ACA

Some expect problems with health insurance exchanges

2013-09-23T06:30:00Z 2013-12-17T11:29:41Z Some expect problems with health insurance exchangesMICHAEL BURKE mburke@journaltimes.com Journal Times

RACINE COUNTY — Now we know which insurers will offer health plans via the new Affordable Care Act exchanges. What remains to be seen is how well they’ll work.

In this county the exchanges, which are supposed to go live Oct. 1, will offer four insurers for individuals and two for small employers, which would shop at a separate exchange, the state announced Thursday.

The exchanges are where people who must buy their own health insurance will have to shop. That group will include current BadgerCare members who exceed 100 percent of the federal poverty level or anyone who is uninsured.

Marquette University Law School professor Alison Barnes, an expert on the ACA, said about Racine County’s exchange options east of Interstate 94, “The problem that you’re having is a common one throughout the country: Some markets have many providers ... and some markets only have one.”

On the flip side, Barnes said, “If you only have two or four choices, you only have so much investigating to do.” As for how easy or difficult that comparison shopping will be, Barnes said, “I think in Wisconsin it’s going to be tough.” Other states have worked to set up their exchanges so comparisons are as easy as possible.

“That kind of clarity, you’re not going to see it (in this state) on Oct. 1,” she predicted. Gov. Scott Walker’s decision that Wisconsin would not set up its own ACA exchange throws state residents and businesses onto the federal exchange.

The Journal Times has been reporting on the new national health care law for months and will continue to do so, including consumer-oriented national and local coverage in the days and weeks to come. For stories so far and other resources, visit us online at journaltimes.com/healthcare.

Someone who sees several potentially sticky issues with the list of insurers on the exchange is Mike Farrell, president of the Wisconsin Employee Benefits Advisors Association. He is an employee benefits consultant at David Insurance, 1300 S. Green Bay Road, who advises public and private employers on health insurance options.

“Common Ground is a co-op with no history of insuring anybody for anything ... but they have been approved to participate,” Farrell commented.

“Who is not participating is every big insurance company you have ever heard of,” Farrell added, naming Anthem Blue Cross, Humana and UnitedHealthcare. All are David Insurance clients on group health insurance options.

Common Ground was created by the ACA and a $56.4 million federal loan just to sell insurance on the exchanges. Therefore it has no track record, Farrell pointed out.

Barnes said about the untested Common Ground’s role, “It’s certainly important and could be very technical in certifying what kinds of policies can be sold. You could do this at many levels of expertise, and I don’t know what they’re bringing to the table.”


In Racine County, the choices for people who buy insurance plans as individuals on the new Affordable Care Act exchanges which are scheduled to become active Oct. 1 are:

• Common Ground Healthcare Cooperative, which covers both Wheaton Franciscan providers — which includes All Saints hospital, 3801 Spring St. — and Aurora providers through Common Ground’s Trilogy network.

• Compcare Health Services Insurance Corp., which administers the health plans sold under the Anthem Blue Cross name. The network is predominantly built around Aurora Health Care providers and does not include Wheaton Franciscan facilities.

• Molina Healthcare of Wisconsin. A search for Racine-area hospitals on the Molina website Thursday turned up some Wheaton Franciscan facilities, but not All Saints hospital on Spring Street. It did show Aurora Memorial Hospital of Burlington.

• Arise Health Plan, a Wisconsin Physicians Service offering. As of late last week, the Arise website shows the Aurora facilities and network, but none for Wheaton Franciscan.

The choices for employers on a separate exchange:

• Common Ground.

• Arise.


Tell us your health care story

The Journal Times has been reporting on the new national health care law for months and will continue to do so, including consumer-oriented national and local coverage in the days and weeks to come.

For stories so far and other resources, visit us online at journaltimes.com/healthcare.

At that page, click on “Tell us your health care story” if you will be willing to speak with a journalist about the health care experience you’ll have under the law — good or bad.

Copyright 2016 Journal Times. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

(20) Comments

  1. sportnut
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    sportnut - September 25, 2013 8:54 am
    With your total lack of understanding of the issues I feel darn sorry for your 54 employees. What do they do, go to the state capital and shine walkers shoes??? You are a joke. Go back and hide under the rock you came out from !!!
  2. shamuplease
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    shamuplease - September 24, 2013 11:55 pm
    It has nothing to do with compassion, and everything to do with common sense. We are a nation of makers and takers, and under this president the takers will soon outnumber the makers. Read the USA Today, President Obama and President Clinton making the rounds to sell the plan. The presidents themselves are aware the american people don't with this to happen. Neither can understand why. Really a couple of ivy leaguers don't realize they will kill the folks in the middle with this. After all who is gonna pay for this? the folks in the middle & seniors that's who. They are out in mass trying to get young adults to enroll "don't worry it will cost the price of a cell phone plan". I can tell you as an employer of 54, no one under the age of 30 has ever opted in even at $72 a month.
  3. granny grits
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    granny grits - September 24, 2013 5:50 am
    Why would you be so anxious for your predictions to come true? Are you really that petty, vindictive and lacking in compassion for your fellow man.

    And if you are cheering Senator Cruz quixotic focus on defunding ACA you'll be very disappointed to know that McConnell and McCain both refuse to go along with his game.

    Mr. Cruz, after sending out the memo that Monday in the Senate was clothing optional day, was the only one who turned up naked.
  4. actualfacts
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    actualfacts - September 23, 2013 7:52 pm
    Since the unions couldn't get exceptions for Obamacare now the unions are saying it is a trainwreck. Unions thought their buddy Obama would give them exception and again have others pay their way. Liberals always want others pay their way, another example of little boys in society expecting daddy to pay for everything. Liberals are known as children for a reason.

    Obama is not giving them exceptions but all his other friends are. I think when the unions failed to unseat the ultimate grownup rockstar in Wisconsin Walker, the unions are now weaker and therefore offer little to the Democrats in terms of campaign money now. Democrats are cutting their ties to the unions just like they would cut ties to their mother for a $1 million.
  5. actualfacts
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    actualfacts - September 23, 2013 7:47 pm
    At least we would have our jobs and have lower premiums. Tell me, how is bankrupting the country going to help the poor? Yep liberal logic at its best.
  6. con
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    con - September 23, 2013 6:36 pm
    Yes. obamacare is not going to be free. I know this infuriates those who have been riding on the backs of the employed. Time to stop making excuses for yourself and take some personal responsibility.
  7. I Come In Peace
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    I Come In Peace - September 23, 2013 3:02 pm
    Y@actual - you know what hurts? People who think that Chris Conover is unbiased, he is a writer for the The Weekly Standard (never been profitable - supported by wealth Conservatives) and the American Enterprise Institute (a right wing think tank). Next time don't post a link to a biased article to support your point, it's a waste of time.
  8. I Come In Peace
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    I Come In Peace - September 23, 2013 2:54 pm
    So you are apparently ok with the alternative which is paying for people without insurance any way.
  9. actualfacts
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    actualfacts - September 23, 2013 2:36 pm
    Why should we pay for this? These ignorant liberals wants this I say send our side of the bill to them. We already are getting taxed enough already on our failed education and their welfare freebies they already get. Why do we need to pay for their healthcare when we can barely afford it ourselves? They wanted it, they voted for the joker than is Obama so they should all own it which means pay it. Anybody who voted for Obama and his ragtag team of ideological community dividers should be left hanging. Time for them to know what accountability really is!
  10. actualfacts
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    actualfacts - September 23, 2013 2:32 pm
    Right on.

    http://www.forbes.com/sites/theapothecary/2013/09/23/its-official-obamacare-will-increase-health-spending-by-7450-for-a-typical-family-of-four/
  11. Green Racinereal
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    Green Racinereal - September 23, 2013 2:23 pm
    Can't wait to see the massive cut in full time jobs and added costs. I hope to God all you Obama voters see the full effect on you. Long waiting times being told you cant get some treatments, welcome to your nightmare
  12. shamuplease
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    shamuplease - September 23, 2013 1:50 pm
    ACA , will be a failure nation wide, Walker said exactly the right thing. He is shielding residents from runaway healthcare expenses. And the expenses will be huge.
  13. sportnut
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    sportnut - September 23, 2013 1:50 pm
    Where did this ignorant king come from??? He continues to open his yap without knowing what he is talking about. He would make a great buddy to the Koch boys. Maybe he should call walker to see if he can carry his water for him!!! Sick Sick /sick
  14. NonUnion Workin' Man
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    NonUnion Workin' Man - September 23, 2013 12:36 pm
    The added costs imposed on taxpayers thru ObamaCare is enough to give each of the 30 million (BS Number) uninsured takers it was supposed to aide... more than $3.5 million EACH!!!
    DeFund this treasonous and criminal train-wreck now!
  15. JT fact checker
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    JT fact checker - September 23, 2013 11:22 am
    Wait until the peeps find out that Obamacare is not free.
  16. sportnut
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    sportnut - September 23, 2013 11:08 am
    Absolutely--you are correct. Walker does not care one bit if he hurts Wisconsin residents. Whatever is best for scottie and his political future is the only thing that counts---forget what is best for Wisconsin. He should go back into the gutter from where he came.
  17. ordmm
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    ordmm - September 23, 2013 9:26 am
    rak.....ACA is a product of the Federal Government. Who better to administer the ACA than the agency that created it? Obama wanted the ACA, The Dems rammed it through, let them deal with it.
  18. speaking frankly
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    speaking frankly - September 23, 2013 8:47 am
    "Some expect problems with health insurance exchanges" NO - REALLY? What have people been saying all along? Total train wreck
  19. rak
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    rak - September 23, 2013 8:28 am
    Walker purposely took the steps he did regarding the ACA so that it would be a failure in Wisconsin and he could say, "I told you so." Nice of him to stick it to our state.
  20. ride2fast4me
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    ride2fast4me - September 23, 2013 7:15 am
    What a mess, how can you not cover Wheaton in Racine. This whole thing needs to be delayed and fixed before they try to roll it out...
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