Wisconsin’s legislative session runs over a two year period, with the session starting in January of the odd numbered years and ending around May of the even numbered years.  The time between the end of a session and the beginning of one is spent by most legislators trying to get re-elected and challengers trying to unseat incumbents.  For lobbying organizations like WAHU, this time of year is typically spent working with all of the candidates for office trying to educate what will be the next year’s legislature about our industry and the value of the insurance agent.  This year is anything but typical.

As you know, we are still recovering from what was one of the most difficult legislative sessions – engaged in countless reform measures as well as the 600 pound gorilla known as Healthy Wisconsin.  For much of the 2007-2008 session, our industry educated legislators against the possibility of a government takeover of our health care, which would eliminate the job of the insurance agent.  While successful in defeating Healthy Wisconsin, we have all known full well this proposal will be back again next session and our association and industry have been working hard to prepare for the debate once again.  Since the introduction of Healthy Wisconsin and even throughout this summer, all of us have feared the threat of this government take over and believed it would be the end of our industry.  Yet, is it possible we have focused on the wrong threat?  Is it possible we may have mistakenly diverted our attention from what might be a more realistic and viable threat to our industry?

While we are all correct to be very concerned with Healthy Wisconsin, there is a high probability that such a proposal would be challenged in the courts relative to ERISA preemption.  Even in today’s hostile environment about this sacred cow, many experts still believe such a challenge would succeed.  If this is true and Healthy Wisconsin pans out to be nothing more than a diversion of our attention, then what is the real threat to our industry?  Many years ago, the Federal Government created the State’s Children Health Insurance Plan, otherwise known as SCHIP.  In Wisconsin, like many other states, we dramatically altered the intent of SCHIP and instead, created an unnecessary expansion of our Medicaid system.  SCHIP was supposed to provide assistance to uninsured children who met a certain poverty level so they may become part of the insured population.  Even our own association was supportive of the concept (although we disagreed with an expansion of Medicaid and instead offered a proposal to provide vouchers for these children).  Instead, when our state adopted the SCHIP plan, otherwise know in Wisconsin as BadgerCare, we expanded the program to also include coverage for the uninsured parents.  We developed a government run health care system for Wisconsin residents who meet certain income requirements (up to 185% of the federal poverty level), all through our Medicaid system. 

As we all began to accept the program, it was expanded to what is known now as BadgerCare Plus.  BadgerCare Plus includes three phases.  The first phase, which has already been implemented, provides the same coverage as BadgerCare, but it raises the income levels for the parents up to 300% of the federal poverty level and provides for government run health insurance to all children in Wisconsin with NO income requirements.  That means a couple earning $500,000 per year can get taxpayer subsidized, government run, health insurance for their children.  It is important to note that it is the programs intention that only children who have been uninsured for the last 12 months are allowed into the program.  However, the advertising and solicitation materials make any mention of the requirement.  More importantly, how would the state determine if the applicant falsely answered the question.  The point we are making here is even with the best of intentions of trying to avoid crowd out, there is no question that children who were previously insured in the private market will be getting coverage under BadgerCare Plus.

The second phase of the expansion will include coverage for childless adults.  The state has submitted its waiver request to the Department of Health and Human Services and is waiting for approval.  This phase would provide taxpayer subsidized, government run, health insurance for any childless adult who meets certain income requirements.  Remember that Medicaid and SCHIP were intended for children. 

The third phase is a bit more difficult to explain as it is still just a proposal and would need legislative approval.  From what has been discussed and from what we know, the third phase would do the following: