As open enrollment begins, there may be more Wisconsinites needing Obamacare this year

With October comes more discussions of what people are going to do for health insurance in 2020. And just in time, there are more options on Wisconsin's Obamacare exchanges.

State insurance officials made the announcement Thursday ahead of open enrollment, the sign-up period when people can purchase private health insurance on Wisconsin’s federally run marketplace. Open enrollment starts Nov. 1 and goes through Dec. 15.

"We’re seeing more insurers come in and we’re also seeing those that are in the marketplace expanding into new counties," said Insurance Commissioner Mark Afable.

Sixty-one of Wisconsin’s 72 counties will have three or more insurance carriers. In 2018, 46 counties offered that many options. An interactive map on the Office of the Commissioner of Insurance website shows which insurers are selling plans for coverage that starts in 2020….

Good thing, too. Because there are a lot more near-poverty Wisconsinites that may need to go to the exchanges for their insurance in the coming months. That's because nearly 40,000 people in the state have gone onto Income Extensions for their BadgerCare over the 15 months.

To review, here's how those Income Extensions work.

A BadgerCare Plus extension is a period of eligibility given to a person when the assistance group's income increases above 100 percent FPL either due to an increase in earned income and/or spousal support and otherwise meets the BadgerCare Plus eligibility criteria for people with incomes below 100 percent FPL.

A parent/caretaker relative or pregnant woman can enter an extension due to an increase above 100 percent FPL in the assistance group’s earned income, spousal support, or both. The children, stepchildren, and NLRR children of the parent/caretaker will also enter the extension at this time, provided they are under age 19, living with the parent/caretakers, and meet the income requirements outlined in Section 18.1.3 Children.

BadgerCare Plus members eligible as childless adults are not eligible for an extension.

So many of these people will be losing their BadgerCare if their incomes remain above the poverty line, and because Scott Walker and the rest of WisGOP refused to expand Medicaid beyond the poverty line, it means those individuals are going to have to go to the Obamacare exchanges and/or private market if they want health care.

This might reverse a trend of lower enrollment in ACA exchanges that we had seen in the lst couple of years.

Enrollment on Healthcare.gov has been falling in recent years — both in the state and across the United States.

The 2019 enrollment on Wisconsin’s federal marketplace was down about 9 percent from 2018. This follows a 7 percent drop from 2017 to 2018.

With the significant jump of Wisconsinites on Income Extensions in the last year, I’d have to think that number goes up this year.

Throwing those individuals onto Obamacare exchanges was done by design by Republicans, originally to try to screw it up by overloading the system with higher costs. But once people signed up for the exchanges and Trump became president, the GOPs realized that they would be held responsible if people got screwed over with higher costs and/or less accessible insurance. So they developed a reinsurance scheme that gives subsidies to insurance companies in the hopes that they'll keep premiums down.

And a Wisconsin Public Radio report from this week said if the goal is to keep Obamacare premiums lower, the reinsurance scheme seems to be working.

The OCI credits a reinsurance program adopted by former Republican Gov. Scott Walker for the expanded coverage. Under the program, the government provides money to insurance providers to pay about 50 percent of claims between $50,000 and $200,000. The reinsurance program will lower the average premium by just over 3 percent, according to state insurance officials.

But we also can expect to see more state taxpayer dollars going to the reinsurance plan next year, because of the larger number of people that will have to get their policies via the Obamacare exchange.

It might also make taking the ACA's Medicaid expansion all the more cost-effective, if those individuals' income levels are in the "100-138% of poverty" range that would be covered by expansion, but aren't now. Allowing those working poor individuals to take the fuller coverage of BadgerCare and having the Feds pick up 90% of the cost seems like a better deal than having to pay tens of millions of dollars to insurance companies in the hopes that they won't gouge the daylights out of those low-income people in need of insurance.

So we need to watch closely what happens during the sign-up period for Obamacare exchanges in Wisconsin. If the large increase in Income Extensions are an indicator that a lot more people are going get insurance from the exchanges in 2020, or if they are forced to go without insurance as they can't afford to take what the Obamacare exchanges or their jobs have to offer, it'll be a major disruption for a lot of people at the start of the year.