The ongoing Medicaid unwinding process is expected to impact this year’s Healthcare.gov open enrollment period, according to a spokesperson for the state Office of the Commissioner of Insurance.
In an interview yesterday, OCI Director of State Affairs Sarah Smith said the agency hopes to see continued growth in the number of health insurance sign-ups this year. A total of 221,128 Wisconsinites signed up for health insurance during the previous open enrollment period, which is the highest that total has been since 2018, when it reached about 225,000.
While Smith cautioned it’s difficult to make projections for this year, she said the Medicaid unwinding process will likely be the most significant factor influencing this year’s enrollment activity. This is occurring due to the expiration of a pandemic-era government program that temporarily required states to keep Medicaid members enrolled.
Every month, people whose renewal window has opened are working with state health officials to see if they’re still eligible or if they need to secure alternative coverage, she said.
“We really will know best when those final numbers come out at the end of the open enrollment period what that impact has been,” she said. “But there’s certainly a possibility that because people are now being disenrolled from Medicaid after three years … that they may suddenly join a plan on the marketplace.”
Still, she noted some people who no longer qualify for Medicaid are moving to employer-based coverage now that states have resumed determining eligibility after renewals were paused during the COVID-19 pandemic. Smith said the state Department of Health Services is working to encourage those who are newly ineligible for Medicaid to seek health coverage elsewhere.
“So that’s certainly going to have some impact, it’s just hard to know what that’s going to look like,” she said, adding those who lost coverage earlier in the year through this process may also be seeking coverage now.
“This is a very fluid situation, so we just may see some impact from that change. Because certainly it’s a large number of people who are being evaluated for Medicaid renewals over the next several months,” Smith said.
This year’s open enrollment period began Nov. 1 and runs through Jan. 15, 2024.
OCI in October announced Wisconsin’s individual health insurance market on Healthcare.gov has the second-most insurers in the country, with 14. Only Texas has more, while New York and California are just below Wisconsin in the ranking, according to a Kaiser Family Foundation report.
Smith attributes the strength of the state’s market to the Wisconsin Healthcare Stability Plan, a state reinsurance program that holds down rates by covering portions of certain high-cost enrollee claims. The state’s waiver for the program was recently extended by federal officials through plan year 2028, she noted. The total funding for the program is $230 million per year, including both federal and state dollars.
“We know that the stability plan has supported insurers remaining in our market and joining our market, and as we continue to see growth, I think that will hopefully remain … every county in the state having multiple options for health plans is not something every state can say,” she said.
See analysis of Wisconsin’s individual health insurance market here: https://oci.wi.gov/Documents/Consumers/Market_Analysis_Final_Report_Aug2022.PDF
See a map of insurer coverage in the state: https://oci.wi.gov/Pages/Consumers/FindHealthInsurer.aspx
–By Alex Moe
