President's Message

September 2017

Kenneth Schellhase, MD – WAFP President

Kenneth Schellhase, MD – WAFP President

Congress, Cost-sharing Reductions, and Graham-Cassidy

Access to affordable health insurance—and therefore access to medical care—is once again threatened in Wisconsin. Congress’ approach to funding cost-sharing reductions in the Affordable Care Act has at best been inconsistent and poorly thought out, at worst it is undermining the stability of the health care insurance market. On your behalf, WAFP signed a joint statement sent to Senators Baldwin and Johnson. This was also signed by most major medical entities in the state. Highlights of the letter are excerpted below:

Since 2014, Wisconsin’s uninsured rate has dropped nearly 40 percent and we now have one of the lowest uninsured rates in the country. Access to affordable health insurance on the exchange has been a key component of Wisconsin’s successful model of coverage expansion. The availability of premium assistance and cost sharing reductions (CSRs) for lower-income individuals in the exchange has been critical to achieving and sustaining coverage expansion in Wisconsin. Indeed, 83 percent (179,000) of those with exchange coverage in Wisconsin are eligible to receive premium assistance with 51 percent (110,000) also eligible to receive CSRs.

However, the current month-by-month approach to funding the CSRs is leading to increased market instability.  Wisconsin is already seeing the impact as multiple insurers on the exchange have pulled out of our state.  It is anticipated that up to 11 Wisconsin counties in 2018 will have just one remaining insurer option.  Further, without sufficiently funding CSRs, premiums and out-of-pocket expenses will increase and coverage will become unaffordable for thousands of newly insured across Wisconsin. 

A similar letter written from a national perspective was sent by AAFP, along with signatories such as the American Benefits Council, the American Hospital Association, the American Medical Association, the Blue Cross Blue Shield Association, the Federation of American Hospitals and the U.S. Chamber of Commerce.

Gains in access to basic health services are at risk not only from the disarray around cost-sharing measures, but also from the introduction of yet another round of legislation designed to end the Affordable Care Act. According to Senate procedural rules, the Graham-Cassidy-Heller-Johnson Act will be allowed just 90 seconds of debate before a vote is called. This vote will change an industry that is nearly one fifth of our entire economy, and more importantly affect the lives of tens of millions of people. Shouldn’t those ideas be considered and openly debated for longer than it takes to measure a blood pressure?

What can you do?

Speak out now to let your elected representatives know how you feel about this.

Ken Schellhase, MD

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