Friday, May 11, 2018

As Wisconsin's uninsured rate rises, Walker flails to fix the problems he caused

The Gallup organization consistently has consistently polled Americans nationwide asking whether they have health insurance for several years, a statistic that has taken on extra interest after the passage and implementation of the Affordable Care Act (ACA).

Gallup does quarterly surveys and one large year-end operation to figure out this rate, and we started seeing warnings last year that the progress that had been made in reducing the uninsured rate since 2013 under the ACA was coming to an end. But this week Gallup put out their full-year report for 2017, which breaks the figures out by state, and things looked noticeably worse.
The uninsured rate rose by statistically significant margins in 17 states in 2017, the first time since the full implementation of the major mechanisms of the Affordable Care Act (ACA) in 2014 that any state had a rate increase. Also, for the first time since 2013, no states had a [statistically significant] lower uninsured rate than the previous year….

Nationwide, the uninsured rate climbed to 12.2% by the final quarter of 2017, up 1.3 points since the low point of 10.9% measured in the last quarter of 2016. Since Gallup-Sharecare's measurement began in 2008, the national uninsured rate reached its highest point in the third quarter of 2013 at 18.0%, and thus the current rate, although up, remains well below this level.

These data, collected as part of the Gallup-Sharecare Well-Being Index, are based on Americans' answers to the question, "Do you have health insurance coverage?" The state-level data are based on daily surveys conducted from January through December 2017 and include state-level sample sizes that range from 465 randomly selected adult residents in Delaware to more than 17,000 in California.
And yes, Wisconsin was one of those 17 states who saw a significant increase in their uninsured population for 2017.

In the "timing is everything" category, the Gallup report came out two days after Walker Administration officials were traveling the state claiming that their method of turning down the fully-funded Medicaid expansion and instead relying on the insurance exchanges to cover many of those people was a success.

We're not in the Top 10 anymore, John. Not only did Wisconsin have one of the largest increases in its uninsured rate (11th out of the 50 states), it slipped badly in a statistic it had previously done well in – keeping its citizens from being uninsured.

Wisconsin rate, ranking for least uninsured
2013 11.7% (8th)
2016 6.2% (Tied for 7th)
2017 8.3% (Tied for 15th)

I’ll give Kos the benefit of the doubt and assume he didn’t know this Gallup survey would make him sound stupid and make his claims wrong and outdated. It sounds better than the other theory- that Koskinen was flat-out lying to an outstate audience and media who wouldn’t check up on his claims.

Given that there were few other changes in health insurance conditions for 2017, the increase indicates that more people chose to go uninsured than pay the costs for an insurance program on the ACA exchanges last year. Which means the pre-election GOP sabotage of Obamacare (especially Marco Rubio’s bill to stop subsidizing risk corridors, which had previous encouraged companies to offer services and keep premiums down) was a key reason behind more Wisconsinites not being insured last year.

Exchange premiums rose more in 2018 due to other GOP sliminess, and that was especially true in Wisconsin, whose GOP-led insurance commission assumed (correctly) that the Trump Administration would do further damage by stopping $7 billion in cost-sharing payments to insurers. Much of those 2018 price spikes were offset by the tax credits, but the GOP's moves in DC made it likely that Wisconsin’s uninsured rate would rise again this year.

There’s one other complication going on that especially hits working poor Wisconsinites. Given that 5 out of 6 of Wisconsin enrollees on the 2016 ACA exchanges got tax credits (available to lower-income individuals) to offset some of their premiums, it seems likely that a lot of those individuals that lost their health insurance in 2017 would also be some of the 75,000 Wisconsinites that are susceptible to losing food stamps in the proposed GOP Farm Bill in Congress.

Passage of that Farm Bill would likely spiral this already alarming increase in Wisconsinites without health insurance higher, as losing SNAP assistance would understandably drive some people into dropping their health insurance in order for the families to keep eating.

Ironically, part of Scott Walker’s cynical goal behind refusing to take expanded Medicaid in the ACA was to see Wisconsinites suffer by having the exchanges be overloaded with high-cost, low-income individuals, and cause people to be angry with Obama and Democrats. Except that Wisconsinites signed up for the exchanges in big numbers (especially in Northern Wisconsin, where Sean Duffy’s district had the most exchange sign-ups in the state), and the state’s uninsured rate was nearly cut in half through 2016.

Now in 2018, Walker’s cynical plan is coming to fruition due to his own party’s chicanery, under a president that’s not Obama. And now Scotty has to face an increasingly uninsured electorate in November. OOPS!

This helps explain why Scotty and his Insurance Commission put together a scheme to pay insurers $200 million ahead of the October 2018 open enrollment period. The hope is that the insurance companies will offer lower premiums for people looking to buy coverage, and then the Feds will pay back most of the difference because they won’t have to pay back as much in tax credits.

But many of these problems and stresses wouldn’t have existed if Walker and the rest of the GOP hadn’t have messed with Obamacare in the first place (AND FOR WHAT, by the way?). Look, I don’t think the ACA was a magic pill that solved all of the problems the US has with health insurance costs and coverage (single-payer or at least a public option is necessary to do it right), but you can’t argue that it was better than what we had before 2010.

Now that the GOP’s own sabotage is threatening to cause major political problems for Republicans this November because of the higher premiums and increased number of people without insurance in the Age of Trump, it is both hilarious and disgusting to see people like Scott Walker try to come up with “solutions” to the problems that they caused.

We are sliding badly in Wisconsin because of Walker’s and WisGOP’s spiteful decisions, and dropping toward mediocrity on having our people covered by health insurance is something all of us should be sickened by. And it won’t get better unless we toss out these saboteurs in 6 months.


  1. "We managed to pull that off without expanding Medicaid."

    That's a lie too: Wisconsin did expand Medicaid, merely in the manner that had the greatest possible cost to Wisconsin taxpayers (extending regular Medicaid to all under 100% of the FPL with ~55% of the cost paid by the Federal government rather than taking ACA Medicaid expansion with 100% initially and 90% ultimately paid by the Feds).

    1. Right, it has cost state taxpayers billions over the last 5 years to cover those extra costs.

      Walker could have chosen to take the Medicaid money, fix the roads, and adequately fund K-12 and the UW. He and the GOP CHOSE not to.

  2. Nothing Scott Walker has done from the minute he entered the governor’s office has ever been intended for the betterment of Wisconsin...only for the betterment of his presidential ambitions.

    Simply being a competent governor who wisely managed his state was no way to make a name for himself nationally. He had to be bold. Flashy. He had to be the GOP rock star. Hence Act 10...refusing a federal dime for anything from Obama...and everything else he’s done to destroy this beautiful state and its citizens.

    And he WAS a rock star, for about two minutes. Then he flamed out, and now, of course, he is stuck cleaning up his own messes.

    In spirit of cleaning up messes, let’s take out the trash this November, Wisconsinites.