Companies offering state health insurance plans in Wisconsin are perceived to be largely unaffected by one change under healthcare reform, unlike their national counterparts.
That change is the requirement that 80 cents of every dollar in premiums from individuals and employers be spent on medical care.
“We don’t have any concern at all about being able to meet those minimums,” said Gary Lenth, medical director of Gundersen Lutheran Health Plan, part of the La Crosse health system.
Lenth says that Gundersen uses 90 percent of its premiums to fund medical care.
Other companies selling state health insurance plans are also optimistic.
“We’ll be fine,” said Terry Bolz, senior vice president of the University of Wisconsin Medical Foundation, which is associated with Unity Health Insurance.
Unlike national health insurers like Humana, WellPoint, and UnitedHealthcare, Wisconsin-based companies are owned by nonprofit healthcare systems and facilities, and would not be pressured to please Wall Street.
That could them give some breathing room when the new regulations under the healthcare reform law take into effect.
The law will also change how health insurance firms determine prices. For instance, state health insurance plans for small employers will no longer be linked to their claims history. Moreover, the law puts a limit on how much seniors can be charged for health insurance. “It’s going to turn out that there are some good things in the legislation and some bad things, and it’s going to be hard to predict what they will be,” Lenth added.
