Gov. Doyle: Highlights success of national health insurance reform on six month anniversary

Contact: Laura Smith, Office of the Governor, 608-261-2162

MADISON – Governor Jim Doyle today recognized the successes of national health insurance reform in Wisconsin on the six-month anniversary of President Obama signing the legislation. This historic law is already benefiting families and small businesses throughout the state.

“Six months ago, President Obama signed into law a historic step forward for health care in America and in Wisconsin,” Governor Doyle said. “National reform will help extend coverage to more than 32 million Americans, and more than 125,000 Wisconsin residents. Already today, Wisconsin is America’s health care leader because of the work we have done over the past seven and a half years. And I’m going to work hard until my last day in office to do as much as I can to help Wisconsin take advantage of health care reform.”

A number of key provisions in the health care law go into effect today. These provisions will help small business owners and their employees, children, young adults, and people who for years have been denied coverage because of a pre-existing condition.

Because of national health care reform, after today:

* No American child with a pre-existing condition can be denied coverage under their parents’ health care plan;

* There can be no annual or lifetime limits on essential benefits;

* Insurance companies cannot drop your coverage just because you get sick;

* You won’t be charged co-pays or deductibles for preventive care – so no one will have to put off a flu shot or a mammogram because they can’t afford one;

* Coverage of emergency services are not subject to prior authorization; and

* Young adults up to 26 will be able to stay on their parents’ insurance plans while they look for a good paying job with benefits – something that is already happening in Wisconsin.

Other key parts of national health care reform are already benefiting people throughout the nation. Already, in the past six months:

* The donut hole in Medicare Part D has been effectively eliminated as seniors have gotten rebate checks;

* Parents who keep their young adult children on their health plans have received a federal tax cut;

* Adults with pre-existing conditions who struggle to find affordable coverage have been given a new option through Wisconsin’s high risk pool plan;

* State universities and teaching hospitals have received millions to train more doctors and nurses, including UW-La Crosse, Viterbo College and Franciscan Skemp;

* More than 50 large employers have qualified for grants to cover up to 80 percent of the costs of covering their early retirees, with more Wisconsin companies being approved every day; and

* Small businesses that choose to offer coverage are beginning to receive tax credits to help make employee coverage more affordable.

In the first six months, national health care reform has brought more than $100 million into Wisconsin – for the public and private sector combined. In the years to come, Wisconsin will receive billions of dollars to help employers, public health and state taxpayers.

By 2014, Wisconsin will launch an online health care marketplace – a one-stop, online resource where business owners and families find apples-to-apples comparisons of what health plans are available in their area, what benefits they cover and exactly how much they cost. Consumers will have access to information in an easy to understand format, and by combining their purchasing power, individuals and small business owners will have access to greatly reduced premiums. Nationwide, more than 13.5 million new employees will have employer-sponsored health care through the exchange, because for the first time in years health insurance will be affordable for small- and medium-sized businesses.

Some examples of people being affected by national health care reform include:

Gillian Sender of Cudahy changed jobs last year and lost her group health insurance. Gillian had been blessed with good physical health and practiced a healthy lifestyle by not smoking, eating well and exercising almost daily. In July of this year, Gillian was diagnosed with cancer. She was terrified because she knew with the pre-existing health condition, it would be very difficult for her to obtain affordable insurance. Family members informed her about the temporary High Risk Pool that went into effect on August 1. She is now covered and has had surgery and her prognosis is very good. She will begin chemotherapy on Monday and after that, radiation. Because of the HIRSP Federal plan, she is now able to receive the medical care she needs.

Joan Schneider, a 67-year-old retired school teacher who lives in River Falls, feels the pain of the Medicare Part D prescription drug donut hole nearly every day. Joan, who is on Medicare, was thankful to receive her $250 rebate check after falling into the donut hole earlier this year, and is thrilled that under the new health care law she will be getting a 50 percent discount on brand name drugs beginning in 2011 once she reaches the coverage gap. Each year, Joan falls into the donut hole where she must pay full price – $1,000 per month – for her expensive diabetes and cholesterol drugs while she is in the coverage gap. Every year after 2011, Joan will pay less for her drugs until 2020, when the gap closes entirely and she will pay no more than a 25 percent co-pay.

Elizabeth Fleig, 21, is a college senior at UW-La Crosse. Elizabeth is a cancer survivor and was diagnosed with Type I diabetes when she was five. She had a birthmark that needed to be removed when she was young for fear that it would turn cancerous. Unfortunately, the birthmark returned and she was diagnosed with cancer at age 19. Elizabeth underwent two additional surgeries to remove the cancer and is now cancer free. She is currently covered under her parents’ health plan and is relieved to know that if she doesn’t get a job right away after graduation, she can keep her coverage.

Tracy Wirtanen of Appleton has a son, Sami Wirtanen-DeBenedet, with neurofibromatosis, a disorder that affects one in 3,000 children and causes tumors to grow anywhere in the body. Because there is no cure for the condition itself, the only therapy for people with neurofibromatosis is a program of treatment by a team of specialists to manage symptoms or complications. Surgery may also be needed when the tumors compress organs or other structures. Tracy’s plan currently has a lifetime limit on care that Sami could easily reach with her condition. Under the Affordable Care Act, Sami’s plan will be banned from imposing a lifetime limit on his care. Tracy and Sami attended an event with President Obama today to share their story.

Under Governor Doyle’s leadership, Wisconsin has built one of the best systems of health care access through BadgerCare Plus, BadgerCare Plus Core, SeniorCare and FamilyCare. Wisconsin is now America’s health care leader, ranking first for health care quality, second in access to coverage, and providing health care access to every child. Governor Doyle has also positioned Wisconsin as a leader in e-health and quality initiatives. National health reform builds on Wisconsin’s health care successes and will bring $750-980 million in additional federal funding to the state, providing real relief to Wisconsin taxpayers.