From WisPolitics.com/WisBusiness.com …
— Insurers seeking ACA plan premium increases in Wisconsin for 2027 say rising medical costs and greater use are driving their double-digit requests, while advocates raise concerns about affordability.
Health insurers in the state are requesting an average premium increase of 20.9% for next year, according to rate review filings posted online. All 12 of the insurers that proposed rates for the state’s Affordable Care Act marketplace are requesting increases, ranging from about 11% to more than 30%.
These proposals reflect the insurers’ experience in the prior year, including how many people were enrolled, what was spent on their medical care and other factors, including broader economic trends such as the impact of tariffs. That’s according to Natasha Murphy, director of health policy for the Center for American Progress, which advocates for progressive policies.
“This year, among some of the filings I’ve seen elements like, you know, even the fact that people are losing coverage, we expect the risk pool to be sicker and therefore cost us as the insurer more moving forward,” Murphy said in a recent interview.
While the regulated review process for these proposals is underway, she expects decisions to be made by the end of August on final rates for next year. Then by late September or early October, commissioners and other regulators around the country will release final lists of which insurers are operating in their marketplaces, Murphy explained.
Wisconsin’s Office of the Commissioner of Insurance confirmed information about participating insurers, service areas and rates is typically available in October.
Of the 12 insurers that requested rate increases in the state, five responded to requests for comment on their proposals.
Common Ground Healthcare Cooperative, which is proposing the largest increase across its plan categories at 30.88%, said its proposal reflects the expected cost of providing coverage in the coming year and aims to “ensure we can continue to provide high-quality coverage” for its customers.
“Like most Marketplace insurers, CareSource is navigating rising medical and pharmacy costs, a changing regulatory environment and increased market uncertainty,” a spokesperson wrote in an email, referring to the insurer’s parent company.
Compcare Health Services Insurance Corporation, which operates as Anthem Blue Cross and Blue Shield in Wisconsin, is requesting a 16.48% rate increase. Spokesperson Emily Snooks says the company’s proposed rates are “a direct reflection of local healthcare costs,” arguing Wisconsin has some of the highest costs in the country.
“Anthem has served Wisconsinites for more than 80 years and we remain committed to lowering health care costs by negotiating reasonable rates for care and ensuring health benefits and services are designed to prioritize high-quality care,” Snooks said in a statement.
Meanwhile, Healthpartners Insurance Company is requesting a 15.59% increase, based on anticipated changes in healthcare utilization and benefits. A spokesperson for the insurer said the increase accounted for expected “future medical inflation” and benefit changes between this year and next, based on shifting state and federal regulations.
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— The measles outbreak in southwestern Wisconsin has now grown to 15 confirmed cases and six probable cases, as health officials say further spread is likely.
“The rapid emergence of these cases, particularly among people who have not traveled outside of Wisconsin, indicates that there is active local transmission, and it’s very likely that additional cases exist in the community that have not yet been identified or reported to public health,” Dr. Ryan Westergaard of DHS said today during a call with reporters.
Westergaard, the chief medical officer for the state Department of Health Services’ Bureau of Communicable Diseases, said the agency’s public health team is working with local health departments in Lafayette and Iowa counties to trace and contain the outbreak with help from the CDC.
While the agency hasn’t identified any public exposure locations, it’s interviewing those who’ve been infected to determine who may have been exposed.
“This is pretty typical early stage of an outbreak where there is community transmission, one person can lead to the transmission of multiple other people depending on the number of contacts they have,” Westergaard said. “So we don’t believe that we’ve identified every single case but that is our goal.”
While the outbreak hasn’t resulted in any hospitalizations, he also noted 95.7% of cases have occurred among people who haven’t been vaccinated against the virus.
Wisconsin has now had 17 confirmed cases of the measles so far this year, including two from January in Dane and Waukesha counties.
See more at the agency’s outbreaks page.
— DHS Secretary Kirsten Johnson says the agency is “deeply concerned about the lack of scientific evidence” in statements from federal officials, following President Donald Trump signing an executive order upending childhood vaccine recommendations.
The state Department of Health Services today issued the statement from Johnson.
She says Trump’s order “does not change our approach” or previous statements, noting DHS continues to endorse vaccine schedules from the American Academy of Pediatrics and the American Academy of Family Physicians.
Johnson today warned of potential impacts on the health of Wisconsin children from the order, which aims to space out certain childhood vaccines, running counter to recommendations from the medical community. That includes the MMR vaccine that covers measles, mumps and rubella.
“Health professionals and parents deserve accurate, credible information,” Johnson said. “There is no new scientific evidence that justifies changing recommendations that have, and continue to, protect children across the United States.”
See the full statement in press releases below.
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Press Releases
