Filed Under:Health Insurance, Individual Health

Wisconsin: How can we choose a benchmark plan NOW?

Wisconsin Gov. Scott Walker (AP Photo/Scott Bauer, File)
Wisconsin Gov. Scott Walker (AP Photo/Scott Bauer, File)

Wisconsin Gov. Scott Walker is ramping up his battle over implementation of the Patient Protection and Affordable Care Act of 2010 (PPACA).

The Republican decided about a year ago to halt all work in the state on implementation of the PPACA health insurance exchange program.

Theodore Nickel, Walker's insurance commissioner, now has written to U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius to say that the state needs at least 60 days after HHS issues the final PPACA essential health benefits (EHB) regulations to choose an EHB benchmark plan.

Wisconsin does not have the necessary information from HHS to make the EHB plan determination by the original Sept. 30, 2012, deadline, Nickel wrote in a letter to Sebelius.

"Recognizing that your office has continually missed regulatory deadlines, we ask that you provide states the same flexibility your office has provided itself," Nickel said.

If HHS postpones the EHB selection deadline until after the EHB regulations are out, Wisconsin will have time to review the regulations and get stakeholder feedback on the benchmark candidate plans available in Wisconsin, Nickel said.

Walker and colleagues are continuing to try to block implementation of PPACA through many channels. 

If the law takes effect on schedule and works as drafters expect, it will require all individual and small group major medical plans to offer the standardized EHB package by 2014.

HHS has asked each state to create its own EHB packages by looking at the federal employee plans, state employee plans and small group plans available in the state. Officials are also supposed to look at a large commercial health maintenance organization (HMO) plan when a large, statewide HMO plan is available.

HHS has said that it will choose a benchmark plan for states that fail to recommend their own benchmark preferences.

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Nichole Morford

Nichole Morford
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