ARE LOWER HEALTH CARE COSTS ON THE WAY?
Last Thursday Wisconsin Citizen Action held a press event in the Marathon County Court House to announce a low “out-of-pocket” health plan.
A local health care insurance company has agreed to this plan: WPS/Arise.
Across the country, the cost of health care has gone up in premiums as well as out-of-pocket dollars. In recent years deductibles alone have risen faster than average wages. Consumers are feeling the pinch at all levels of the health system.
The federal government stepped forward to help consumers reduce high health care costs. The feds designed an insurance plan they hope all insurance companies would offer for 2017. The plans are simple to understand and all had much lower out of pocket costs:
$ 0 deductible on all prescription drugs
$ 0 deductible on doctor visits and specialist visits
$ 0 deductibles for mental health or substance use disorder treatments
Research on these plans found they were not likely to increase premiums. Their partial purpose was to encourage people who considered themselves healthy and unlikely to use a full deductible to sign up for coverage that helped them immediately. Getting healthy people covered helps everyone!
However the federal government has let the states decide whether to require insurers to offer these “Low Out-of-Pocket” health plans. States like California, Oregon and Vermont have, but Wisconsin has not. Instead they have allowed insurance companies to decide for themselves whether to offer them.
Citizen Action Organizing Cooperative members took many actions to urge companies to offer these plans, including calls, letters, media events and meeting with company executives.
Five companies have said they plan on introducing these plans for 2017 including Common Ground, Molina Healthcare, Network Health WPS/Arise, Molena and Group Health Cooperative of SEWI. These companies will offer Low Out-of-Pocket Health plans in at least 57 of the 72 Wisconsin counties.
What does this mean for consumers?
Average deductible on prescription drugs will drop from $1450 to $ 0.
Average deductible on doctor visits will drop from $3450 to $ 0.
Total savings for consumers statewide: Between $100-$200 million per year in lower deductibles depending on how many people choose these plans.
These plans help consumers but prescription drug corporations and medical industries are still raising prices. What is needed is increased transparency and oversight to find excessive or unwarranted medical cost increase and stop them.
All of these things can be done in Wisconsin, but only if State government has the will to challenge the pharmaceutical corporations and medical interests profiting off of health conditions. Call your legislators and let them know.