Gov. Scott Walker will use his State of the State speech to roll out a new plan his administration says could help rein in health care costs for about 200,000 Wisconsinites who buy their coverage through the Affordable Care Act’s individual market.

It’s part of a three-part approach on health care Walker will highlight in his Wednesday speech. He also plans to seek a permanent waiver for the state’s prescription drug program and urge the state Senate to approve an Assembly bill that would protect coverage for those with pre-existing conditions.

In announcing the plan, Walker said he routinely hears from people that they want stability when it comes to health care, not just in the markets, but how it affects their lives. But they’re not getting that from Washington, D.C.

“It’s become clear that their failure to act on this issue is yet another call for us to step up and lead,” Walker said.

That call will be part of Walker’s final State of the State speech before he faces the voters this fall for a third term.

Senate Minority Leader Jennifer Shilling, D-La Crosse, lumped Walker’s State of State message in with his push to move up the closing of Wisconsin’s youth prisons and and provide more state aid to small, rural schools while allowing low-spending districts to raise more money through property taxes. She charged he’s looking to find any proposal that will boost his poll numbers in his re-election year.

“Yet again, Gov. Walker is being a political opportunist and is now using the people he denied health care coverage to as stepping stones for his re-election,” Shilling said. “He has done a lot of talking lately, but until I see any action, this is just another empty promise.”

Dems also immediately accused Walker of flipping his stance on Obamacare after years of being a vocal critic and refusing to create a state-run exchange under the law. Along with calling for the law’s replacement, he previously said he’d consider option out of the law’s pre-existing condition rules before saying he would not.

But Walker rejected the suggestion he’s embracing Dem ideas ahead of his re-election.

“I don’t think those are Democrat issues. Those are Wisconsin issues,” Walker said.

The biggest piece of Walker’s health care call is a request to to the federal government for permission to create a reinsurance program for the 200,000 Wisconsinites who buy coverage through Obamacare’s individual market.

The vast majority of Wisconsinites get their health insurance through an employer or a state program. But those in the individual market saw their premiums go up an average of 36 percent this year, though government subsidies offset those increases for most people.

Details of the waiver request have not been finalized. But under an outline from the Walker administration, the new plan would cover catastrophic claims, likely between $50,000 and $250,000, which is similar to Minnesota’s program. The Walker administration believes covering those claims would significantly cut premium increases for those in the individual market.

Walker’s administration estimates the program would cost $200 million with the state picking up $50 million of the costs. The Department of Health Services would be required to cover the $50 million by finding savings through existing state Medicaid funds, while the federal government would pick up the rest of the costs.

To establish the program, the Legislature would have to approve a bill giving the administration permission to seek the needed federal waiver.

Of the two other pieces in Walker’s health care call, one would need federal approval, while the other would need sign off from the state Senate.

The state created the SeniorCare program in 2002, and the federal government has approved waivers to extend it four times. The most recent one, approved in 2015, is scheduled to expire at the end of 2018.

Walker has previously sought to require those on SeniorCare who qualify for the federal government’s plan to sign up for that program. But the Legislature has rejected those moves, and he said it’s been clear that Wisconsin seniors prefer having the state program rather than Medicare Part D.

The Assembly in June approved AB 365, which would ban a group health plan from excluding those with preexisting conditions or placing coverage limitations related to one. The bill was sent to the Senate’s Insurance, Housing and Trade Committee shortly after Assembly passage. But it has yet to receive a hearing or vote in the Senate committee.

State Sen. Jon Erpenbach, D-Middleton, suggested politics was at play in Walker’s move to protect those with pre-existing conditions, questioning why he did not support a similar proposal he co-sponsored with Rep. Daniel Riemer, D-Milwaukee.

“Clearly coverage for preexisting conditions is — and has always been — a huge concern for the people of Wisconsin,” Erpenbach said. Governor Walker did not speak up when President Donald Trump and Congress tried to repeal ObamaCare — it is interesting that he is speaking up now.”

See the Walker release.

See background on the plan.

 

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