all types of health insurance, Milwaukee, Racine, Wausau, have the highest costs in Wisconsin while Madison has the lowest.

• Regional Cost Disparities Persist. There continue to be wide cost variations between higher and lower cost areas of the state. The cost variation is even higher in our composite index for all types of health insurance than they are in the large group market. There is a 30% cost variation between the highest cost metro area (Milwaukee) and the lowest cost metro area (Madison), which amounts to a $2,221.48 difference for a single policy each year.

• Regional Cost Disparities Are Greatest on the Individual Market. Although there are large regional cost variations for all types of insurance, the biggest disparities are in the individual market. The highest cost areas (Wausau, Stevens Point, Wisconsin Rapids, and Marshfield) are an astounding 69% higher than the lowest cost areas (Madison, Appleton, and Janesville/Beloit). This amounts to a gap of $4,470 per year for individual coverage.

• Disparities within Regions Suggest Underlying Medical Costs are Not the Only Driver of Insurance Costs. Insurers often claim that their prices merely reflect medical costs. However, there are major variations in relative cost within regions for different types of insurance. This suggest that the numbers measure not only underlying medical costs but also distortions in the insurance market. For example, the Fox Valley has above average insurance rates in large group insurance and well below average rates in the individual and small group markets. Wausau has very high costs for large group and individual market insurance, but relatively low costs in small group. Madison is not nearly as low in the small group market as it is for the other types of insurance. Eau Claire is high in all employer-based insurance, but below average on the individual market.

• Individual Market Costs Increased Substantially Statewide. There was a 28% increase statewide in premiums and deductibles combined from 2015-2016 .

• Striking Price Volatility on the Individual Market in a Major Policy Concern. Some metro areas had very large increases in cost from 2015 to 2016 while others actually saw reductions. Individual market prices increased by over 69% in Racine, and 60% in Milwaukee, while declining by over 8% in Madison and Janesville/Beloit. This 79% percent spread in inflation rates between Wisconsin cities is a warning sign that insurance rate setting practices may require greater scrutiny.

• Price Volatility is also a Concern on the Small Group Market. Although not as severe as the individual market, there were significant disparities in the rate of inflation between Wisconsin metro areas for small employers. While Green Bay and the Fox Valley saw greater than 10% increases, Stevens Point, Wisconsin Rapids, and Marshfield saw cost reductions of over 12%.

• Cost and Quality are not Correlated. As in past reports, the 2016 report finds that there is no clear correlation between quality and health insurance costs, with some of the low cost areas of the state having higher quality insurance plans and some higher costs areas having lower quality plans.

Additional data and 11 ranking charts ranking each metro area in Wisconsin are available in the full report which can be downloaded here.

Today's Republican Party appears to be terminally ill. Gone is Reagan’s optimistic faith that our best days are ahead of us, replaced by a dark fatalism about America’s decline and eventual demise.

MADISON - When political parties die they don’t suffer heart attacks. They contract terminal illnesses. The end does not come abruptly. There is advance notice.

Notice has been given. The Republican Party appears to be terminally ill.

The GOP was the party of Lincoln. It was the party of Teddy Roosevelt. The party of Eisenhower. It was a party dedicated to creating opportunity for all. Today it’s given itself up to the 1%. Today’s Republicans clearly have lost confidence in their ability to peddle their ideas to another 49%, and have resorted to a dizzying array of voter suppression tactics to whittle down the size of the electorate and blatant manipulation of political boundaries in hopes of rigging election outcomes. But they still aren’t sure enough people will buy the feed-the-rich, screw-the-poor policies they are selling, so they desperately turn to shameless — and shameful — appeals to racism and xenophobia to dredge up enough energy to stay alive.

Gone is Reagan’s optimistic faith that our best days are ahead of us, replaced by a dark fatalism about America’s decline and eventual demise. A true love of country and a sincere belief in the inscription on the Statue of Liberty have given way to paranoid obsessions with walls and borders and surveillance.

The Republican Party has lost its way. It has become a party that deserves to die.

It tends to be forgotten that parties have died before. It tends to be forgotten that the American experiment was underway for three quarters of a century before the Republican Party was born. It tends to be forgotten that the GOP’s birth in the 1850s coincided with the death of one of the two major parties at the time. Slavery not only divided the nation, it divided the Whig Party. The Whigs lost their leader in Illinois, none other than Abraham Lincoln, along with most of their northern supporters. The party could not survive the injury.

Like the ill-fated Whigs of the 19th Century, today’s Republicans have lost their right of association with Lincoln. They no longer sound anything like Teddy Roosevelt. They no longer act anything like Eisenhower. They try to evoke Reagan’s memory, but have grown estranged from his ways.

The signs are clear and conspicuous. The Republican Party is on the verge of flatlining.

Mike McCabe of Blue Jean Nation makes the point that Democrats (and Progressives) may gain more in the long run by standing up for their values than by being "smart" campaigners.

MADISON - A great football coach once said “winning isn’t everything, it’s the only thing.”

That line is often attributed to legendary Green Bay Packers coach Vince Lombardi. Lombardi wasn’t the first to say it. Maybe he heard it first from college football coach Red Sanders, who said it close to a decade before Lombardi made the aphorism famous. Maybe he lifted his signature saying from the 1953 John Wayne movie Trouble Along the Way. It’s doubtful Lombardi actually believed winning is the only thing. Roughly three years after he made the “only thing” remark, he was quoted in a magazine article offering an amended version: “Winning isn’t everything, but wanting to win is.”

Good coaches are good teachers, and they realize that more can be learned from a loss than a win. They tend to see long winning streaks as fool’s gold, because they know from experience that bad habits have a way of forming while their teams are stringing together wins, and those habits are only exposed as damaging after they lead to a defeat.

So it is in politics. You win some and you lose some. But when you lose, you need to lose with a purpose. Something has to be gained from every defeat. Seeds planted during today’s loss grow into the fruits of tomorrow’s victory. How you lose is what defines you.

In recent times, Republicans have lost much more purposefully than Democrats. Democratic Party dominance in the 1960s and especially Barry Goldwater’s landslide loss in 1964 inspired the 1971 Powell Memo that was a blueprint for a merger of corporation and state and an accompanying Republican renaissance.

The Democratic establishment’s response to what the Powell Memo has wrought has been curious to say the least. I wrote in my book Blue Jeans in High Places about a young woman in rural Wisconsin who ran for a seat in the state Assembly. Democratic operatives coached her to avoid being pinned down on issues and to steer clear of controversial stands. The Democrats’ nominee for governor similarly advised her to be as vague as possible on the issues and said her job as a candidate was to be “present and pleasant.” She followed the script. She lost.

In fact, the Democrats lost twice in that instance. Not only was that election lost, but nothing was said or done to get voters to start thinking differently or challenge the other side’s orthodoxy. Nothing was said or done to create conditions favorable to winning the next election.

Since my book was published, I’ve lost count of the number of former candidates for state and federal offices who have told me they received the same coaching. They followed the same script. They also lost. Twice. Democrats across the country are making a habit of running scared for the sake of “electability” . . . and losing anyway.

You lose in politics sometimes. But every loss has to have a purpose. There was a purpose to Goldwater’s defeat. Present and pleasant serves no purpose.

Phone companies are changing and copper phone lines are expensive to maintain. Modern technology is making copper lines obsolete. But Sen. Kathleen Vinehout wonders if state law should allow phone companies to dump their landline customers in the name of profit.

CHIPPEWA FALLS, WI - “I was furious,” said Cindy from Chippewa Falls. “I wouldn’t have stayed on the phone this long with this dinky cell phone.” She just found out state law allowed phone companies to dump their landline customers.

Cindy waited 40 minutes on her “dinky cell phone” to join a telephone town hall meeting with 7,373 other seniors.

AARP (formerly the American Association of Retired Persons) hosted the town hall. I was the guest senator. We joined forces to promote my “Home Phone” bill – Senate Bill 240. The bill would return state law to pre-2011 language and protect phone customers from losing landlines.

Phone companies are changing. Modern technology may make copper phone lines obsolete. Copper lines are expensive to maintain. That is the industry’s side of the story. The last point – copper lines are expensive to maintain – is what led to Marge’s problem.

Marge lives in Maiden Rock surrounded by the hilly, rocky, rural bluffs. The phone line is aging and quality is poor. But cell phones don’t work unless Marge gets in the car and drives to the top of the bluff. When I met Marge last summer, she had been without her landline phone service for several weeks. At that time, the phone company refused to repair the line. We weren’t certain they would ever do the necessary repair.

Landline home phones are vital to the protection, security and social support of not only seniors but many of the residents in rural areas. Prior to 2011 Act 22, Wisconsin residents were assured of landline telephone service through “provider of last resort” obligations. This law required telephone companies to make basic voice service available to all residential customers within the area in which they operated.

Four years ago, when I fought to stop 2011 Act 22, I was told not to worry because a federal law would protect landline phones. Now, one of Wisconsin’s largest telecommunication providers petitioned the federal government to remove the federal regulation, putting Wisconsin citizens at risk.

The Wall Street Journal reported in 2014 telephone giants “are racing to replace their phone networks with new technology.” Further, the WSJ reported the “FCC decided to allow carriers to launch ‘experiments’ aimed at weaning people off old, circuit-switched phone networks…two carriers, with a total of more than 250 million customers, aren’t shy about their ultimate goal: turning off their old networks forever”.

In our town hall meeting, we heard from seniors who lived through harrowing experiences saved by their landline phone.

James from rural Hayward told us his neighbor would not be alive without the connection of her landline phone to “Life Alert”. Marilyn fell outside in the winter and broke her hip. She pushed the emergency button connected to her landline phone, which alerted emergency responders.

“I used to work for AT&T,” James told town hall participants. When he worked for the company, they were proud to guarantee phone service. “What’s happened?” he asked.

Doris from Cornell said a landline phone is a lifeline for her husband who has a heart condition. The machine that helps his heart beat is monitored through a signal that can only be transmitted over a landline phone. The signal goes to Pennsylvania and then back to a hospital in Eau Claire.

Another concerned participant explained that her 84-year-old Aunt wears a bracelet that connects her to emergency services. The cell phone company will not support the service needed to make her bracelet work. A landline phone is critical to allow her Aunt to stay safely at home.

Cindy from Jump River lives in a low area and said she cannot get any cell reception. She was worried about reaching emergency services. “I have my landline and I wouldn’t want to give it up.”

Helen Marks Dicks, AARP’s Associate State Director/Advocacy Director, asked seniors to call their elected representatives and “tell them why landline service is so important to them.” People should “ask their legislator to request a hearing on SB 240.” The bill is in the Senate Committee on Workforce Development, Public Works and Military Affairs chaired by Senator Roger Roth.

You can use the AARP hotline to call for action: 844-254-6876. Call now – while you still can!

Three months have passed since Governor Scott Walker said he would repay taxpayers for bills run up while he was running for President. Has he given himself a no-interest loan?

MADISON - Nearly three months have passed since Governor Walker ended his presidential campaign and the day he promised to repay state taxpayers for costs incurred during his presidential campaign. As homeowners and small businesses begin receiving their property tax bills, the outstanding debt racked up by Governor Walker’s presidential campaign has largely gone unpaid.

The most recent news accounts suggest he still owes Wisconsin taxpayers nearly $70,000 for expenses he charged to taxpayers during the first 6 months of 2015.

“Millions of Wisconsin homeowners and small business owners are in the process of paying their property tax bills while Governor Walker continues to ignore his responsibility to repay taxpayers for the costs they incurred for his presidential campaign,” said Senator Dave Hansen (D-Green Bay). “Essentially he is receiving a no interest loan from state taxpayers. It’s a sweetheart deal that he’s giving himself and it really does seem to straddle--if not cross--an ethical line.”

Hansen and State Representative Katrina Shankland (D-Stevens Point) introduced the Taxpayer Protection Act earlier this year that would require state elected officials running for federal office to report and swiftly reimburse taxpayers for campaign related travel expenses.

Said Hansen, “His lack of concern for taxpayers makes our case for why we need to pass the Taxpayer Protection Act, so this never happens again.”

“So far he hasn’t even repaid taxpayers what he owes for the first part of the year. And we don’t even know how much he owes from the remainder of his campaign. Given his million dollars of campaign debt who knows if taxpayers will ever see a full accounting of what he owes them much less receive full payment from him,” Hansen said.

Earlier this month Wisconsin homeowners and small businesses began receiving their property tax bills, many of them containing an increase. As they begin to pay those bills many might be wondering if it’s time for the Governor to pay his as well.

“At this point I think they should go back and add on interest and penalties to his entire bill", says Hansen. "Most taxpayers don’t get no-interest, sweetheart loans like he’s getting."

"If he is looking for guidance he could consult the state tax code and pay the interest rate and penalties that are added on to the bills of those people who fall behind on paying their taxes", concludes Hansen. "Perhaps that would provide some incentive for him to make good on his promise to repay taxpayers.”

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Legislative Staffer Jay Wadd contributed to this story.