Issue update on self-funding proposals under consideration by the Group Insurance Board

A new threat to Wisconsin's competitive health insurance market has emerged: regionalization.

DETF collects sufficient data.

Barak Richman (combined clips - 4:46)

Former Wisconsin Insurance Commissioner and Wisconsin Health Information Organization CEO Jo Musser writes in this Milwaukee Journal Sentinel column that the alternative is consolidation--fewer health plans, fewer consumer choices, potential disruption and reduced access.

Self-funding is not the answer for certain employers in competitive markets. In some cases projected savings never materialize, costs grow, choices are lost and care is disrupted. This subject was explored in a recent analysis in industry newsletter HCTrends.

The results of a request for proposals (RFP) to evaluate self-funding can provide a vendor's projections of administrative costs, but the full impact of the proposed change cannot be determined from proposers' cost projections. The Benefit Services Group explains there are serious considerations beyond the scope of the RFP process that should be explored, including the potential harm to Wisconsin's competitive health insurance market.

The Benefit Services Group describes Wisconsin's unique State Group Health Program and competitive health insurance market and explains why Wisconsin will not reap many of the benefits of self-funding. Projected savings may never be realized, putting at risk the State Budget and funding for other state programs. Self-funding would also create disruption and instability in the market and increase costs for the state.

A 14-member coalition delivered a memo to Governor Scott Walker November 14 to state its concerns about the impact self-funding the State Group Health Program will have on consumers, the competitive health care market and the state.

A 1980s newspaper story highlights the positive attention Wisconsin received for controlling State Group Health Program costs by switching to a market competition model.

Analysis of the State Group Health Program enrollment directly affected by the Group Insurance Board self-funding decision.

Membership counts, distributed to health plans March 7, 2017.

Market competition expert Barak Richman was the main speaker at the 2016 Education Program. The Duke University professor of law and business said more competition in health care and health insurance markets results in lower costs and higher quality. He said other states can learn something from Wisconsin, which has the most competitive health insurance market in the country.

Chair of the Antitrust and Trade Regulation Practice Group at Godfrey & Kahn and former Wisconsin Assistant Attorney General, Kevin O'Connor said Wisconsin's competitive health insurance market was developed over time through enforcement of antitrust laws, smart health care purchasing decisions by the state and avoidance of anti-competition regulations. He said self-funding the State Group Health Program could undermine many of Wisconsin's historical pro-competition policies and their positive results.

UW Business School Professor Justin Sydnor presented two visions for Wisconsin health care. He said research is broadly supportive of the vision that represents Wisconsin's competitive health care and insurance markets.

Broker and consultant Gerald Frye of The Benefit Services Group said Wisconsin's current health insurance structure is delivering a high level of value and state budget stability. He said the reasons many states and employers self-fund don't apply to the State Group Health Program.