Governor’s Reinsurance Proposal Could Help Lessen Key Problem in ACA

Wisconsin is on track to join states such as Minnesota and Oregon that have a program to help lessen the problems with the Affordable Care Act.

Gov. Scott Walker, a longstanding opponent of the law, has proposed using a mix of federal and state dollars to lower premiums — or at least check future increases — for insurance sold directly to individuals and families.

The proposed program would pay as much as 80% of the insurance claims of people with high medical bills, lowering insurers’ costs and enabling them to set rates with more certainty.

The program, known as reinsurance, addresses one of the key problems with the Affordable Care Act: The health plans have drawn too many people with high medical bills and not enough healthy people to offset the costs.

That has contributed to health insurers incurring large losses that lead to steep increases in premiums. The hope is that a state-run reinsurance program would lower rates and pull more healthy people into the market.

A similar program in Minnesota is estimated to have lowered premiums by 20% compared with what they would have been otherwise this year. Reinsurance also has worked well in the market for Medicare prescription drug plans, known as Part D, sold by private health insurers.