Health Care Coverage Profile:

Wisconsin

HEALTH COVERAGE AT A GLANCE i

More Wisconsin residents get their insurance from employer sponsored insurance plans (59.5%) than the
national average for this type of insurance 52.3%.

Meanwhile, less Wisconsin residents are covered under public plans when compared to the nation at large.
Only 13.2% of Wisconsin residents get their health insurance through Badger Care, Wisconsin’s Medicaid
program. Additionally, Wisconsin residents are far less likely to be uninsured than the average American.
Only 9% of all Wisconsin residents are uninsured compared to 15.4 % of Americans.

Health Insurance Coverage of the

Total Population of Wisconsin Compared to United States

Employer
56.8 4.7 12.4 15.4 Individual
United States 14.1 1.2
Medicaid
Medicare
5.1 15.2 9.8 Other Public
Wisconsin 52.3 12.9 0.3 Uninsured

0% 20% 40% 60% 80% 100%

CHANGES IN INSURANCE COVERAGE TYPE IN WISCONSIN ii

While Wisconsin residents are less likely to be uninsured than the typical American, the rate of uninsured is
rising rapidly in Wisconsin. Between 2007 and 2008, Wisconsin experienced a 1.7% increase in the
percentage of its population without health insurance.

The primary reason for the increase in uninsured comes from the fact that less Wisconsin residents are
able to get insurance through employer-sponsored plans. Moreover, the drop in employer sponsored
insurance coverage does not correlate to any measurable increase in the unemployment rate, as the
unemployment rate in Wisconsin remained at 4.8% between 2007 and 2008.iii Instead, Wisconsin firms
have simply stopped offering health insurance all together.

To make matters worse, high insurance premiums are forcing a greater number of Wisconsin residents out
of the individual insurance market. The combined effect of the decrease in employer sponsored insurance
and the decrease in individual insurance has overburdened state and federal programs, which proved

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National Coalition on Health Care July 2010
unable to absorb the influx of residents.

Wisconsin: Percent Change Among Non-elderly by Coverage Type, 2007-2008 iv

Wisconsin U.S.
Employer Sponsored Insurance -3.6% -1.2%
Individual Market -0.6% -0.2%
Medicaid 2.1% 1.0%
Other Public 0.5% -0.2%
Uninsured 1.7% 0.2%

A SUMMARY OF PROVISIONS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA)RELATED
TO HEALTH INSURANCE COVERAGEv
Individual Mandate
Starting in January of 2014, all individuals will be required to have a certain minimum level of health
insurance. Failure to purchase a minimum level of health insurance will result in a penalty of no greater
than $695 for an individual or $2,085 per family. The individual mandate is expected to help decrease the
number of uninsured in Wisconsin.
Health Insurance Exchanges and Federal Subsidies
Each state will create and administer a health insurance exchange. There will be two separate exchanges,
one for individuals seeking to purchase insurance on the individual market and another for employers. The
Department of Health and Human Services (HHS) will establish a minimum benefit package that insurance
companies must offer if they wish to be included in the exchange. Wisconsin residents who earn between
133% and 400% of the federal poverty levelvi may be eligible for individual tax credits.
Employer Coverage
As of 2007, 10.1% of Wisconsin's working population was uninsured.vii Generally, small businesses cannot
afford to offer health insurance; thus, only 37.6% of private businesses with fewer than 50 employees
offered health insurance, while 98.6% of private businesses with more than 50 employees offered health
insurance.viii In order to help small business employees gain access to employer-based health insurance
coverage, ACA provides a tax credit to qualifying small businesses that offer health insurance.
Additionally, while ACA does not require employers to provide health insurance to employees, employers
with 50 or more employees will be assessed a fee of $2,000 per full-time employee (excluding the first 30
employees) if they do not offer coverage and if they have at least one employee who receives a premium
credit through an exchange.
Medicaid Expansion
Medicaid will be expanded to all individuals under age 65 with incomes up to 133% of the federal poverty
level. This will establish a minimum eligibility threshold throughout the 50 states and will eliminate a
limitation on the program that prohibits most adults without dependent children from enrolling in
Medicaid. The new legislation may make approximately 128,000 previously uninsured Wisconsin residents
eligible to join Medicaid.ix

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National Coalition on Health Care July 2010
i
THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured
estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual Social and Economic
Supplements), available at http://www.statehealthfacts.org:/comparetable.jsp?ind=125&cat=3 (last accessed June 2010).
ii
Unless otherwise cited: THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on
Medicaid and the Uninsured estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual
Social and Economic Supplements), available at http://www.statehealthfacts.org/comparetable.jsp?ind=165&cat=3 (last accessed July
2010).
iii
BUREAU OF LABOR STATISTICS, Over-the-Year Change in Unemployment Rates for States Annual Average Rankings: 2007-2008, available at
http://www.bls.gov/lau/lastch08.htm.
iv
THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured
estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual Social and Economic
Supplements), available at http://www.statehealthfacts.org/comparetable.jsp?ind=165&cat=3 (last accessed July 2010).
v
Unless otherwise cited: The Kaiser Family Foundation, Summary of New Health Reform Law (2010), available at
http://www.kff.org/healthreform/upload/8061.pdf (last accessed June 2010).
vi
The federal poverty level for the 48 contiguous states is $10,830 for a single individual. ASSISTANT SEC'Y FOR PLANNING AND EVALUATION, U.S.
DEP’T OF HEALTH & HUMAN SERVS. THE 2009 HHS POVERTY GUIDELINES (2010), available at http://aspe.hhs.gov/poverty/09poverty.shtml (last
accessed June 2010).
vii
COVER THE UNINSURED, ROBERT WOOD JOHNSON FOUNDATION, U.S. UNINSURED WORKERS, available at
http://covertheuninsured.org/uninsured_workers#map (last accessed June 2010). These figures are from 2006-2007.
viii
U.S. DEP’T OF HEALTH & HUMAN SERVS. MEDICAL EXPENDITURE PANEL SURVEY (2008), available at
http://www.meps.ahrq.gov/mepsweb/data_stats/summ_tables/insr/state/series_2/2008/ic08_iia_f.pdf (last accessed June 2010). These
figures are from 2008.
ix
JOHN HOLAHAN & IRENE HEADEN, KAISER COMMISSION ON MEDICAID AND THE UNINSURED, MEDICAID COVERAGE AND SPENDING IN HEALTH REFORM: NATIONAL
AND STATE‐BY‐STATE RESULTS FOR ADULTS AT OR BELOW 133% FPL 41 (2010), available at http://www.kff.org/healthreform/upload/Medicaid-
Coverage-and-Spending-in-Health-Reform-National-and-State-By-State-Results-for-Adults-at-or-Below-133-FPL.pdf (last accessed June
2010).

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National Coalition on Health Care July 2010